Treating the dual challenges of AFib in one visit

When Jerry Gadowski developed atrial fibrillation (AFib), he knew he faced not one health issue, but two. The first was the irregular cardiac rhythm that defines the condition, when his heart would pound and he could scarcely catch his breath - including once, memorably, while on a hike in a remote national park. "I couldn't keep up," remembers Jerry, age 77. "That was dramatic."

His wife Sharon nods. "It changed our lifestyle," she adds. "We became more homebound."

But as a retired cardiologist, Jerry realized there was also a second threat to his health: People with AFib face five times the risk of stroke. For protection, he started taking an oral anticoagulant, also known as a blood thinner. These medications are very effective, but also present higher bleeding risks, and soon Jerry began having unsettling episodes, such as when one night, heading into a party, he bumped his elbow and was surprised to see so much blood. "It was a hemorrhage," recalls Sharon. "A nightmare. We had to leave."

The couple was just two years into Jerry's retirement and had imagined their golden years unfolding differently - filled with golf, travel and the long bike rides they enjoyed together. AFib seemed to be stealing all that from them. Then Jerry's cardiology team suggested a solution: If Jerry was interested, he could be relieved of both his AFib symptoms and his need for long-term blood thinners by getting two minimally invasive procedures at once.

Recalls Jerry, "I said, 'Sign me up.'"

Beyond blood thinners

Treating AFib symptoms and reducing stroke risk require different approaches. That often means getting multiple procedures on the heart over time, along with all the inconveniences, costs, anxieties and risks multiple hospital visits can bring.

For example, take two leading-edge procedures for symptom relief and stroke risk reduction, respectively: pulsed field ablation (PFA) and left atrial appendage closure (LAAC). Patients who qualify for both typically receive the two treatments in two visits, often separated by several months. That can mean traveling twice, undergoing anesthesia twice and recovering twice - and can feel like twice the burden on patients and their families. The two-procedure process can also present a strain on doctors and hospital systems, especially since AFib, already a common condition affecting 59 million people globally, is steadily growing in prevalence.

However, for patients with AFib and a high risk of stroke or history of bleeding, like Jerry, there is now the possibility of getting both procedures in the same visit, an approach that can streamline care while addressing both issues at once. "It's the best kind of convergence - when what's good for patients and what's good for hospital systems come together," says Brad Sutton, M.D., chief medical officer, Atrial Fibrillation Solutions, Boston Scientific.

Two procedures, one recovery

The combination of cardiac ablation and LAAC involves two procedures performed while the patient is under anesthesia, with one immediately following the other:

• Cardiac ablation treats AFib by targeting the heart cells that send erratic signals. Traditional thermal ablation destroys those cells by burning or freezing them. By contrast, the new approach, PFA, uses precisely targeted electrical signals, resulting in an equally safe and more predictable method that doctors find relatively easier to apply. The FARAPULSE™ PFA Platform is one of the systems driving adoption of PFA; it was the world's first PFA technology to launch and has been used to treat more than 500,000 patients to date.
• LAAC is a one-time procedure that reduces stroke risk for patients with non-valvular AFib (AFib not caused by a heart problem). Most clots form during AFib inside the left atrial appendage, a nook within the upper left side of the heart. By placing a tiny implant to close that nook, clots can no longer form there and escape - reducing the risk of stroke and, for many patients, eliminating their long-term reliance on blood thinners. The WATCHMAN™ LAAC implant was the first medical device of its kind when it launched in 2015; to date, it has allowed more than 600,000 patients to leave blood thinners behind.

In January 2025 a sub-analysis of a major clinical trial showed the combined approach of traditional thermal cardiac ablation and LAAC with the WATCHMAN device was safe and effective. In addition, a reimbursement pathway was established for performing the procedures together, a move with the potential to expand patient access and streamline care delivery.

For Jerry, the combined procedures have made a world of difference. Before, between the twin threats of AFib symptoms and bleeding episodes, "I was always concerned about getting into trouble," he remembers. Now, relieved of his symptoms and no longer taking blood thinners, Jerry finds himself feeling not only healthier but also free of worry. He says, "Being off anticoagulation gives me a level of comfort," allowing him and Sharon to finally live out the active retirement they'd imagined.

"We're not afraid," says Sharon, smiling. "We're doing things again. With a totally different mindset."

Learn more about AFib treatment plus stroke protection with FARAWATCH™ : the combined FARAPULSE and WATCHMAN procedures .