Medically Reviewed by Kishore Subnani, MD
Patients living with A-fib now have access to a new treatment option, FDA-approved pulsed field ablation (PFA), available at both McLeod Health Seacoast and McLeod Regional Medical Center in Florence.
Performed by McLeod Electrophysiologists Dr. Kishore Subnani (Seacoast) along with Dr. Prabal Guha and Dr. Cyrus Kocherla (McLeod Regional Medical Center), PFA catheter therapy uses short bursts of high energy to affect heart tissue that causes A-fib, as opposed to using heat or cold energy as with traditional ablations.
Benefits of PFA
- Safer procedure
- Shorter ablation times
- Only targets affected cells and not surrounding tissue
- Successful results
One of the benefits to patients undergoing PFA catheter therapy is shorter ablation times, thereby reducing anesthesia time and removing some of the risks of traditional A-fib ablations. In addition, PFA catheter therapy targets affected cells, avoiding damage to areas surrounding the heart.
Definition
A-fib, or Atrial fibrillation, is a type of arrhythmia or irregular heartbeat. It is the most common electrical problem of the heart, with more than two million Americans living with some form of A-fib.
The heart has two upper chambers and two lower chambers whose job is to circulate the blood throughout the body.
When a heart is in A-fib, the upper chambers cannot contract sufficiently and are unable to push the blood to the lower chambers smoothly. Instead, it is very disorganized, making the heart look like it is quivering.
Because of the “quivering,” the heartbeats are irregular, and in some cases, faster than normal. When this happens patients may feel like their heart is pounding or fluttering. Also, since the lower chambers are not completely filling with blood, patients can undergo feelings of fatigue, dizziness, lightheadedness, shortness of breath, or lack of energy during exercise. However not everyone will experience these symptoms. Many patients aren’t even aware they have it.
The greatest problem is that a-fib increases the risk of stroke. Patients with A-fib are five times more likely to have a stroke compared to those without this condition. Since the upper heart chambers do not push blood well to the lower chambers it can pool in the upper chambers and form clots. These clots may dislodge, travel through the arteries to the brain and cause a stroke.
Risk Factors
Older adults are more likely to develop A-fib making age the most important risk factor.
Obesity, the most modifiable risk factor, is closely linked to the risk of developing A-fib and increases the likelihood of recurrences after treatment. Weight loss is recommended for both the prevention and management of atrial fibrillation.
Other risk factors include coronary artery disease, heart failure, heart valve disease, and hypertension.
Diagnosis
An electrocardiogram (ECG) confirms the diagnosis of A-fib. It is a quick and painless test, which records a few seconds of the electrical activity of the heart. If A-fib is not detected by the ECG a heart monitor is required.
The Holter monitoring test involves a small recording device attached by wires to four places on the chest. The device is worn under the clothes and patients can carry on with their daily activities. This test provides detailed information on the heart rhythm for the doctor.
Correcting the Problem
Restoring a normal heart rhythm is important for patients who have been newly diagnosed and/or have noticeable symptoms. Special medicines or electrical cardioversion, an electrical shock to the heart, can restore heart rhythm. If these methods fail, then an ablation can be performed.
An ablation is a catheter procedure to reroute the heart’s electrical activity in the upper chambers by destroying small areas in the heart involved in the abnormal rhythm. This prevents any abnormal electrical signals from moving through the heart.
Important Points
1. Let your doctor know if you have palpitations, shortness of breath, or fatigue, or if you notice any change in your endurance.
2. Many patients with atrial fibrillation have no symptoms so discuss your risk level with your primary care physician.
3. Atrial fibrillation is a condition with a high stroke risk. Anyone diagnosed with atrial fibrillation should establish care with a cardiologist to discuss treatment options.
Dr. Kishore Subnani, Clinical Cardiac Electrophysiologist, is part of the excellent cardiology team at McLeod Cardiology Associates. Dr. Subnani is Board Certified in Cardiovascular Disease, Internal Medicine, and Clinical Cardiac Electrophysiology. He received his medical degree at the American University of the Caribbean in Coral Gables, Florida. Dr. Subnani completed his medical residency and his Clinical Cardiovascular Fellowship at SUNY Downstate Medical Center in Brooklyn, New York. He completed his fellowship in Clinical Cardiac Electrophysiology at the NYU Langone Medical Center in New York, New York.
