Duke University is now offering pulsed field ablation (PFA) as a treatment option for atrial fibrillation (Afib), providing an alternative to traditional cardiac ablation methods. Cardiac ablation, a minimally invasive procedure, targets heart tissue responsible for arrhythmia. The common methods include radiofrequency ablation and cryoablation, which use heat and extreme cold, respectively. However, these methods can sometimes damage nearby structures such as the esophagus or phrenic nerve.
“Injury to adjacent structures are pretty low with standard energy modalities, but they’re not zero,” said Duke electrophysiologist Jonathan P. Piccini, Sr., MD. “And some of those bystander injuries can be life-threatening.”
Pulsed field ablation employs electroporation, delivering electrical pulses to create holes in problematic heart cells while sparing surrounding tissues. Dr. Piccini explained that this method affects only specific types of cells: “Every type of human tissue has a threshold for this type of electrical energy. Just like X-rays are only absorbed by denser materials like bones but easily pass through your skin, muscles, and organs, the specific PFA frequencies we’re using affect heart tissue but do not pose a risk to other tissues inside the chest.”
Studies indicate that PFA is as effective as thermal cardiac ablation in reducing Afib activity and may reduce severe complications associated with traditional methods. Electroporation also causes less inflammation than thermal techniques, leading to less discomfort post-procedure.
Dr. Piccini highlighted another advantage of PFA: its shorter procedure time. “The less time you need to be under general anesthesia, the better your recovery,” he said. “There’s also less opportunity for cardiac inflammation and other difficulties.”
Duke’s reputation for low complication rates and advanced technology makes it a reliable choice for cardiac ablation procedures. Duke electrophysiologists have significant experience with PFA and contributed to its development for Afib treatment. “We believe this technology is going to give patients the best outcome,” Dr. Piccini stated.
