Four patients suffering from potentially life-threatening atrial fibrillation underwent the latest high-tech procedure this week at Providence Saint John’s Health Center, the first patients treated in the Greater Los Angeles Area since the treatment was approved.
All four patients, three men and a woman, were doing well in the hours following pulsed field ablations, said electrophysiologist Shephal Doshi, M.D., who previously had performed approximately 20 of the procedures in U.S. clinical trials and in Europe.
“This is a paradigm shift for the management of the A-fib patient, allowing procedures to be done more easily, significantly faster, safer and with excellent outcomes,” said Dr. Doshi, director of Providence Saint John’s cardiac electrophysiology and pacing program, the Sandra and Vin Scully Heart Rhythm Center and executive director of the hospital’s Minerd Heart and Vascular Institute.
Among these firsts was Rob Sears, who has suffered for eight years with the heart pounding that comes with A-fib. Sears, 79, traveled to Santa Monica from his home in Western Washington to undergo the new procedure. Two other treatments had failed since he was first diagnosed in 2016. Recently he awakened after surgery and knew the procedure had worked.
“To stand up and not feel dizzy is kind of new to me,” he said.
Boston Scientific’s FARAPULSE PFA System, approved Jan. 31 by the Food and Drug Administration, involves the application of high-voltage electrical impulses to destroy the scarred heart tissue that causes the irregular beat.
“It’s a gamechanger,” Dr. Doshi said. “This technology allows us to do these procedures safely and more quickly with less anesthesia. Most patients will go home after just a few hours.”
The procedure, called PFA, is the latest generation of a treatment that destroys tissue on the heart that causes A-Fib, an erratic heartbeat that if untreated can lead to stroke or heart failure. PFI takes a fraction of the time – about 30 minutes – compared to four or five hours for standard ablations. It’s also more effective in deadening defective heart tissue to stop A-Fib, is significantly safer, does not damage surrounding tissue and results in a quicker recovery.
And because PFA takes much less time, more patients can be treated in a single day, avoiding weeks of waiting to be scheduled for the procedure.
Cardiac ablations are performed by inserting a tool into a thin tube called a catheter, which is manipulated through a blood vessel in the groin – or sometimes through the shoulder or neck – to the heart. An estimated 300,000 cardiac ablations are performed each year in the U.S. Ablations are up to 95% effective, including cases where the procedure is repeated.
The risk of complications considerably low for standard ablation procedures, and even lower with PFA, studies show. Traditional ablations cauterize or freeze the problem tissue. While considered safe, burning or freezing tissue has been linked to a low rate of complications including damage to the esophagus, the phrenic nerve and the arteries.
Pulsed field technology is also growing in cancer treatment. In 2023, the FDA approved the procedure for soft tissues, and clinical trials are showing promise for the treatment of solid tumors.
Providence Saint John’s is a leading regional heart center in Southern California, committed to investing in new technology to advance safe and effective care. Dr. Doshi was the first in the nation to implant the WATCHMAN device in a patient after FDA approval in 2015. That device is an alternative to blood thinning medications for heart patients.
“We are continuing a long list of firsts in cardiac electrophysiology in the U.S. and the Los Angeles Area,” Dr. Doshi said.
Submitted by Patricia Aidem, Director, Public Relations
