Pulsed field ablation produces results for Penn State Health patients with AFib
One is a retired dentist who lives near State College. Another is an insurance professional and mother of two from Harrisburg. The third is a retired high school teacher from the Reading area.
They’ve never met but share common bonds.
All suffer from atrial fibrillation, or AFib, which is caused by an irregular and often rapid heartbeat in the upper chambers of the heart. It is the most common heart rhythm disorder in adults in the United States.
This summer, the trio was among the first patients to undergo a newly approved heart ablation procedure at Penn State Health hospitals.
Now, all three are feeling more energetic with fewer, if any, episodes of atrial fibrillation since having a pulsed field ablation (PFA).
“Before, I was so exhausted. I would just sleep and not want to walk or exercise or anything. And I’m a ‘go’ person. I go all the time,” said Krissy Baker, a 48-year-old insurance claims manager who had the PFA procedure in July at Penn State Health Holy Spirit Medical Center in Camp Hill. “Now, I’m pretty much back to the energy I used to have.”
Traditionally, cardiac ablation, a procedure used to create small scars in the tissue to block faulty signals in the heart, has used either cold (cryoablation) or heat (radiofrequency) energy techniques.
Although thermal ablations are still utilized, new PFA technology was approved by the U.S. Food and Drug Administration in January. The FARAPULSE system (Boston Scientific) uses PFA and is now available at Holy Spirit Medical Center, Penn State Health Milton S. Hershey Medical Center and Penn State Health St. Joseph Medical Center.
“We have been performing this procedure since June, soon after it became commercially available,” said Dr. Sarah Hussain, an electrophysiologist at Penn State Heart and Vascular Institute and associate professor of medicine at Penn State College of Medicine. “We have done over 100 PFA procedures across the Penn State Health system.”
Pulsed field ablation, which uses short bursts of electrical energy to target cardiac tissue, gives doctors another option to treat atrial fibrillation, according to Hussain.
“We try and individualize our therapies to each patient,” Hussain said. “It’s important to continue to expand our toolkit of treatment options for AFib. Certain therapies work differently for different patients.”
From secret excuses to Great Dane walks
Busy working full-time and raising two teenagers, Baker began having heart issues a few years ago. Diagnosed with a low, resting heartbeat, or bradycardia, she had a pacemaker inserted. She also dealt with intermittent AFib, experiencing what felt like a hot pinprick that traveled in a line from the bottom of the right side of her heart, diagonally, to the top left.
“Sometimes it would be a little more intense than others, and those times I’d feel like I needed to go to the hospital,” Baker said. “Sometimes the AFib sensations wouldn’t let up right away. Sometimes they would.”
Baker was at a friend’s house last Easter when her group decided to go for a walk after dinner. She secretly was dealing with a prolonged AFib episode, so she made excuses about not having sneakers and not feeling well because she was afraid of what would happen if she joined the walk. Her heart condition continually affected her quality of life.
Within three months, Baker received a pulsed field ablation. Initially, she still didn’t feel much better and experienced at least one significant AFib event post-procedure. Gradually, her energy increased. She’s now walking 10,000 or more steps a day, including a daily lunchtime stroll with her Great Dane. She hasn’t had an AFib episode since mid-August.
The goal of AFib ablations is to improve quality of life and allow patients to return to their previous activity level without experiencing future episodes or experiencing ones which are shorter and more infrequent than before, said Dr. Jamal Hajjari, the electrophysiologist who performed Baker’s ablation using the PFA technique at Holy Spirit Medical Center. In some patients, it may require more than one ablation to reduce the burden of atrial fibrillation, he said.
Fewer complications
Joseph Martin of Bellefonte, seen here in a submitted photo with his 9-year-old granddaughter Evelynn, received a pulsed field ablation at Milton S. Hershey Medical Center in August.
Hajjari said clinical evidence shows the PFA technique has roughly the same efficacy as thermal ablation methods used on patients with intermittent AFib. The reported success is greater than 70% with a single ablation. The procedure takes about the same amount of time using each technique, but PFA has improved the overall efficiency of AFib ablations.
The primary advantage PFA has over the other techniques, Hajjari said, is that it is less likely to cause collateral damage to areas around the heart. The percentage of major complications after ablations is less than 2%, he noted, and the risk of collateral damage to the phrenic nerve, which controls the diaphragm, or the esophagus from thermal ablations is below 1%.
That safety aspect was a selling point for Joseph Martin, a retired dentist from Bellefonte, who learned after a stroke in 2020 that he also suffered from AFib. At the end of 2022, he had an RF (heat) ablation, and though it worked initially, his AFib returned. Doctors recommended a second ablation, but Martin was reluctant. The first procedure had lasted more than six hours and afterward he dealt with heartburn and nausea.
Martin researched the new PFA procedure and was considering having it at a hospital in Ohio in October when he learned that Penn State Health would be offering it this summer. Hussain performed the PFA at Milton S. Hershey Medical Center on Aug. 8.
“I don’t feel near the degree of symptoms that I felt before,” Martin said. “Any type of physical activity, I would feel winded and a little bit lightheaded and sometimes would get a feeling of anxiety. Knock on wood, I haven’t felt those since I had the PFA done.”
Hajjari said some patients don’t realize dissipating energy and shortness of breath can be due to more than the normal aging process. It’s best to seek a doctor’s advice when those symptoms first appear.
Palpitations gone
David Moerder, a Leesport resident who spent 34 years teaching at Conrad Weiser High School, twice dealt with elevated heartbeats and trouble breathing last year. Each time, he went to the emergency room. He ultimately was diagnosed with AFib and received a PFA performed by Dr. Christopher Rogers at St. Joseph Medical Center in July.
After undergoing a pulse field ablation at St. Joseph Medical Center, David Moerder of Leesport was able to return to the golf course.
Rogers explained the new treatment option and gave Moerder extensive literature to help his patient make the best decision. A former tech-ed instructor, Moerder, 68, thought the PFA technology was the right option for him. He continues to believe that.
“I used to feel a lot more palpitations in my chest, my heart,” Moerder said. “And after the procedure, they’ve almost all gone away.”
Penn State Health will continue to offer multiple ablation options to treat AFib, and this newest technology provides patients with another effective option.
“I would recommend it, especially because my wife and I are very active,” Martin, the retired dentist, said. “We’re very involved with our grandkids, so I think it’s worth trying it. If you want to live an active, healthy life where you’re not feeling fatigued, you’re not feeling that level of anxiety, then, yes, I’d recommend it.”
For more information on the PFA procedure at Penn State Health, click here.
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