Pulse field ablation

Posted by wews @wews, 6 days ago

Has anyone had a pulse field ablation? I have three precious ablations but none have worked because the place in my heart that the cardiologist needs to ablate is too close to my esophagus. I am scheduled to have one in mid December. He said I have a 60% chance of it working. Does anyone have any experience with this? Has anyone had one? Has it worked? Any insights or downsides are appreciated.

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Profile picture for suerte @suerte

Did your EP have a CT scan done prior to the ablation? I had CT scan done and it was done specifically to locate the esophagus as well as other organs around the heart.

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@suerteMy EP did blood work and CT scan of the chest to identify all the appropriate anatomy of the veins/arteries and rule out any possible physical issues.

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Profile picture for sjm46 @sjm46

@wews I am so excited for you! I am only two days in and I feel better already! No pounding of the heart at night! I read the surgical notes from the electrocardiologist after I got home yesterday and it sounds like he practically stood on his head to hit all the spots that needed to be "zapped". He reported some unusual anatomy and narrowing in places unique to me apparently. I think he worked on me for almost 4 hours and he used PFA so I am sooo pleased. I wish the very best for you. I think I have a good cardiologist but if I had not done my homework and checked out all the info on YouTube from the experts from all over, I would still be struggling with meds and having more outbreaks. I practically demanded that I get a referral to an electrophysiologist. I know I am not "cured" but I feel much more comfortable with advocating for myself. It helps to be a nurse and know what to expect on some level, but I was not nervous about doing this. I counted down the days! My husband had a progressive cardiologist years ago who told him "all meds are really poison and you only hope the benefits will outweigh the side effects." I truly believe that the less you can take, the better off you are so if surgical intervention is the best option out there now, I hope more people will pursue it! Again, good luck to you; I hope you will be as happy as I am to get this done. Merry Christmas!

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@sjm46
Do you have more energy and stamina after the ablation?

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I had one in August 2024. So far so good. Been off all meds since December 2024. Back to the activities I enjoy with no holdback. Downhill skiing, waterskiing, biking, and long walks either the dogs. I thank God and my Dr everyday!!!

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I just got on the schedule for my pulsed field ablation, hooray! Still waiting for confirmation that I will also get a watchman. I will be first up on the schedule. Any idea how long to expect it to take?

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Profile picture for tekkie50 @tekkie50

I just got on the schedule for my pulsed field ablation, hooray! Still waiting for confirmation that I will also get a watchman. I will be first up on the schedule. Any idea how long to expect it to take?

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@tekkie50 Depends on the EP's experience with PFA and with what he/she finds needs that application of the appliance's energy. Most EPs will only try a PVI* first, especially for paroxysmal AF patients. As your stages evolve over time, and if you get more walls affected by the reentrants where the signals emerge into the endothelial lining of the left atrium, the EP will have to spend more time finding them and then zapping them to stop their intrusions. So, the answer is, it depends.

PVI = Pulmonary Vein Isolation

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Profile picture for bens1 @bens1

@sjm46
Do you have more energy and stamina after the ablation?

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@bens1 I am only three days post ablation and I have had no rhythm problems but the general anesthesia is what I think really wipes you out. It takes time to get out of your system and also to eliminate all the fluids that they fill you with during the procedure. I feel good overall but just a little groggy and I can't get warm for some reason without my space heater! I am more than happy with the process though. I am a mover, so this "taking it easy" is not easy for me. I can go back to the gym in a week. I intend to follow the directions given to me "by the letter!" I don't want to mess anything up! As far as pain is concerned, practically none; only the sore throat from being intubated. Getting much better though. All I have read is that the sooner you get the ablation and control the outbreaks, the better the result. I am very hopeful that this is going to work for me.

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Profile picture for dclifford47 @dclifford47

Had a pfa two months ago. Did not work. Since, I have had another cardioversion, which, also did not work(5th one).
I will probably be scheduled for another pfa, soon. These are all normal experiences while trying to stop AFib.

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@dclifford47 How long have you had an A-fib diagnosis? Just curious since I have been reading that the sooner you have an ablation after diagnosis, the better the results. I wish I had known this when I was diagnosed a year ago and I would have asked for an electrophysiologist immediately instead of going the medication route for months. I am very sympathetic for your problems. I had only one cardioversion and then sought out PFA with a really highly rated doctor. I hope you find relief.

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Profile picture for sjm46 @sjm46

@bens1 I am only three days post ablation and I have had no rhythm problems but the general anesthesia is what I think really wipes you out. It takes time to get out of your system and also to eliminate all the fluids that they fill you with during the procedure. I feel good overall but just a little groggy and I can't get warm for some reason without my space heater! I am more than happy with the process though. I am a mover, so this "taking it easy" is not easy for me. I can go back to the gym in a week. I intend to follow the directions given to me "by the letter!" I don't want to mess anything up! As far as pain is concerned, practically none; only the sore throat from being intubated. Getting much better though. All I have read is that the sooner you get the ablation and control the outbreaks, the better the result. I am very hopeful that this is going to work for me.

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@sjm46 thanks so much for sharing. I am hoping for the same result. Unfortunately I have had this problem. Since 2021 and not much has worked. I was in atrial flutter before the last ablation and came out in atrial tachycardia and have been in that since 2023. Praying it works. So glad you have had positive results.

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Profile picture for gloaming @gloaming

@tekkie50 Depends on the EP's experience with PFA and with what he/she finds needs that application of the appliance's energy. Most EPs will only try a PVI* first, especially for paroxysmal AF patients. As your stages evolve over time, and if you get more walls affected by the reentrants where the signals emerge into the endothelial lining of the left atrium, the EP will have to spend more time finding them and then zapping them to stop their intrusions. So, the answer is, it depends.

PVI = Pulmonary Vein Isolation

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@gloaming well I am fortunate since my Cardiologist was one of the first to do PFAs. He has had a lot of experience so I hope that means he will be able to get to my problems.

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Profile picture for sjm46 @sjm46

@dclifford47 How long have you had an A-fib diagnosis? Just curious since I have been reading that the sooner you have an ablation after diagnosis, the better the results. I wish I had known this when I was diagnosed a year ago and I would have asked for an electrophysiologist immediately instead of going the medication route for months. I am very sympathetic for your problems. I had only one cardioversion and then sought out PFA with a really highly rated doctor. I hope you find relief.

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@sjm46 I believe I was diagnosed 3/4 years ago. It took awhile before my first ablation, as my heart is on the right side of my body, so I had to find a Dr that was versed in doing ablations with the heart on the right. Hopefully, this second one will do the trick. If not, I will try to engage a Dr Natale in Austin, who has an outstanding rating for doing ablations. He has an office in La Joya CA, which is not far from Palm Desert where we live.

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