Drugs vs Ablation for Atrial Fibrillation (AF)

Posted by gloaming @gloaming, Jul 29 5:35pm

Those trying to make up their minds to get an ablation or to commence, or stay on, a regimen of anti-arrhythmic medicines might be interested in new evidence:

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

vjs003 | @vjs003 | Aug 9 1:06pm

Pulsed Field Ablation (PFA) is an advanced, minimally invasive catheter procedure used to treat atrial fibrillation (AFib). Instead of using extreme heat or cold (thermal energy) like older methods, PFA uses short bursts of high-voltage electrical energy to target and destroy the specific heart tissue causing irregular rhythms. How PFA Works - Non-thermal energy: Uses a process called irreversible electroporation, creating microscopic pores in targeted cell membranes without heating or freezing. Tissue selectivity: Heart muscle cells are far more sensitive to the electrical field than other tissues, protecting surrounding structures. Catheter delivery: A thin tube is threaded through a vein in your groin up to the left atrium of the heart to isolate the pulmonary veins. Benefits Over Traditional Ablation - Higher safety margin: Dramatically lowers the risk of collateral damage to the esophagus, nearby nerves (like the phrenic nerve), and blood vessel narrowing. Faster procedures: Total delivery time for the electrical pulses takes less than a minute, cutting overall procedure and anesthesia time down to 1 to 3 hours. Quicker recovery: Most patients experience less post-procedural chest inflammation and can safely return home the same day. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/pulsed-field-ablation

Colleen Young, Connect Director | @colleenyoung | Aug 9 1:30pm

In reply to @vjs003 "Pulsed Field Ablation (PFA) is an advanced, minimally invasive catheter procedure used to treat atrial fibrillation..." + (show)

@vjs003, when copying and pasting from an online source, please add a link to the original source as per the Community Guidelines (https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/)

Can you please share the link where you found this information? Thanks.

vjs003 | @vjs003 | Aug 9 3:00pm

In reply to @colleenyoung "@vjs003, when copying and pasting from an online source, please add a link to the original..." + (show)

@colleenyoung I had asked A.I. about this so there really was no real link but John Hopkins was close so I put that link in my comment.

vjs003 | @vjs003 | Aug 9 3:07pm

In reply to @vjs003 "Pulsed Field Ablation (PFA) is an advanced, minimally invasive catheter procedure used to treat atrial fibrillation..." + (show)

@vjs003 another link to tell about this from the Mayo Clinic...https://www.mayoclinic.org/medical-professionals/cardiovascular-diseases/news/novel-pulsed-field-ablation-offers-patients-safer-and-faster-atrial-fibrillation-ablation/mac-20567834

kdaf | @kdaf | Aug 9 3:12pm

In reply to @gloaming "This video is a bit dated, but here is an EP talking about what, at the..." + (show)

@gloaming thanks for sharing this. I found it very helpful, as I try to figure out my next steps.

Colleen Young, Connect Director | @colleenyoung | Aug 9 5:38pm

In reply to @vjs003 "@vjs003 another link to tell about this from the Mayo Clinic...https://www.mayoclinic.org/medical-professionals/cardiovascular-diseases/news/novel-pulsed-field-ablation-offers-patients-safer-and-faster-atrial-fibrillation-ablation/mac-20567834" + (show)

@vjs003, thank you. I thought it might be from AI. Sometimes AI can sound right even when it's wrong. So I appreciate that you added to original sources. 🙂

diane07710 | @diane07710 | Aug 9 8:48pm

In reply to @smwhit "awoke in afib 150-170, to ER, started on diltiazem drip x 4 hours with no results..." + (show)

@smwhit

aard | @aard | Aug 10 8:00am

In reply to @vjs003 "@colleenyoung I had asked A.I. about this so there really was no real link but John..." + (show)

@vjs003
If you just paste an AI response, please state that. I wouldn't put much faith in AI responses so would like to know that that is what it is.
Thanks.

Colleen Young, Connect Director | @colleenyoung | Aug 22 12:34pm

In reply to @aard "@vjs003 If you just paste an AI response, please state that. I wouldn't put much faith..." + (show)

@aard, good point. This is also the recommendation in Connect's Community Guidelines https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/ that one should state when their post contains AI information. AI generated answers may not be correct.

Mayo Clinic Connect is about connection and sharing your personal experiences first and foremost. 🙂

loswalt0525 | @loswalt0525 | 5 days ago

I had a PFA ablation 6 months after my first Afib episode. I opted for it because all the medicine has dangerous risks. It helped a lot but I still had Afib 8-14% one week out of a month. My EP did not and does not want me to settle for that. So, instead of a 2nd ablation, I started Multaq. I was on it 2 months with diarrhea, fatigue, lethargy, swelling ending up in the ER with new congestive heart failure. However, that subsided and I don’t have heart failure. The EP said I could stop Multaq on 8/6/26. Since then, I had 44% Afib the week of 8/17/26 and my resting heart rate has gone from high 50’s to 80’s. It is now controlled with double the metoprolol I was taking before Multaq. I can schedule the 2nd ablation but in the meantime, is this everyday in and out of Afib going to stop and my heart act like it was before Multaq without starting back on amiodarone until the ablation can be scheduled? If so, I would like to wait it out because I am weary of amiodarone risks especially blindness. What would you do?

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