Morning at Royal Victoria Hospital
It's early morning, and nurses are preparing to take Michael Robinson to theatre. Michael has been living with atrial fibrillation (AF), a prevalent heart rhythm disorder affecting 1.4 million people in the UK. This condition causes the heart to beat irregularly and often too rapidly.
"It's very debilitating. On my worst day I feel very tired, my heart rate increases rapidly - I could walk for 2 or 3 miles and be okay, I could walk for 100 yards and it would hit me."
Michael was diagnosed with AF five years ago after the death of his younger brother from a heart condition. He is now hopeful that a new, cutting-edge treatment will significantly enhance his quality of life.
"I got quite a shock when I was diagnosed as I had been pretty active but after my younger brother died, we all got checked out and I was diagnosed with AF five years ago, I'd never heard of it," Michael said.
"I was to go on holiday and had to pull out and recently attended a wedding reception but had to come home after half an hour, hopefully this treatment will normalise things for me."
Introducing the Volt Pulsed Field Ablation System
Belfast's Royal Victoria Hospital (RVH) is the first hospital in the UK to trial the Volt Pulsed Field Ablation System (VPA), a procedure designed to stop irregular heart rhythms when medication is ineffective.
This innovative treatment offers several advantages, including the ability to treat up to three patients daily compared to just one with previous methods, and a faster recovery time.
Patients undergo the procedure under conscious sedation, eliminating the need for an anaesthetist. Additionally, patients are admitted and discharged on the same day, which helps free up valuable hospital beds.
"It's a wee bit scary, but I've a lot of faith in the staff," the 67-year-old said as he went to theatre.
What is Atrial Fibrillation?
A normal heart rate ranges between 60 and 100 beats per minute. In individuals with AF, the heart rate can exceed 100 beats per minute significantly.
AF is a progressive condition that increases the risk of stroke and heart failure. Symptoms include a fast, irregular, or pounding heartbeat (palpitations), dizziness, fatigue, shortness of breath, and chest discomfort.
It is estimated that many people live with AF undiagnosed and unaware of the associated health risks. Episodes can begin suddenly and last from seconds to days, sometimes occurring without any symptoms.
Trial Progress and Benefits
Sixty patients have been treated at RVH during the trial phase.
"This benefits the hospital when it comes to patient flow and addressing waiting lists, also there is no need for an anaesthetist which is good as there is a global shortage of specialists," said Dr Nick Cromie, a cardiac Electrophysiologist.
Dr Cromie explained that the Volt PFA System uses high-energy electrical pulses to precisely target and treat abnormal cardiac tissue. This approach minimizes the risk of damage to surrounding structures such as the oesophagus or blood vessels.
"This system is a big step forward in both patient safety and the hospital being a lot more efficient with its staff and use of theatre time," he added.
Dr Cromie, one of several consultants at RVH performing the procedure, emphasized that the goal is to prevent more serious illnesses such as stroke and heart attack.
"We entered the bloodstream at the top of the inner thigh and then travelled up through the bloodstream all the way up to Michael's heart - where we punctured a small hole to access the chamber where the problem is and then inflated a small balloon.
That helps us conduct electrical signals in the catheter into the heart tissue which needs treated," he explained.
Expansion and Expert Opinions
Following the pilot in Belfast, some hospitals in England are preparing to adopt the Volt PFA system, developed by the global healthcare company Abbott.
Dr Riyaz Somani, consultant cardiologist at the University Hospitals of Leicester NHS Trust, was the first electrophysiologist in England to use the new system.
"Our initial experience has been overwhelmingly positive, with all patients tolerating the procedure very well with excellent acute success rates," he said.
Previous Treatments and Patient Outcome
Michael had previously undergone cryotherapy, a minimally invasive procedure that freezes and destroys small areas of heart tissue causing irregular heartbeats. However, this treatment often results in discomfort, including gastric upset, and many patients do not achieve full recovery.
Seven hours after his procedure, Michael was ready to leave the hospital.
"The Royal Victoria Hospital has been so good to me - I am feeling much better already – in fact I might even go and play a game of football," he said laughing.
