Pulsed field ablation is a newer option in the treatment of atrial fibrillation (AFib). Instead of using heat or cold to treat abnormal heart rhythms, pulsed field ablation relies on electrical energy.
Although a more recent discovery, interest in pulsed field ablation is growing as an alternative treatment for AFib. In our Lima market, our cardiac team at Mercy Health – St. Rita’s Medical Center is performing this treatment as yet another tool to expand access to high-quality, specialized heart care.
If you have atrial fibrillation, make an appointment with your cardiologist to discuss if pulsed field ablation is an option for you.
What is pulsed field ablation?
Pulsed field ablation is a catheter‑based procedure used to treat atrial fibrillation and certain other heart rhythm disorders. During the procedure, a physician delivers short bursts of high‑voltage electrical energy to specific areas of heart tissue that are responsible for abnormal electrical signals.
Unlike traditional ablation methods, pulsed field ablation does not rely on heat (radiofrequency ablation) or freezing (cryoablation). Instead, it works at the cellular level using a process known as irreversible electroporation. It’s designed to target heart muscle cells while limiting effects on nearby structures.
How pulsed field ablation works
The key mechanism behind pulsed field ablation is irreversible electroporation.
In practical terms, this means:
- Electrical pulses create tiny openings in the membranes of heart muscle cells.
- When the electrical exposure is strong enough, those cells lose their ability to function.
- The abnormal electrical pathways that contribute to atrial fibrillation are disrupted.
What makes this approach particularly interesting is that heart muscle cells appear to be more sensitive to these electrical fields than many surrounding tissues. This tissue selectivity is a central reason pulsed field ablation is being closely studied.
How it differs from traditional ablation
For years, catheter ablation for atrial fibrillation has relied on thermal energy – either heating or freezing tissue to stop abnormal signals. These approaches are effective, but they can carry risks because nearby structures may also be affected.
Pulsed field ablation takes a different approach:
- It doesn’t significantly change tissue temperature
- It focuses its effect on myocardial (heart muscle) cells
- It aims to reduce unintended injury to adjacent tissues such as the esophagus or phrenic nerve
Because of this, pulsed field ablation is often described as a promising alternative rather than a direct replacement for thermal ablation.
George Joseph, MD, is a cardiologist at Mercy Health – St. Rita’s Medical Center. As a member of the cardiac team performing this procedure in Lima, he is using this innovative treatment to offer yet another option to patients with atrial fibrillation.
“I have never been so excited about new developments in atrial fibrillation therapy as I am with pulsed field ablation,” he says. “It has revolutionized the field of ablation for atrial fibrillation.”
Does it work?
Clinical trials and multicenter studies have shown that pulsed field ablation is comparable in effectiveness to traditional ablation techniques for certain patients with atrial fibrillation, particularly those with paroxysmal AFib.
Researchers reported:
- Similar success rates in controlling atrial arrhythmias
- Efficient pulmonary vein isolation
- Shorter ablation times in many cases
That said, long‑term outcomes are still being studied.
Is it safe?
From a safety standpoint, pulsed field ablation has attracted attention because of its non‑thermal design. Evidence suggests that this approach may reduce the risk of some complications associated with heat‑based or cold‑based ablation.
However, it’s important to remember:
- Pulsed field ablation is still an invasive catheter procedure
- Risks related to vascular access, anticoagulation and catheter manipulation remain
- Researchers continue to monitor for complications unique to electroporation
Several pulsed field ablation systems have received approval from the U.S. Food and Drug Administration for the treatment of atrial fibrillation. Initial approvals focused on paroxysmal AFib, with later expansions based on additional clinical data.
Who is a good candidate for pulsed field ablation?
Pulsed field ablation is increasingly considered for:
- Patients with symptomatic, drug‑resistant atrial fibrillation
- Pulmonary vein isolation procedures
- Clinical settings where minimizing collateral tissue injury is a priority
Ongoing research will continue to clarify how and when pulsed field ablation should be used alongside – or instead of – traditional ablation methods.
How we can help
Pulsed field ablation is a newer form of treatment for atrial fibrillation. While not everyone is a good fit for it in place of more traditional treatment options, it’s worth a conversation with your provider.
Our cardiovascular team at Mercy Health – St. Rita’s Medical Center offers this innovative treatment to patients in Lima. Make an appointment with your cardiologist to discuss whether this treatment is right for you.
Learn about the heart and vascular services we offer at Mercy Health. Also, read more about the care available to you in our Lima market.
