Pulsed-Field Ablation:A less risky approach to a healthier heartbeat

The Novant Health Heart & Vascular Institute has performed one of the first new atrial fibrillation procedures in the country, using FDA-approved technology that promises safer and more efficient AFib treatments.

Medtronic’s pulsed-field ablation approach, known as PulseSelect, resolves irregular heartbeats by using a mapping catheter and electrodes to treat heart tissue. This represents a significant advancement from traditional AFib treatment, said cardiac electrophysiologist Dr. Taylor Bazemore of Novant Health Heart & Vascular Institute - Wilmington Main.

“This technology allows us to effectively treat abnormal heart cells without posing risks to other nearby organs,” he said.

Pam Wooddell, a 71-year-old real estate agent in Wilmington, was the first patient in North Carolina to undergo pulsed-field ablation with the Medtronic PulseSelect system. The treatment, performed by Dr. Bazemore in April, is a minimally invasive procedure that sends electrical pulses to the heart to restore its regular rhythm.

The milestone procedure marks the institute’s first step toward treating the most common type of cardiac arrhythmia. The abnormality restricts blood flow and is on track to affect 12 million people in the U.S. by the end of the decade, the American Heart Association reports.

AFib causes symptoms and can increase risk of heart failure and stroke, so it’s important to identify and successfully treat the condition,” said Dr. Bill Smith, clinical physician executive for Novant Health Heart & Vascular Institute in the health system’s Coastal region. “Launching this new treatment is a testament to a strong effort to offer the latest advanced treatment options to our patients.”

The new technology

During traditional ablation, a catheter accesses the heart muscle through a vein in the leg. Extreme temperatures are applied to help enable the heartbeat to resume normally.

Pulsed-field ablation differs with its quick, precise delivery of consistent energy to the target.

The advantage with pulsed-field ablation is using an electrical field instead of thermal temperature to correct the problem,” said clinical cardiac electrophysiologist Dr. Mark Mitchell. “Clinical trials suggest that this will lead to safer outcomes and shorter procedures.”

During those trials, 300 patients were studied in nine countries. The result: one of the lowest safety event rates of any past ablation trial, according to PulseSelect.

Symptoms

One day, Wooddell’s daily routine went off-course. She felt more tired and dizzier than usual, even struggling to walk her dogs without catching her breath. Then she caught sight of the flesh pulsing near her collarbone.

Wooddell’s family nurse practitioner diagnosed the irregular heartbeat and referred her to Novant Health Heart & Vascular Institute - Wilmington Main. The Institute’s team approach to care involves working directly with the patient’s primary care physician and cardiologist.

Referring providers should be aware of which patients qualify as potential candidates.

AFib patients whose symptomatic and recurrent episodes cannot be controlled with medications may be eligible for pulsed-field ablation, said Dr. Bazemore.

Potential side events include bleeding, bruising, hematoma and anemia, among others. The catheter is not recommended for patients who have experienced a recent embolic event.

The recovery time for pulsed-field ablation is three months, at which point the arrhythmia should be halted and the ablated tissue completely healed, Dr. Bazemore said.

In Wooddell’s case, she experienced no side effects and returned to her job the day after her procedure.

“It’s amazing that something so vital is also simple to recover from,” Wooddell said. “Dr. Bazemore takes the time to listen, so it made my decision easy.”