UToledo Health Performs First Dual-Energy Cardiac Ablation Procedures in Toledo Area

UToledo Health Performs First Dual-Energy Cardiac Ablation Procedures in Toledo Area

UToledo Health is the first health system in the Toledo area to perform cardiac ablation procedures using new dual energy catheter technology, a significant advancement in the treatment of atrial fibrillation and other heart rhythm disorders.

Dr. Abhishek Maan, a UToledo Health cardiac electrophysiologist and an assistant professor of cardiovascular medicine at UToledo's College of Medicine and Life Sciences, performed the first dual-energy ablation procedures at the University of Toledo Medical Center in late September, adding a third catheter option to an already advanced electrophysiology program.

"Cardiac ablation is a procedure we do to get people back into regular rhythm," Maan said. "The goal is always to personalize that, to understand where in this particular patient's heart the ablation needs to happen."

Atrial fibrillation, commonly known as AFib, is an irregular heart rhythm that affects millions of Americans and significantly increases the risk of stroke and heart failure. Catheter ablation is a minimally invasive procedure in which a physician navigates a thin, flexible tube through blood vessels to the heart and applies energy to disrupt abnormal electrical signals through purposeful scarring of the cardiovascular tissue. It has become an increasingly effective alternative to long-term medication management, which offers a success rate of only 40 to 45%. Ablation, by comparison, carries a success rate of approximately 75 to 80%.

Pulse field ablation (PFA), introduced broadly around 2020, represented a major leap forward in cardiac ablation because of its tissue selectivity, targeting specific heart cells while leaving surrounding structures largely unaffected.

One of the more serious risks of traditional radiofrequency (RF) ablation has been inadvertent damage to the esophagus, which sits directly behind the heart.

Maan said after approximately 500,000 pulse field ablation procedures performed worldwide, not a single case of the most feared complication, atrioesophageal fistula, has been reported.

"The deadliest complication of radiofrequency used to be damage to the esophagus," Maan said. "That has not been reported with pulse field ablation yet."

Now, the new Biosense Webster THERMOCOOL SMARTTOUCH SF Dual Energy catheter combines two distinct energy sources, traditional radiofrequency and the newer pulse field ablation, in a single device.

"If you think about RF and PFA, it's like a hybrid EV or hybrid car," he said.

The dual energy catheter adds precision beyond what pulse field alone can achieve, offering the ability to better fit each specific patient's needs.

"We really needed a different form of energy which at least has the option of toggling back and forth between radio frequency and pulse field so that we could deliver deeper transmural lesions, and that could translate to long-term success," Maan said.

The result, he said, is ablation that is applied in a precise, point-by-point manner, allowing for deeper lesions in areas of the heart that were previously difficult to treat effectively.

The technology is also contributing to improved patient experience. Maan said he has begun sending select ablation patients home the same day as their procedure, a meaningful shift from the longer hospital stays historically associated with cardiac procedures.

UTMC now offers three distinct catheter options for cardiac ablation: the Farapulse, the Varipulse and the new dual energy catheter, allowing Maan and his team to tailor the approach to each patient's specific anatomy and clinical history.

"It allows us to present this portfolio of options to our patients," Maan said. "We have three different types of catheters that we can potentially use to get a good success rate."

Maan, who trained at Massachusetts General Hospital and Mount Sinai and has traveled to Europe to gain firsthand experience with catheter technologies before their U.S. approval, credits the success of UToledo's electrophysiology program to the UToledo Health team around him.

"The EP staff at UToledo is the best that I have worked with in my entire career," he said. "Whatever success I have had is really to them."