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Pulsed Field Ablation Proves Safe Without Cerebral Complications
We have written many articles on Pulsed Field Ablation (PFA), a new and very effective treatment option for the ablation of A-Fib. (For a background on PFA, see my post: Pulsed Field Ablation—Emerging Tech for Atrial Fibrillation.)
PFA continues in clinical trials, is awaiting FDA approval in the U.S. (expected in 2024), and is already in daily use in some countries.
Previous studies have shown that PFA performs catheter ablation effectively with no adverse effects, such as coronary artery stenosis, persistent phrenic nerve palsy, or esophageal damage. PFA doesn’t damage surrounding non-cardiac tissue.
But what about cerebral damage?
Thermal (RF) Ablation: Silent Cerebral Lesions
When using thermal ablation (Radio Frequency), procedure-associated stroke, while rare, can be among the most severe disabling complications of RF ablation.
Recent studies using magnetic resonance imaging (MRI) have shown the occurrence of silent cerebral lesions and/or events with possible cerebral complications using RF ablation.
Are there cerebral complications with Pulsed Field Ablation as the energy source?
Pulsed Field Ablation: No Neurological Problems
In a small (though probably definitive) study from Germany, 30 patients with symptomatic paroxysmal A-Fib received a Pulmonary Vein Isolation using Pulsed Field Ablation energy. Stroke scores, using the National Institutes of Health Stroke Scale, were assessed before the ablation and afterwards at 2 days and 30 days.
One day after receiving their Pulsed Field Ablation, patients underwent a cerebral MRI. Of patients, 97% showed no silent cerebral lesions or events. One patient did have a single, newly visible, asymptomatic, transient brain lesion. But forty days after the procedure, a follow-up MRI scan showed complete regression of the lesion.
None of the patients receiving the Pulsed Field Ablation had any neurological deficits.
Editor’s Comments:
Yet another study demonstrating the neurological safety of Pulsed Field Ablation (PFA). This study from Germany, used MRI to detect possible brain damage and found that PFA produced no neurological problems.
In practical terms, PFA is safer than current ablation energy sources.
Pulsed Field Ablation is a true game changer! I repeat my previous prediction that Pulsed Field Ablation will supersede all other types of catheter ablation for A-Fib.
