The largest heart hospital in Malaysia was the first in the country to introduce “pulsed-field ablation”, which uses a device known as the Farapulse Pulsed Field Ablation System from global medical device company Boston Scientific.
“We were fortunate to gain early experience with this technology,” Dr Azlan Hussin, clinical director of the invasive cardiovascular laboratory at IJN, told FMT Lifestyle in conjunction with World Heart Day today.
At least 170 patients have been treated using this procedure since it was introduced in May last year.
Ablation, Azlan explained, is used to treat conditions related to the heart beating too quickly, the medical term for which is “tachycardia”. This can occur in the upper room of the chambers of the heart, known as the atrium, and the lower room or ventricle.
Symptoms include palpitations, breathlessness, chest pain, and fainting episodes. “Left untreated, it can cause the heart to weaken and the patient could go into heart failure. The patient might also experience low blood pressure,” he added.
Although arrhythmia can be controlled with medication, cardiac ablation may be required in more severe cases. This procedure eliminates specific tissue that cause disruptions in the heart’s electrical signals.
Traditional methods involve the use of extreme temperatures to burn problematic tissue with radiofrequency, or freezing the tissue away through cryoablation. But despite the effectiveness of these methods, it could result in damage to the nerves, oesophagus or lungs.
The Farapulse Pulsed Field Ablation System, on the other hand, applies ultra-rapid electrical pulses across a broader surface area without altering temperature, which enables doctors to avoid damage to adjacent organs or tissues.
Speed, precision, safety
“Pulsed-field ablation also incorporates a system that maps the precise location of the catheter that delivers the pulsed-field energy within the heart. This mapping system was passed to IJN in May this year,” Azlan said.
With this technology, “we now have the capability to be very accurate in the placement of the catheter where the ablation is carried out”, making the procedure faster and safer.
“A radiofrequency ablation procedure would take 109 minutes, while cryoablation takes 92 minutes. With pulsed-field ablation, it only takes us about 52 minutes,” he noted.
According to Azlan, the prognosis for those who undergo this procedure is as good as with radiofrequency or cryoablation, with the same recovery time.
Nevertheless, as is the case with radiofrequency and cryoablation, those who have a blood clot in their heart are ineligible for pulsed-field ablation owing to the risk of stroke.
“Pulsed-field ablation is covered by most, if not all, insurance companies, provided the premium and coverage taken by the patient includes such procedures,” Azlan concluded.
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