New Ablation Tech Holds Promise for People with AFib

Ablation has long been used to steady an irregular heartbeat. Now, it’s getting a technology upgrade.

Healthy Heart|Jan.19, 2024

Of all the sophisticated machines that run on electricity, the most important is the one beating inside your chest right now.

Your heart uses its own electrical system to start up every single beat. As far as features of the human body go, it’s pretty fascinating, actually.

But even the most fascinating systems can break down. If there’s a power leak or surge in there? If a connection goes bad? Suddenly, you have a problem — one that will have you calling a cardiologist, not an electrician.

“When ‘current’ leaks out, extra heartbeats happen, the heart starts going too fast and arrhythmias occur,” explains Dr. Christopher Piorkowski, Chief Medical Officer of Electrophysiology at Abbott.

It often leads to the most common type of irregular heartbeat, atrial fibrillation, or AFib, for short.

In certain cases, you might need a procedure called cardiac ablation to treat AFib. Otherwise, your overworked heart could lead you down the road to heart failure. (If you’re already living with heart failure when AFib strikes, the risks to your health get even more serious.)

Which brings us to our news: We’re testing a promising new technology in a global clinical trial, our Volt pulsed-field ablation (PFA) catheter. We believe it could make a huge difference for people suffering from irregular heartbeats due to AFib.

What is Ablation for AFib?

Ablation involves damaging tiny bits of tissue in the heart to “smooth out” the electrical signal that tells your heart when and how to beat.

It sounds counterintuitive, but damaging or removing that tissue actually improves the flow of electrical current in people with AFib.

Think of it like the wiring in a home. If power doesn’t flow evenly — maybe there’s a disconnected wire, a switch that isn’t working, an outlet with too much plugged into it — the entire system might shut down. For many people, ablation is the fix that lets them reset their internal circuit breakers.

“It just helps to bring the heart’s electrical currents back into their normal pathways of flow, to suppress any abnormal heart rhythms,” Piorkowski says.

In a traditional ablation procedure, a cardiologist goes into the pulmonary vein and burns or freezes the tissue that needs to be damaged.

Yes, we said “burns or freezes.” Thermal ablation is safe and FDA-approved, but this is where the analogy to electrical wiring ends (please, please do not try to fix your house with a blowtorch).

Let’s instead pivot to the innovation we mentioned earlier: pulsed-field ablation.

Pulsed-field ablation (PFA) directs a targeted application of electricity at the faulty spots that need to be “turned off.”

Whereas thermal energy can damage the site and organs around the pulmonary vein, PFA technology delivers controlled pulses, in milliseconds, that only ablate heart muscle tissue and spare other organs.

“Pulsed-field ablation spares the phrenic nerve, which runs to the diaphragm and helps the patient breathe. It spares the esophagus. It has great potential to make these procedures even safer,” Piorkowski says.

How Volt Moves Ablation Forward

Our new Volt PFA catheter, currently being used in clinical trials in Australia, was designed to advance ablation for AFib and help treat more patients faster and more effectively. Let’s dive deeper into how that design helps with the job at hand.

The end of our catheter is a basket-like pattern of ablating electrodes, sitting around a tiny balloon.

When the balloon inflates, it shields the electrodes from the blood flow so that the electric pulses can go more precisely into the heart muscle where they are intended (and don’t get swept somewhere downstream). This feature is unique to Volt and to Abbott.

This way the balloon helps drive what is known as lesion depth, meaning that the pulses go deeper into the targeted tissue and increase the odds that you have completely deactivated faulty electrical circuits. As we said, turning those sites “off” ultimately gets the electricity back in its natural flow.

We could go on in more detail, but — before we short-circuit any brains here — why don’t we just get to the bottom line?

Which is this: Every bit of Volt’s complex engineering is aimed at improving people’s lives. At giving them more life to live.  

“There’s a spectrum of responses to PFA for AFib,” Piorkowski says. “Some people feel the benefit even within days. They can walk stairs again. They can catch their breath again.

“But beyond that, they live longer.”

What an energizing thought.