Germans Trias Hospital launches a safer and more effective technique in Catalonia to treat patients with the most common arrhythmia

It’s a system — called PulseSelect — that the service’s arrhythmia unit has been using on about a dozen patients since June that ablates atrial fibrillation using pulsed fields and a circular catheter. In general, the technology, which was approved this year in the United States and recently in Europe, involves delivering high-energy electrical shocks to the heart cells involved in the arrhythmia.

The novelty of this system compared to other techniques is that the type of energy used does not heat or cool the ear tissue where it is applied. Thus, the fact that these tissues are no longer burned (with radiofrequency) or frozen (with cryoablation) eliminates the risk of affecting nearby structures, such as the esophagus, lungs or phrenic nerve. It also significantly reduces pulmonary vein stenosis – narrowing of the veins that carry blood between the lungs and the heart – as well as esophageal ulcers and a rare but potentially fatal complication: atrio-esophageal fistula, which occurs when the esophagus communicates with the ear.

Simple procedure and better healing.

This technique is also characterised by its simplicity and reduced intervention time. Thus, unlike others, only one catheter is used to access the heart through the femoral veins. In addition, the procedure no longer lasts more than an hour – with the consequent reduced use of anesthesia – and its learning curve is short, so specialists can perform it with excellence, quickly enough and with very homogeneous results.

With this new technique, it has been observed that the patient’s recovery is faster because when he wakes up after the procedure, he usually does not notice pain or discomfort and does not need to be given painkillers, as often happens when heat or cold. Applications are used. By reducing the time of the procedure, anesthesia and subsequent treatments, it is possible to consider a procedure without hospitalization and discharge on the same day.

This technique is indicated for patients for whom drug therapy is ineffective, and who suffer from recurrent arrhythmias. Atrial fibrillation is characterized by a rapid and irregular heartbeat. All this leads to an impact on the patient’s quality of life – with palpitations, discomfort and fatigue – which can lead to heart failure and even cause a stroke due to blockage of the cerebral arteries.

The effectiveness of the techniques used so far to permanently eliminate arrhythmias is about 80%, with a lot of variation depending on the characteristics of the case. It is estimated that this type of arrhythmia affects about 1% of the population over 60 years of age, and may affect 10% of the population over 75 years of age. The cause is the aging of the heart or various risk factors such as high blood pressure, obesity, sleep disorders, heart failure, valve or thyroid disease or many years of resistance exercise.