Atrial fibrillation (A-fib) is the most common heart rhythm disorder and a major contributor to stroke risk, heart failure, hospitalizations, and diminished quality of life. Northside Hospital Heart Institute is highlighting how advances in electrophysiology and structural heart technology are transforming A-fib care — offering patients safer procedures, improved outcomes, and more individualized treatment strategies.
Northside’s A-fib program is built on three core pillars: state-of-the-art catheter ablation technology, including pulse field ablation; a comprehensive, high-volume electrophysiology infrastructure with deep procedural expertise; and advanced stroke-prevention therapies, such as left atrial appendage occlusion (LAAO) using the WATCHMAN™ and Amplatzer™ Amulet™ devices. Together, these capabilities allow Northside to deliver leading-edge, patient-centered care across the full spectrum of atrial fibrillation management.
Pulse field ablation: The next major leap in A-fib treatment
Catheter ablation has long been a cornerstone therapy for patients with symptomatic A-fib who do not achieve adequate rhythm control with medications. Traditional ablation techniques use thermal energy such as radiofrequency heat or cryotherapy, to isolate the pulmonary veins and disrupt abnormal electrical signals. While effective, thermal approaches carry inherent risks related to collateral tissue injury.
Pulse field ablation (PFA) represents a major technological advance. PFA uses ultra-short, high-voltage electrical pulses that selectively affect heart muscle cells while minimizing injury to surrounding structures such as the esophagus, phrenic nerve, and pulmonary veins. This tissue selectivity has the potential to improve procedural safety while maintaining excellent efficacy.
Northside Hospital was an early adopter of PFA technology, including becoming the first hospital in Georgia to perform atrial fibrillation ablation using a pulse field ablation system. The program has continued to expand its PFA platform options, allowing physicians to tailor ablation strategies to each patient’s anatomy and A-fib pattern. Today, Northside is widely recognized as one of the highest-volume A-fib ablation centers in the Southeastern United States, a distinction that reflects both patient trust and clinical excellence.
Leadership in fluoroless (radiation-free) ablation
A defining feature of Northside’s electrophysiology program is its commitment to minimizing radiation exposure whenever possible. Through the use of advanced three-dimensional electroanatomic mapping systems, intracardiac echocardiography, and refined procedural workflows, many ablation procedures can be performed with minimal or no fluoroscopy.
Research trials and early access to emerging technologies
High procedural volume and consistently strong outcomes position Northside to participate in advanced research and early-access technology initiatives. The A-fib program is actively involved in clinical research trials and limited market releases of next-generation tools that may further enhance patient care.
One example is Abbott’s Volt™ Pulse Field Ablation System, an investigational platform currently undergoing evaluation in the United States. Participation in such trials allows Northside physicians to help shape the future of A-fib treatment while offering eligible patients access to innovative therapies under carefully regulated research protocols. This commitment ensures that Northside patients benefit not only from today’s best practices, but also from tomorrow’s breakthroughs as they become available.
Who is typically eligible?
Treatment decisions for A-fib are highly individualized. Below are general eligibility considerations frequently discussed during consultation; final candidacy is determined after comprehensive evaluation by an electrophysiologist.
Pulse Field Ablation (A-fib Ablation)
Patients commonly considered for cardiac catheter ablation include those with:
- Symptomatic atrial fibrillation (paroxysmal or persistent) that impacts quality of life despite lifestyle modification and/or medication.
- A desire for rhythm control due to A-fib burden, symptoms, medication intolerance, or concerns about AF-related cardiomyopathy.
- Cardiac anatomy suitable for pulmonary vein isolation with a favorable risk-benefit profile.
Patients may not be immediate candidates if there is active infection, uncontrolled bleeding risk, or inability to tolerate anticoagulation around the time of the procedure. In some cases, alternative strategies may be recommended based on imaging and clinical factors.
Left atrial appendage occlusion: WATCHMAN and Amulet
For many patients with A-fib, stroke prevention is achieved with oral anticoagulant medications. However, some patients are unable to safely remain on long-term blood thinners. For these individuals, LAAO devices provide an alternative strategy by sealing off the left atrial appendage, where most AF-related blood clots form.
Typical eligibility includes:
- Nonvalvular atrial fibrillation
- Elevated stroke risk, commonly assessed using the CHA₂DS₂-VASc score
- A clear reason to avoid long-term anticoagulation, such as prior major bleeding, high bleeding risk, or medication intolerance
- Suitable left atrial appendage anatomy on transesophageal echocardiography or cardiac CT
Both WATCHMAN and Amulet are FDA-approved options. Device selection is based on appendage anatomy, procedural considerations, and individualized physician assessment.
In many cases, left atrial appendage occlusion can be performed at the same time as catheter ablation for atrial fibrillation, offering a more streamlined treatment approach. Emerging data also suggest that, for select patients, long-term oral anticoagulation may be safely discontinued following a successful ablation procedure. At Northside EP, we combine advanced expertise with a personalized approach, working closely with each patient through shared decision-making to determine the most appropriate and effective treatment strategy.
A patient-centered message
A-fib care is no longer one-size-fits-all. At Northside Hospital, patients have access to cutting-edge rhythm-control therapies like pulse field ablation, innovative fluoroless procedural techniques, and modern stroke-prevention alternatives when blood thinners are not the right long-term solution. Through high procedural volume, clinical expertise, and active research participation, Northside continues to lead the way — delivering both today’s most advanced care and tomorrow’s innovations.
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