Pulsed Field Ablation: A New Way to Treat Atrial Fibrillation

Electrophysiologists at Winchester Medical Center are among the first in the region to offer a new treatment option to patients with atrial fibrillation (AFib), a heart condition that results in an abnormal heart rhythm and carries the risk of stroke, heart failure and blood clots.

Symptoms of AFib include heart palpitations, shortness of breath, extreme fatigue and chest pain. The condition results in about 158,000 deaths each year in the U.S. and causes about one in seven strokes, according to the U.S. Centers for Disease Control and Prevention. Risk factors include obesity, smoking, high blood pressure, advancing age, heart failure and diabetes.

Depending on the individual patient’s needs, treatment for AFib may involve lifestyle changes, medications, or a procedure called an ablation. The electrophysiologists at Winchester Medical Center (WMC) perform minimally invasive ablations using catheters inserted through vessels in the leg. Ablation techniques have traditionally used heat or cold energy to disable the heart cells that are the source of the electrical abnormality, thereby restoring a regular heartbeat.

Safer Procedure, Faster Recovery

Valley Health is one of the first in the region to implement pulsed field ablation for arrhythmia management. Pulsed field ablation, or PFA, is a recent FDA-approved technology that uses ultrarapid electrical pulses, rather than thermal energy, to better target myocardial tissue. During PFA, electrical pulses lasting a nanosecond to a microsecond disable cardiac cells, resulting in a safer procedure and more protection for surrounding tissue.

“Having done AFib ablation for the past 15 years, I have seen evolutionary changes that have improved the efficacy, safety and durability of the procedure,” says Daniel Alexander, DO, chairman of the Winchester Medical Center Electrophysiology Clinical Council. “Pulsed field ablation is the newest energy-delivery device, improving on the safety profile for AFib ablation that will help us treat this condition for a greater number of patients, safely and effectively.”

The electrophysiology team at WMC has used PFA to treat patients with AFib, resulting in shorter procedure times and less time under anesthesia. Most importantly, the precision of this new nonthermal ablation technology allows electrophysiologists to use tightly controlled pulsed electrical fields to target the exact cardiac cells they wish to treat, with reduced risk of injury to surrounding cardiac tissue.

Pulsed Field Ablation at WMC

“We have been watching the evolution of the science and clinical performance of PFA for years leading up to the first application at Winchester Medical Center,” says Valley Health electrophysiologist Todd Teigeler, MD. “There was remarkable coordination between the doctors, the leadership at Valley Health and industry partners to make this leading-edge technology available to our community.”

Emmanuel Ekanem, MD, a cardiac electrophysiologist with Winchester Cardiology and Vascular Medicine | Valley Health, played an important role in establishing the safety profile for the new technology, serving as the lead investigator in clinical research of PFA in patients with AFib. Dr. Ekanem is the lead author of a 2024 paper published in the prestigious journal Nature Medicine that studies the safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation across Europe.

“The prevalence of atrial fibrillation continues to increase with significant impact on the quality of life and clinical outcomes of our patients,” Dr. Ekanem says. “This represents a major advancement in the treatment of atrial fibrillation. We are excited for the opportunity to use this leading-edge technology to continue to deliver world-class care to our patients in the region.”