First Successful Pulsed Field Ablation for Atrial Fibrillation at Friendship Hospital

First Successful Pulsed Field Ablation for Atrial Fibrillation at Friendship Hospital

On October 28th, under the guidance of Vice President Dr. Song Xiantao, Friendship Hospital's Cardiology Department, led by Chief Physician Dr. Zhang He Ping and assisted by Dr. Yu Shandong and Dr. Gao Huikuan, successfully performed the hospital’s first pulsed field ablation (PFA) for atrial fibrillation (AF). This groundbreaking procedure marks a significant milestone in the field of arrhythmia intervention, offering a safer, more effective, and minimally invasive treatment option for millions of AF patients.

Surgical Process: Precision Ablation to Restore Heart Rhythm

The patient, a 64-year-old male, had been suffering from recurrent palpitations for many years and had a history of coronary artery bypass graft surgery, along with hypertension and diabetes. Over the past month, the patient experienced frequent episodes of AF with rapid ventricular rates, with heart rates reaching above 150 beats per minute, significantly affecting his quality of life. After thorough preoperative assessment and consultation with the anesthesiology team led by Dr. Dong Peng, it was decided to perform the PFA under general anesthesia.

The surgery, guided by magnetic-electrical dual navigation and three-dimensional mapping, took approximately 70 minutes. During the procedure, the team created a three-dimensional model of the left atrium and performed high-density mapping to precisely locate the abnormal electrical activity. This was followed by pulmonary vein isolation on both sides. The surgery was completed without complications, and the patient maintained normal sinus rhythm postoperatively.

After just 8 hours, the patient was able to get out of bed and was discharged the following day. A week later, follow-up revealed that the patient no longer experienced palpitations and was recovering well.

Understanding Atrial Fibrillation: The Hidden “Silent Killer” of the Heart

Atrial fibrillation (AF) is one of the most common arrhythmias and poses a growing threat to cardiovascular health, especially in aging populations. In China, the number of AF patients exceeds 10 million, and this figure continues to rise with the aging population. The dangers of AF go beyond irregular heartbeats—when the heart is in AF, the atria lose their ability to contract effectively, causing blood stasis and the formation of blood clots. These clots can travel to the brain, causing ischemic strokes, with a risk five times higher than that of the general population, and they are associated with high morbidity and mortality. Long-term AF can also lead to heart failure, increased risks of myocardial infarction, and cognitive decline, placing a significant burden on both the healthcare system and families.

Ablation Therapy: The Key to Restoring Heart Rhythm

The primary goal of AF treatment is to restore and maintain normal sinus rhythm, thereby reducing the risk of complications and improving quality of life. While medications can control heart rate and prevent blood clots, they cannot cure AF, and some patients may experience adverse side effects. With advancements in interventional cardiology, catheter ablation has become a first-line treatment for AF. This procedure involves delivering energy through a catheter to the abnormal areas in the heart to disrupt the electrical activity, restoring normal rhythm.

Traditional catheter ablation methods, such as radiofrequency ablation and cryoablation, have been widely used but still have limitations. Radiofrequency ablation can damage surrounding healthy tissue and increase the risk of complications like pericardial effusion or pulmonary vein stenosis. Cryoablation, while effective, may result in incomplete ablation due to uneven ice ball formation and requires highly skilled operators. As a result, there is an urgent need for safer, more efficient, and easier-to-use technologies.