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Is Pulse Field Ablation a Better Choice Than Cardioversion
Heart Rhythm Conditions | Last Active: Oct 31 1:15pm | Replies (12)Comment receiving replies
Thanks for the comments to my question. When I read about PFA from sources that were from centers of excellence, the one thing that seemed to be repeated was the change in risk, even though I read non PFA ablation has a .5 to 5% risk, which is obviously low. I was concerned about the esophagus and the phrenic nerve which could affect her breathing and PFA data, so far, showed no impact in those areas.
Replies to "Thanks for the comments to my question. When I read about PFA from sources that were..."
The danger from the RF wand is considerable, but it depends on both the skill and experience of the EP performing the procedure AND the location of the re-entrant...the entry point of the unwanted and damnable ...er...sorry....dammable electrical signal. 😀
The typical points that have to be ablated, in order of highest to lowest probability are:
a. pulmonary vein ostia
b. coronary sinus
c. left atrial appendage (yeah, that place again)
c. Vein of Marshal (usually treated with cryo-therapy, meaning they pump icy fluid through it to kill the focus), and
d. the septum....the wall between the two atria.
The pulmonary veins, because of where they enter the left atrium, and the atrial appendage, I believe (not sure) are the two most risky because of the orientation of the typically oriented heart. Those two places are most proximal to the two areas wanting to be spared by having a TEE placed to monitor while the EP is placing the RF and making small lesions that will scar and become impassable to the spurious electrical signal. Blocked signal, contained inside a 'coffer' dam of fibrosis left from the scarred tissue created via RF = no more ectopy...no more extra beats.
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Excellent - you're getting GOOD data! And PFA has another significant advantage, in the left atrium. That's pulmonary vein [PV] stenosis. Older technologies "stiffen" the PV.