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Pulse field ablation
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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I personally had PFA in Dec 25 that was a total failure then another in January 26 that one lasted a week. Consulted with Dr. Gerstenfeld at UCSF here's what he says about PFA and pulmonary vein ablation. "We have learned that particular PFA catheter , while it works well for pulmonary veins has a high rate of recurrence when used for linear ablation."
@nevets True, at least insofar as the research suggests, but that reduced catheter dwell time doesn't translate into improved outcomes....not yet. Maybe they need to rethink the dwell time, in which case there may eventually be no advantage over RF in terms of the risks to the phrenic nerve and to the esophagus, and also to the Vagus nerve (which I didn't mention earlier). We'll see eventually.
I just read a report that PFA also causes an acute reduction in blood pressure but mostly when the left superior PV is ablated with its first one or two applications. The other PVs are not affected, and each subsequent application in circulation around those veins doesn't show any further drop in BP. One center, one set of data, but it bears more scrutiny.
@gloaming
Reduced dwell time equals a shorter procedure, which is never a bad thing regardless of the outcome. Of course, new medical technologies are usually viewed as superior from the manufacturer's perspective ($$$) and who knows to what extent they have their thumb on the medical community scales?
@nevets It may mean a shorter procedure, which may mean less anesthetic, but there's that problem of increased exposure to fluoroscopy. Seems there no magic bullet in the world of catheter ablations. I am optimistic we'll get 'there', hopefully before I need a third ablation. So far, so good....
I am a 72 year old male and had a pulsed field ablation (PFA) in February of '25 due to ongoing paroxysmal Afib. My trigger was small quantities of lite beer. I could have had the heat or freezing ablation procedures earlier, but everyone I spoke with told me to wait for the PFA. So glad I did. Absolutely no pain or discomfort. I had to lay flat and still for 6 hours after the procedure, which I believe is normal protocol, and remained in the hospital overnight. Procedure was roughly 2 hours. I was under general anesthesia. Catheters went up through an artery in the groin area. Next day I was up and walking normally. Happy to report I have not had an Afib episode since (going on 15 months). Only drink a couple of non-alcoholic beers now as well. Good luck. I hope your experience with the PFA is as successful as mine has been. Just make sure your EP has done several in the past. Mine, at the time, had done roughly 30.