In early Spring, 2024, the Electrophysiology team at the Heart and Vascular Institute of Eastern Kentucky at Pikeville Medical Center (PMC) made history during a procedure to treat atrial fibrillation (AFib) in a 55-year-old patient. PMC Electrophysiologist Joseph Souza, MD, was preparing to perform a routine catheter ablation on the patient when it was discovered the patient had an extremely rare heart condition.

Instead of having one muscular wall separating the upper chambers of the heart, there were two, a heart anomaly that had only been documented 18 times worldwide. This required Dr. Souza and his team to take a different approach to treating the patient, ultimately deciding to use advanced technology available at PMC to perform a procedure that had never been documented before.

During this minimally invasive procedure, Dr. Souza used a balloon septostomy to allow a catheter to successfully pass through the double-wall septa and move from the right atrium of the heart to the left. He then utilized the state-of-the-art Medtronic PulseSelect Pulsed Field Ablation (PFA) System to deliver pulsed electric fields through an ablation catheter designed specifically to interrupt the irregular electrical pathways in the heart that trigger AFib.

The members of the electrophysiology (EP) team at the Heart and Vascular Institute of Eastern Kentucky at PMC were thrilled to perform this procedure, knowing they had successfully navigated new territory in the treatment of atrial fibrillation. Dr. Souza was assisted by PMC Electrophysiologists Dr. Chase Reynolds, Dr. Rahul Dhawan and Dr. Michael Antimisiaris in addition to PMC Cardiologist Dr. Raymon Nelson.

“To our knowledge, we reported the first case of this kind utilizing the PFA technology,” explained Dr. Souza. “We wanted to share this news with the medical community and other electrophysiologists with the hope that they may find this technique helpful when dealing with difficult cases. This could have not happened without the support we consistently receive from the administration at Pikeville Medical Center.”

Dr. Souza and the EP team at PMC submitted an article detailing the novel procedure to Heart Rhythm Case Reports, the premier medical journal in the field of electrophysiology. The article was published within weeks, spreading the news of this history-making event worldwide.

“As we look to improve cardiovascular care in the region, PMC strives to utilize the latest technology available to meet the needs of our patients and our physicians,” explained PMC Chairman, President and CEO Donovan Blackburn. “This is most certainly a monumental moment for our medical center and our entire region.”

The EP team at Pikeville Medical Center first made headlines using PFA in February 2024, becoming one of the first hospitals in the United States to utilize this advanced technology to treat AFib.

For more information on the Heart and Vascular Institute of Eastern Kentucky at Pikeville Medical Center, visit https://www.pikevillehospital.org/heart/.

To read the article published in Heart Rhythm Case Reports, visit: https://www.heartrhythmcasereports.com/article/S2214-0271(24)00098-8/fulltext