Pulsed Field Ablation: A Safer, Faster Treatment for Atrial Fibrillation
How an innovative heart rhythm procedure at UHealth helped a cancer survivor regain her life, without long procedures or long‑term medication.
Christina Goble did not know that after surviving synchronous cancers in 2021 — one in the breast and another in the colon — she would face yet another battle. Her heart that suddenly began beating out of control. While recovering from a mastectomy, a colon resection, multiple procedures and intense chemotherapy, she began to feel a strange sensation in her chest.
“You feel this pressure. The tachycardia feels like an engine out of control, like when a car is broken,” she recalled.
What Is Atrial Fibrillation and Why It’s So Common
At UHealth — University of Miami Health System, Raúl Mitrani, M.D., professor of clinical medicine and director of cardiac electrophysiology at the University of Miami Miller School of Medicine, explained that she was experiencing atrial fibrillation. The condition is an electrical disorder that affects the atria, the upper chambers of the heart, causing them to beat rapidly and irregularly instead of contracting in a coordinated manner. The result is palpitations, shortness of breath and extreme fatigue.
That constant “thump, thump, thump” Goble describes is exactly what happens when the atria lose their normal rhythm and go into fibrillation.
Atrial fibrillation is not an isolated problem.
“There is a true epidemic in this country and worldwide of people with atrial fibrillation,” said Dr. Mitrani.
It is estimated that one in four people will develop this arrhythmia before the age of 80. Its incidence continues to rise due to population aging and risk factors such as obesity, hypertension and sleep apnea.
Why Medications Don’t Work for Many AFib Patients
Beyond the debilitating symptoms, this arrhythmia also increases the risk of blood clots forming inside the heart, which can travel to the brain and cause a stroke. That is why many patients require blood thinners. In certain cases, devices such as the WATCHMAN implant reduce risk.
Some patients can treat atrial fibrillation with medications. However, these drugs are effective in only about 30 to 60 percent of cases and may produce side effects.
“The other option, which has greater effectiveness, is catheter ablation inside the heart to eliminate the electrical circuits that trigger fibrillation,” Dr. Mitrani said.
Depending on the type of atrial fibrillation a patient has, the procedure can be 70 to 80 percent effective in some cases and 60 to 70 percent in others. Many patients choose ablation because they do not want to depend on long-term medication and are seeking a more effective alternative.
How Pulsed Field Ablation Works
When Goble was referred to Dr. Mitrani in 2024, he spoke to her about this more definitive option. This minimally invasive procedure is performed through the groin, without opening the chest. Using catheters, specialists map abnormal electrical circuits and eliminate the tissue responsible for the arrhythmia to restore normal rhythm.
“Here at UHealth, we have the most advanced technology,” Dr. Mitrani said. “With it, we apply highly controlled electrical pulses and can eliminate the electrical circuits that are triggering and causing fibrillation.”
This technology selectively targets the heart tissue responsible for the arrhythmia, reducing the risk of affecting neighboring structures such as the esophagus or nerves. It also significantly shortens the procedure time.
“With previous technology, the procedure could last between two and four hours. With PFA, in many cases we are talking about one to two hours, with an excellent safety profile,” Dr. Mitrani said.
UHealth’s Comprehensive Approach to Treating AFib
Dr. Mitrani also emphasizes the program’s comprehensive approach.
“We are leaders in this area because, first of all, we have a specialized atrial fibrillation center,” he said. “It is not just about performing a procedure. We treat the patient, alongside all the necessary specialists. That way we can reduce risk factors and choose the best strategy between medications and ablation.”
In Goble’s case, medications were not enough. She was treated with beta blockers and cardiac glycosides, but episodes would wake her in the middle of the night.
“The tachycardia would wake me up,” she said. “It’s like an elephant sitting on your chest.”
Eating became a challenge and walking a constant concern. She lived calculating every movement, afraid of another episode. But the decision to undergo pulsed field ablation was not immediate.
“After so many procedures for cancer, I didn’t want another one,” she said.
The fear was understandable. But so was the exhaustion of living in anticipation of the next irregular heartbeat. Finally, she agreed.
A Patient’s Story: Life After Pulsed Field Ablation
“Thank God, Dr. Mitrani performed the ablation and now I feel brand new,” Goble said. “I didn’t feel anything. They told me I might have pain from the groin entry site, but I had none. It was a great relief.”
The ablation was performed a year ago. Since then, her progress has been excellent. Goble has not experienced any recurrence of atrial fibrillation. She now sleeps peacefully. Walks without fear. She eats without anxiety. She dances again while cleaning her house.
At UHealth, the approach to atrial fibrillation is comprehensive and multidisciplinary, incorporating blood pressure control, sleep apnea management, weight management and other conditions that influence arrhythmia. Technology is key but so is human support.
“It’s the best decision I’ve made in my life,” Goble said. “Honestly, they gave me a new life.”
Article based on video written and produced by Shirley Ravachi for Cuidando Su Salud, a series of health care stories regularly broadcast on Telemundo 51.
More from Miller School Cardiovascular Medicine
The Miller School’s Dr. Jeffrey Goldberger predicts substantial advances in the treatment of cardiac arrhythmia.
Miller School cardiovascular medicine researchers have created a risk factor modification program for atrial fibrillation patients.
An international array of cardiovascular specialists showcased the field’s latest imaging tools, devices and interventional procedures.
Dr. Litsa Lambrakos joined leaders in cardiac electrophysiology to rethink how to care for people with persistent atrial fibrillation.
Tags: arrhythmia, atrial fibrillation, cardiac electrophysiology, Cardiovascular Division, Dr. Raul Mitrani, heart care, heart disease, Newsroom