Pulsed field ablation

Pulsed field ablation is a new technology which uses non-thermal energy to quickly, safely, and effectively treat patients with atrial fibrillation.

What is pulsed field ablation?

Pulsed field ablation (PFA) is a type of catheter ablation used for the treatment of atrial fibrillation.

Catheter ablation, also known as ablation, is a minimally invasive procedure that treats abnormal heart rhythms (arrhythmias). Conventionally, this has been performed using thermal energy – either heat (radiofrequency energy) or freezing (cryoablation) – to destroy (ablate) the areas of heart tissue that are causing irregular heartbeats. Rarely, this thermal energy may cause damage to surrounding healthy structures.

Pulsed field ablation is a new type of catheter ablation. It uses tissue-selective, non-thermal electric fields to effectively ablate the heart tissue and avoid damage to surrounding structures. At Cromwell Hospital, we use a specific technology called FARAPULSE by Boston Scientific. Pulsed field ablation benefits from a shorter procedure time compared to standard catheter ablation with similar outcomes.

At present, Cromwell Hospital is one of the only UK private hospitals to provide pulsed field ablation using FARAPULSE.

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Pulsed field ablation is suitable for patients whose atrial fibrillation is negatively impacting their daily life and has not responded to other treatments, like medication.

Your eligibility for this treatment will be determined following a consultation with a cardiologist.

Pulsed field ablation is often carried out under general anaesthesia (where you’re asleep).

Your cardiologist will begin by passing small tubes (sheaths) into the vein in the leg. They will then guide several small, thin, flexible tubes (catheters) through the sheath, into the blood vessels, and up to the heart. These catheters have electrodes at the end.

Once the catheter is in place, the electrodes at the end are used within the heart to locate the area causing the abnormal rhythm; this area is usually very small. Once this area is located, the electrodes deliver non-thermal energy to effectively ablate the heart tissue while avoiding damage to the surrounding areas.

In total, pulsed field ablation takes around one hour to complete.

In 12-month clinical trials which directly compared the efficacy and safety of the FARAPULSE system against standard thermal ablation, it was found that FARAPULSE was as safe and effective as conventional thermal ablation, with statistically shorter procedure times.

Following your procedure, you will be monitored in hospital for several hours before being discharged. Occasionally, you may need to stay overnight.

In the days following the procedure, you may experience symptoms such as chest ache or discomfort and bruising in the area where the catheter was inserted. Any discomfort should be mild, and you will be able to return to normal activities within a few days.

If you’re looking to pay privately for pulsed field ablation, our dedicated Self-Pay team will be able to provide you with personalised advice and support – from walking you through our flexible payment plans to helping you choose the right consultant. There’s no obligation to book an appointment when you call us, and we’d be happy to answer any questions you might have.

We also welcome patients with private health insurance or embassy sponsorship.

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This page was reviewed for clinical accuracy by Dr Syed Ahsan, Consultant Cardiologist.

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