Patients are clamoring for the next breakthrough in cardiac electrophysiology— and they know it by name.
"We have people calling saying, 'I want an ablation, but I want to have it when you have pulsed field ablation (PFA), so keep us posted,'" says Jonathan Sussman, MD, a board-certified, fellowship-trained cardiac electrophysiologist at Morristown Medical Center, part of Atlantic Health System.
Jonathan Sussman, MD
PFA has rapidly gained traction among physicians and healthcare professionals as a promising alternative to traditional ablation methods for treating cardiac arrhythmias, especially atrial fibrillation (AFib).
“A large focus in my practice is AFib, which is one of the most common abnormal heart rhythms,” says Dr. Sussman. “Probably somewhere like five million Americans have AFib at this point and it can have life-threatening consequences.”
As the evidence supporting the effectiveness of PFA continues to grow, Dr. Sussman believes this technique will likely become increasingly integrated into the standard armamentarium of a new era of safer, more precise, and effective interventions for patients with rhythm disorders.
PFA utilizes pulsed electric fields to create irreversible electroporation, inducing targeted cell death in cardiac tissue responsible for arrhythmia. Unlike conventional thermal ablation techniques, such as radiofrequency or cryoablation, PFA relies on non-thermal energy to achieve its therapeutic effects, thereby minimizing collateral damage to surrounding tissues and preserving the integrity of critical structures.
"PFA looks like a technology that is much more selective for the heart muscle that does not pose the same risk to other structures nearby, while if at the same time configured correctly, will create that irreversible damage that we want to create," says Dr. Sussman.
The Gagnon Cardiovascular Institute at Morristown Medical Center, part of Atlantic Health System, includes six cardiac electrophysiology specialists. So far, they participated in one clinical trial, with plans to join an upcoming PFA clinical trial in the next few months. The cardiac electrophysiology team routinely collaborates with manufacturers like Medtronic, which received FDA approval for its PFA system in December.1 Once available to the wider markethis team will be trained with technology and make it accessible to patients as soon as is feasible.
"The learning curve is not steep for this kind of technology," says Dr. Sussman. "It is building on what we already do. We have a track record of working well with this technology and bringing that technology to bear."
According to Dr. Sussman, the efficiency of PFA has led to reduced procedure times compared to traditional ablation techniques. He notes that shorter recovery times and less anesthesia exposure enhance patient experience and satisfaction.
Dr. Sussman also touts PFA’s improved safety profile compared to traditional methods.
"Just knowing that we expect to see fewer people with any significant complications down the road makes a big difference when a patient signs up for a procedure," says Dr. Sussman.
Looking back on his career, Dr. Sussman remembers the challenging cases as motivation toward innovation.
"I think it is seeing the times we did not succeed that really kind of drive, wanting to bring in new tools and new techniques," he says. What's so exciting about these new tools that come along is seeing, 'What's the problem that they can fix and do they really fix it?' And then you think back and say, 'I wish we had this when I took care of that patient, back in 2008.'"
Reference:
- Medtronic Creates History with FDA Approval of its Novel PulseSelect™ Pulsed Field Ablation System to Treat Atrial Fibrillation. Medtronic Newsroom. https://news.medtronic.com/2023-12-13-Medtronic-creates-history-with-FDA-approval-of-its-novel-PulseSelect-TM-Pulsed-Field-Ablation-System-to-treat-atrial-fibrillation. Published December 13, 2023. Accessed January 9, 2024.