Atrial fibrillation (atrial fibrillation) is the most common form of irregular heart rhythm, affecting millions of people worldwide, particularly older adults. This condition occurs when the heart’s electrical signals become disorganised, causing the upper chambers of the heart (atria) to quiver instead of beating efficiently. Over time, atrial fibrillation can lead to fatigue, breathlessness, and even serious complications such as stroke or heart failure.

Northern Heart Hospital is proud to be at the forefront of atrial fibrillation treatment with the successful completion of its first Pulsed Field Ablation (PFA) procedure, led by Dr Tuan Jiun Haur and his expert team. Combining cutting-edge technology with exceptional care, Northern Heart Hospital is now offering this groundbreaking treatment to help patients reclaim their health and quality of life.

What is Atrial Fibrillation?

Advanced 3D mapping technology used in Pulsed Field Ablation at Northern Heart Hospital.

Before delving into PFA, it is important to understand atrial fibrillation. Atrial fibrillation disrupts the heart’s normal rhythm and pumping efficiency, causing the heart to beat too fast, too slow, or irregularly. People with atrial fibrillation may experience:

  • Heart palpitations: A racing, fluttering, or pounding sensation in the chest.
  • Fatigue and weakness: Even simple tasks, such as climbing stairs, can feel exhausting.
  • Dizziness or light-headedness: Due to inadequate blood flow.
  • Shortness of breath: Often during physical activity or when lying flat.
  • Chest discomfort: Mild pressure or pain in some cases.

If left untreated, atrial fibrillation significantly increases the risk of blood clots forming in the heart. These clots can travel to the brain, causing a stroke. Therefore, timely diagnosis and treatment are essential.

The Evolution of atrial fibrillation Treatments

Over the years, treatment for atrial fibrillation has evolved from simply managing symptoms with medication to advanced techniques such as catheter ablation, which directly addresses the root cause. Traditional ablation methods, including radiofrequency ablation (using heat) and cryoablation (using extreme cold), have been effective but come with limitations, including the potential for damage to surrounding tissues.

This is where Pulsed Field Ablation (PFA) emerges as an innovative technology which has the potential to revolutionise the way atrial fibrillation is treated.

What is Pulsed Field Ablation (PFA), and How Does It Work?

PFA is a cutting-edge technique that uses precisely controlled electrical pulses to destroy the heart tissue responsible for abnormal rhythms. Northern Heart Hospital is proud to bring this cutting-edge technology to its patients, backed by a team of highly skilled cardiologists, world-class equipment, and state-of-the-art facilities.

Unlike traditional methods, which rely on thermal energy, PFA uses electroporation – a process that selectively affects heart cells while sparing nearby structures such as blood vessels and the oesophagus. It is, therefore, particularly useful in catheter ablation of AF, where several areas of the heart need to be targeted in one session.
Here’s how the procedure works:

  • Preparation and Access: A small catheter is inserted into a blood vessel in the groin and guided to the heart using advanced imaging techniques.
  • Mapping the Heart: The electrophysiologist creates a detailed map of the heart’s electrical activity to locate the areas causing the irregular rhythm.
  • Delivering Pulses: Once the target areas are identified, the PFA system delivers short, high-energy electrical pulses. These pulses create microscopic openings in the cell membranes of the targeted tissue, disrupting their ability to conduct abnormal electrical signals.
  • Restoring Normal Rhythm: With the problematic tissue neutralised, the heart’s natural rhythm is restored.

What are the advantages of PFA?

At Northern Heart Hospital, every PFA procedure is carefully tailored to meet the needs of each patient. Currently, PFA is only recommended for patients who need catheter ablation for AF.
Here’s what you can expect:

  • Precision targeting and safety: Although conventional ablation technologies such as RF ablation are already very safe, PFA provides an extra level of safety and precision by being able to target the area of interest more accurately so that nearby tissues are less likely to be affected.
  • Reduced procedure time: PFA is able to deliver multiple pulses of energy to destroy abnormal electrical tissue in a short time, which results in reduced time spent manipulating catheters and instrumentation within the heart. This also means a shorter time under sedation and anaesthesia, leading to a potentially quicker recovery in the early post-procedure phase.
  • Effective Results: Early studies have shown PFA to be highly effective in achieving rhythm control for different types of AF, giving hope to patients who are troubled by this condition.

Who Can Benefit from PFA?

PFA is most commonly recommended for patients with paroxysmal atrial fibrillation (atrial fibrillation that comes and goes) or persistent atrial fibrillation (lasting longer than seven days). It is particularly suitable for individuals who:

  • Have not responded to medication or lifestyle changes.
  • Are seeking minimally invasive solutions with a shorter recovery time.

What to Expect During and After the Procedure

At Northern Heart Hospital, we recognise that every patient is unique. That’s why we take a personalised approach to diagnosing and treating atrial fibrillation. Whether you’ve just been diagnosed or have struggled with atrial fibrillation for years, our specialists will work closely with you to create a tailored treatment plan, ensuring the best possible care.

  • Pre-procedure: The procedure is carried out under GA to ensure comfort. The medical team explains each step and answers any last-minute questions before proceeding.
  • During the procedure: Using real-time imaging, catheters are carefully positioned in the heart before PFA pulses are delivered.
  • Post-procedure: After the procedure, patients are typically monitored overnight before being discharged the next morning. Some may experience mild soreness at the catheter site, but this usually resolves quickly.
  • Follow-up: Regular check-ups are scheduled to monitor the heart’s rhythm and overall health.

Why Choose Northern Heart Hospital for PFA?

PFA can be considered as a complementary tool which adds to our list of effective therapies for AF. Each individual’s suitability for a particular treatment will need to be considered on an individual basis. In some cases, a combination of treatment strategies e.g., PFA together with traditional ablation techniques such as RF ablation can also be used to achieve optimal outcomes for patients. We should also not forget that medication, including risk factor modification will still play important roles in the overall treatment approach of AF.
Northern Heart Hospital is at the forefront of innovation in cardiac care. Led by a team of seasoned experts, our hospital combines cutting-edge technology with compassionate care. Here’s what sets us apart:

  • State-of-the-art facilities: Our advanced imaging systems and 3D mapping technologies ensure precision and safety.
  • Experienced specialists: Our medical experts bring unmatched expertise in performing complex cardiac procedures.
  • Patient-centred approach: We prioritise your comfort, safety, and long-term health outcomes.
  • Comprehensive care: From diagnosis to recovery, our team supports you every step of the way.

Why Act Now?

Living with atrial fibrillation can be challenging, but advanced treatments like Pulsed Field Ablation are offering new hope. At Northern Heart Hospital, we combine expertise, technology, and compassionate care to help you regain control of your heart health.

If you or a loved one are experiencing symptoms of atrial fibrillation, don’t wait. Early intervention can make all the difference. Contact Northern Heart Hospital today to schedule a consultation and explore your treatment options.