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.