Expanding advanced heart rhythm care with updated technology

Loma Linda University Health (LLUH) continues to lead the Inland Empire in advanced heart rhythm care with an important update to its pulsed field ablation (PFA) program using the Farapulse system, a new approach designed to make atrial fibrillation (AFib) treatment safer, faster, and more efficient for patients.

AFib is the most common heart rhythm disorder, affecting millions of Americans and significantly increasing the risk of stroke, heart failure, and reduced quality of life. For decades, catheter ablation relied on radiofrequency energy, a thermal technique that creates controlled burns in heart tissue to disrupt abnormal electrical signals.

"Traditional radiofrequency ablation has been effective, but it relies on heat," says Ravi Mandapati, MD, cardiac electrophysiologist at Loma Linda University Health. "Although rare, thermal energy can spread beyond the target area and affect nearby structures. Pulsed field ablation represents a meaningful shift because it's non-thermal and selectively targets heart cells while sparing surrounding tissue."

What's new: integrated mapping and single-catheter precision

The latest Farapulse update builds on the original safety profile of PFA by integrating magnetic tracking within a cardiac mapping system, allowing physicians to map and ablate using a single catheter.

"The ablation strategy itself hasn't changed, but the technology has," says Mandapati. "With this new process, we're able to reduce the number of device exchanges during a procedure. That means safer navigation, shorter procedure times, and a more streamlined experience for patients."

Unlike traditional point-by-point ablation, Farapulse uses a "single-shot" approach to isolate the pulmonary veins or the area where AFib commonly originates, delivering precise electrical pulses in milliseconds.

"This single-shot design allows us to map and treat with the same catheter," Mandapati says. "That efficiency is the future of electrophysiology."

Shorter procedures, improved safety

The update has had a noticeable impact on daily clinical practice. Procedures are significantly shorter, which can reduce time under anesthesia and increase the number of patients who can be treated.

"By removing the risks associated with thermal energy and shortening overall procedure times, we're improving patient safety on multiple levels," Mandapati says. "That's one of the most important advancements we're seeing."

Expanding options for complex arrhythmias

Beyond atrial fibrillation, LLUH electrophysiologists have also used pulsed field ablation in compassionate-use cases for complex atrial flutters and ventricular tachycardias, particularly for patients who previously failed multiple radiofrequency ablations.

"These are patients who often have limited options," says Mandapati. "In select cases, pulsed field ablation has helped improve symptoms and quality of life when traditional approaches were no longer effective."

Leading the Inland Empire in innovation

LLUH is the region's leader in treatment of complex heart disorders offering patients in San Bernardino County and the broader Inland Empire access to cutting-edge electrophysiology care close to home.

"As this technology continues to evolve, we expect to see new catheter designs that allow us to treat an even wider range of arrhythmias," Mandapati says. "The goal is faster, safer procedures with better outcomes and pulsed field ablation is moving us decisively in that direction."

Patients experiencing symptoms of atrial fibrillation or other heart rhythm disorders can learn more about advanced electrophysiology services at Loma Linda University International Heart Institute. To request an appointment or referral, visit lluh.org/heart-vascular.