Our Summary

This study looks at a new method called pulsed-field ablation (PFA) used to treat irregular heartbeats. The researchers were unsure if the method, which involves applying electrical fields to the heart, was creating effective enough lesions (areas of damaged tissue) in the heart.

They used a looped catheter (a thin tube) to apply the PFA multiple times and at different levels of force. They tested this on a model made from a potato and a model of a beating pig heart to see how the number of applications, the force used, and the positioning of the catheter affected the lesions.

They found that the lesions developed over time - 18 hours in the potato model and 6 hours in the pig heart model. They also found that the number of applications and the force used affected the depth of the lesions. In the pig heart model, applying the PFA multiple times led to deeper lesions than a single application. The more force used, the deeper and more continuous the lesions were in the potato model.

In conclusion, the study showed that applying PFA multiple times and with more force led to deeper lesions. This suggests that effective PFA treatment is more related to the physics of the PFA method than just reducing the electrical signals in the heart.

FAQs

  1. What is pulsed-field ablation (PFA) and how does it work?
  2. How does the number of applications and the force used in PFA affect the treatment’s effectiveness?
  3. What conclusions were drawn from this study about the effectiveness of PFA in treating irregular heartbeats?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cardiac ablation is to follow post-procedure care instructions carefully, including taking prescribed medications, avoiding strenuous activity, and attending follow-up appointments. It is important to monitor for any signs of infection or complications, such as chest pain, fever, or swelling at the catheter insertion site, and to contact your healthcare provider if you experience any concerning symptoms. Additionally, maintaining a healthy lifestyle with regular exercise, a balanced diet, and stress management can help support the success of the ablation procedure and overall heart health.

Suitable For

Cardiac ablation is typically recommended for patients with certain types of cardiac arrhythmias, such as atrial fibrillation, atrial flutter, supraventricular tachycardia, and ventricular tachycardia. These patients may experience symptoms such as palpitations, dizziness, shortness of breath, chest pain, or fainting episodes due to their irregular heartbeats.

Patients who have not responded well to medications or other non-invasive treatments may be recommended for cardiac ablation. Additionally, patients who have a high risk of complications from their arrhythmias, such as those with underlying heart conditions like heart failure or structural heart defects, may also be candidates for this procedure.

Overall, the goal of cardiac ablation is to restore the normal rhythm of the heart and improve the patient’s quality of life. It is important for patients to discuss the risks and benefits of this procedure with their healthcare provider to determine if it is the right treatment option for them.

Timeline

Before cardiac ablation:

  1. Patient is diagnosed with an irregular heartbeat (arrhythmia) through symptoms such as palpitations, dizziness, or fainting episodes.
  2. Patient undergoes various tests such as an electrocardiogram (ECG), echocardiogram, and possibly a stress test to determine the cause of the arrhythmia.
  3. If medications are not effective in controlling the arrhythmia, the patient may be recommended for a cardiac ablation procedure.
  4. Patient meets with a cardiac electrophysiologist to discuss the procedure, risks, and benefits.

After cardiac ablation:

  1. Patient is prepared for the procedure, which may involve fasting for a certain period of time and stopping certain medications.
  2. Cardiac ablation procedure is performed, where a catheter is inserted into the heart and radiofrequency or cryoenergy is used to create scars on the heart tissue to block abnormal electrical signals.
  3. Patient is monitored for a few hours post-procedure in the hospital to ensure there are no complications.
  4. Patient may experience some discomfort at the catheter insertion site, but this usually resolves within a few days.
  5. Patient is discharged from the hospital with instructions for recovery, including avoiding strenuous activities for a certain period of time.
  6. Patient follows up with their cardiac electrophysiologist for monitoring of the heart rhythm and adjustments to medications if needed.

What to Ask Your Doctor

  1. What is cardiac ablation and how does it work?
  2. Am I a candidate for cardiac ablation?
  3. What are the potential risks and complications associated with cardiac ablation?
  4. What is the success rate of cardiac ablation in treating my specific heart condition?
  5. How long will the procedure take and what is the recovery process like?
  6. Will I need to take any medications after the procedure?
  7. Are there any lifestyle changes I should make post-ablation to improve my heart health?
  8. Will I need follow-up appointments or additional treatments after the procedure?
  9. What are the alternative treatment options available for my condition?
  10. Can you explain the specific method of cardiac ablation that will be used in my case and why it is recommended?

Reference

Authors: Di Biase L, Marazzato J, Gomez T, Byun E, Zou F, Grupposo V, Mohanty S, La Fazia VM, Ammirati G, Lin A, Garcia DY, Della Rocca D, Al Ahamad A, Schiavone M, Gasperetti A, Freilich M, Serna JC, Forleo G, Liu X, Lakkireddy D, Tondo C, Natale A, Zhang XD. Journal: Europace. 2024 Aug 30;26(9):euae220. doi: 10.1093/europace/euae220. PMID: 39150065