A new procedure using electrical pulses for treating the common heart rhythm disorder atrial fibrillation causes fewer complications than the standard-of-care technique, according to a large study.
Doctors have long known that by destroying tiny sections of heart tissue in patients with this arrhythmia, they can block faulty heart signals and restore a normal heartbeat. Traditionally, they destroy that tissue using heat.
The new, nonthermal technique, called pulsed field ablation (PFA), uses short, high-voltage electrical current pulses to damage cell membranes and induce cell death. Other studies have shown that PFA more accurately targets heart cells, avoiding injuries to nearby tissues such as the esophagus, the pulmonary vein and local nerves, all common side effects of older approaches.
Researchers analyzed 17,642 patients with either intermittent or constant atrial fibrillation who underwent PFA procedures in 2021 with a then-experimental Boston Scientific device. They found no esophageal damage, no dangerous effects on the pulmonary vein, and no persistent injuries to nerves controlling the muscles used for breathing, according to a report published in Nature Medicine.
Rates of stroke and death were 0.12% and 0.03%, respectively.
PFA “has the potential to be transformative for the management of patients with atrial fibrillation,” the researchers said.
Boston Scientific’s device won U.S. approval in January a month after the Food and Drug Administration approved PFA devices from Medtronic and Biosense Webster.
The website Medical Device Network says 1.7 million ablation procedures will occur this year, with 20% involving PFA. By 2030, that proportion is forecast to reach 75% to 80%.
