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PFA procedure with stroke risks

Posted by toshy @toshy, Jun 5 4:54pm

Hello, I was given 3 choices by my EP after 5 failed cardio versions:
1) do nothing, 2) new medications, 3) PFA
I have been debating if I should do nothing and stay in A-FIB or risk any type of stroke before or after PFA. My EP is very confident about PFA as he has done over 1,000 procedures, but I cannot deal with having a stroke as I have almost no support. Trying to decide, this is very difficult at 76.

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gloaming | @gloaming | Jun 27 10:32am
In reply to @nevets "When quoting success percentages for PFA it's worth noting that PFA is very new. It remains..." + (show)
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When quoting success percentages for PFA it's worth noting that PFA is very new. It remains to be seen how durable PFA results are compared to the other types of ablation over time (5+ years). It may turn out that PFA is actually superior RF or cryo in the long run?

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Yes, that is true, but a recent analysis, I believe last year already, shows that
PFA does not confer on the patient an improved chance of success (success meaning 'one full year free of arrhythmia from the date of ablation'). All it shows at present is the preclusion of a TEE due to the dangers of Phrenic nerve and esophageal damage which can happen with the radio frequency technique (RF ablation). So, two advantages: slim to no chance of damage to either component mentioned, but that advantage also obviates the TEE or trans-esophageal echocardiogram.
Since there is a standard definition of 'success', and that PFA has been routinely performed widely for almost two years now, the initial reports show a mounting statistically insignificant difference between the two most popular approaches to catheter ablation. This does not mean that, as PFA is improved and as EPs learn more/better how to use it, that the differences won't mount, but we'll have to wait on that.,.I agree.

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