What is the VARIPULSE Platform?

The VARIPULSE Platform from Johnson & Johnson MedTech is a pulsed field ablation system that works with the CARTO 3 mapping system. It includes the VARIPULSE Catheter, which maps the heart and delivers the pulses, and the TRUPULSE Generator, which produces them.

How is pulsed field ablation different from other types of ablation?

Radiofrequency ablation uses heat and cryoablation uses cold to create small scars in the heart tissue. Pulsed field ablation creates those scars with short electrical pulses instead of extreme temperatures. Your physician can explain which approach is appropriate for you.

What should I expect during the procedure?

The procedure is performed in an electrophysiology (EP) lab under sedation or anesthesia determined by your physician. Thin, flexible tubes called catheters are inserted through a vein in your groin and guided to your heart, where your physician maps the heart's electrical activity and delivers the pulses. The length of the procedure depends on your individual condition.

What are the pre-op instructions?

You will likely be asked to fast for 8 hours before the procedure. Your healthcare team will give you specific instructions about your medications. Arrange for transportation home, as you will not be able to drive after the procedure.

Should I stop taking my medications before the procedure?

Do not stop or change any medication, including blood thinners, unless your physician tells you to. Your physician will give you detailed guidance based on your current medication regimen.

What can I expect after the procedure?

You will be monitored in a recovery area and may feel groggy from the sedation. Some patients have minor discomfort at the catheter insertion site. All patients will go home the same day unless otherwise determined by your physician.

When should I seek medical attention after the procedure?

Seek immediate medical attention if you experience chest pain, difficulty breathing, excessive bleeding or swelling at the catheter insertion site, fever, or signs of infection such as redness or discharge. Also contact your physician if you notice new or worsening symptoms related to your heart rhythm.

Procedure Details

Pulsed Field Ablation

Pulsed field ablation (PFA) is a catheter-based procedure that uses short electrical pulses, rather than heat or cold, to treat atrial fibrillation.

What is Pulsed Field Ablation?

Pulsed field ablation (PFA) is a catheter-based procedure used to treat atrial fibrillation (AFib), a common type of irregular heartbeat. Like other forms of cardiac ablation, it creates tiny scars in the heart tissue that block the abnormal electrical signals causing the arrhythmia. Instead of using heat (radiofrequency) or cold (cryoablation), PFA delivers short electrical pulses to the targeted tissue.

With the VARIPULSE™ Platform, PFA is used for pulmonary vein isolation (PVI). PVI targets the openings of the pulmonary veins, the blood vessels that enter the heart's left upper chamber, to block abnormal electrical signals from reaching the rest of the heart.

The VARIPULSE™ Platform

Our electrophysiology (EP) lab uses the VARIPULSE™ Platform from Johnson & Johnson MedTech, a PFA system that works directly with the CARTO™ 3 mapping system. The platform includes:

VARIPULSE™ Catheter: A loop-shaped catheter that adjusts from 35 mm to 25 mm to fit your anatomy. Its 10 electrodes map the heart's electrical activity, deliver the pulses, and can pace the heart.
TRUPULSE™ Generator: The console that produces the pulse sequence, which is tailored to the catheter's design.
CARTO™ 3 System: The mapping system that shows the catheter on a 3-D view of your heart.

How the Platform Supports Your Physician

Checking Tissue Contact: A Tissue Proximity Indicator shows which electrodes are in contact with the heart tissue before, during, and after each ablation.
Tracking Treatment: The VARIPULSE™ Software Module marks treated locations on the 3-D map, which helps your physician see any areas around the pulmonary vein opening that still need treatment.
Viewing the Catheter: Because the catheter appears on the map, the integrated system may reduce the need for multiple ways of visualizing it during the procedure.

Johnson & Johnson MedTech reports that, in preclinical studies, the platform's pulse sequence showed tissue-selective properties and preserved the structure of the tissue. Your physician can explain what this may mean for you. You can read more on the manufacturer's website, which is written for healthcare professionals.

Why is the Procedure Performed?

The goal of pulsed field ablation is to treat AFib and reduce symptoms such as palpitations, shortness of breath, and fatigue. Your physician will determine whether PFA is an appropriate option based on your type of arrhythmia, your health history, and your treatment goals.

How is the Procedure Performed?

Pulsed field ablation is performed in our EP lab under sedation or anesthesia determined by your physician. The process involves:

Catheter Insertion: Thin, flexible tubes (catheters) are inserted through a vein in the groin and guided to the heart.
Mapping: The catheter's electrodes and the CARTO™ 3 System map the heart's electrical activity in 3-D to guide treatment.
Ablation: Your physician positions the catheter's loop at the opening of each pulmonary vein and delivers short electrical pulses, creating small scars that block the abnormal signals.
Monitoring: Your physician uses the map to check for any untreated areas and monitors the heart's activity to confirm the result before the catheters are removed.

What are the Risks and Benefits of the Procedure?

Benefits:
- Can reduce how often AFib occurs and how severe it is.
- Improvement in symptoms and quality of life.
Risks:
- As with any procedure involving the heart, there are risks, though serious complications are rare. These can include bleeding or infection at the catheter insertion site, damage to the heart or blood vessels, blood clots, stroke, and in rare cases, worsening of the arrhythmia or the need for a pacemaker.
- Your physician will review the risks that apply to you before the procedure.

Preparing for Pulsed Field Ablation

Tip: Prepare for your procedure by visiting our patient instructions page.

Pre-op Instructions

Fasting: You will need to fast (not eat or drink) for 8 hours before the procedure.
Medication Review: Discuss all medications you are taking with your physician. Do not stop any medication, including blood thinners, without first consulting your healthcare provider.
Pre-Procedure Testing: You may undergo tests, such as blood tests, an EKG, or imaging studies before your procedure.

What to Bring to the Surgery Center

A List of Medications: Bring a list of your current medications, including doses and how often you take them.
Personal Items: Wear loose-fitting clothing to the procedure and leave valuables at home.
Medical Insurance Information: Have your medical insurance card and any necessary medical documents or referrals with you.

What to Expect After the Procedure

Immediate Post-op: You will be taken to a recovery area to be monitored. You may need to lie flat for several hours to prevent bleeding from the catheter insertion site.
Activity Restrictions: Avoid strenuous activities and lifting heavy objects for a period of time as advised by your physician.
Site Care: Keep the catheter insertion site clean and dry, and follow your physician's instructions on how to care for it.

When to Seek Medical Attention

Emergency Symptoms: If you experience chest pain, difficulty breathing, excessive bleeding or swelling at the catheter insertion site, fever, or signs of infection, seek medical attention immediately.
Concerns: Contact your physician if you have questions or concerns about your recovery, especially if you notice changes in your heart rhythm or other new symptoms.