Atrial fibrillation — better known as AFib — is the most common type of arrhythmia, or abnormal heart rhythm. It affects more than 6 million Americans, a number expected to rise significantly as the U.S. population ages.
To treat AFib, experts at the UPMC Heart and Vascular Institute use a new minimally invasive procedure called pulsed field ablation (PFA).
What Is Atrial Fibrillation (AFib)?
AFib is when the heart’s upper chambers beat out of sync due to faulty electrical signals. This can lead to a fast, irregular heartbeat and reduce the heart’s ability to pump blood effectively.
There are several types of atrial fibrillation, including:
- Paroxysmal atrial fibrillation — Symptoms usually stop in less than 24 hours but may last up to a week.
- Persistent atrial fibrillation — Lasts longer than a week but less than a year.
- Long-term persistent atrial fibrillation — Lasts more than a year.
- Permanent atrial fibrillation — When AFib persists despite your doctor trying to restore normal heart rhythm with medicine or other treatment.
If left untreated, AFib can increase the risk of serious health issues like stroke, blood clots, or heart failure. But early diagnosis and treatment can manage symptoms and protect your heart.
What Are the Risk Factors of AFib?
Age is the biggest risk factor for AFib. As you get older, your risk of developing atrial fibrillation increases.
“As you age, just like any other organ in your body, the heart’s electrical system also goes through wear and tear,” says Chinmay Patel, MD, director of electrophysiology at the UPMC Heart and Vascular Institute in Central Pa.
Even the healthiest adults can develop AFib. Besides age, other risk factors include:
- Caffeine and alcohol use, especially in large amounts.
- Family history of AFib or heart disease.
- High blood pressure, sleep apnea, obesity, or other chronic health problems.
- Hyperactive thyroid function.
- Intense physical activity, such as endurance sports.
- Personal history of heart problems or heart surgery.
- Smoking tobacco or using illegal drugs.
- Valvular heart disease.
What Are the Signs and Symptoms of AFib?
The most common symptom of atrial fibrillation is a fast, irregular pulse, or feeling like your heart is “beating out of your chest,” says Dr. Patel. Other AFib symptoms include:
- Fatigue.
- Lightheadedness.
- Shortness of breath.
Some people may have no symptoms or only vague signs of AFib. If you’re at risk, regular checkups and monitoring are vital.
How Do You Treat AFib?
Several treatments can help manage AFib symptoms and reduce the risk of serious complications. Your doctor may prescribe:
- Blood thinners — Prevent blood clots and reduce the risk of stroke.
- Certain medications — Control heart rate and rhythm.
Other AFib treatment options include:
- Cardioversion — Uses electric shock to reset the heart rhythm.
- Ablation procedures — Selectively eliminate the heart tissue causing irregular rhythm.
- Appendage closure devices — like Watchman and Amulet for people who can’t tolerate blood thinners.
Some people may benefit from a hybrid ablation, a procedure that combines surgical and catheter-based techniques.
What Is Pulsed Field Ablation (PFA)?
Pulsed field ablation (PFA) is a new minimally invasive treatment option for AFib.
During PFA, surgeons deliver short bursts of electrical energy through a specially designed catheter to target and destroy the problematic heart tissue. This creates small holes in the cell membrane of the targeted tissue, leading to cell death without affecting the surrounding tissue.
“This ablation technique allows for a more targeted approach that spares other tissues from damage,” says Dr. Patel.
Compared to thermal ablation, PFA poses a lower risk of injury to surrounding structures. Other PFA benefits include:
- Faster recovery.
- Likely better long-term outcomes.
- Reduced risk of collateral damage.
- Shorter procedure times.
Traditional catheter ablation vs. PFA
Traditional catheter ablation techniques use thermal energy — either extreme heat (radiofrequency) or extreme cold (cryoablation) — to kill the cells that cause AFib. While effective, these techniques carry a small risk of damaging nearby tissue, including the esophagus and phrenic nerve.
Why Choose UPMC Heart and Vascular Institute for Pulsed Field Ablation?
The UPMC Heart and Vascular Institute is one of the leading centers for cardiovascular care in the United States. Our experts have many years of experience in diagnosing and treating a wide range of conditions, from common to complex. Plus, at UPMC, we’re always working to introduce new innovative technologies.
UPMC experts have extensive experience with pulsed field ablation and were the first Pa. team to participate in a national clinical trial to evaluate its safety and effectiveness.