Introduction

What is Atrial Fibrillation?

Atrial fibrillation (AF) is a common heart rhythm disorder characterized by irregular and often very rapid heartbeats. It is divided into three types:

  • ● Paroxysmal AF: Episodes last for less than 7 days, usually resolving within 24 hours
  • ● Persistent AF: Episodes last longer than 7 days
  • ● Permanent AF: Continuous AF lasting for more than a year

It is estimated that about 1% of the population in Hong Kong (over 70,000 people) suffer from AF. Although AF may not be immediately life-threatening, it is a chronic condition that can lead to serious complications if left untreated.

AF is associated with significantly increased health risks:

  • ● Stroke: 5 times higher risk than individuals without AF
  • ● Heart failure: 3 times higher risk
  • ● Heart attack: Approximately 70% higher risk
  • ● Dementia: Approximately 40% higher risk
  • ● All-cause mortality: 4 times higher risk

Early diagnosis and treatment are important to reduce these risks and improve quality of life.

Causes

Causes

  • ● Structural changes in the heart (e.g. valve disease, hypertension, heart failure)
  • ● Coronary artery disease
  • ● Hyperthyroidism
  • ● Sleep apnea
  • ● Excessive alcohol or caffeine intake
  • ● Genetic predisposition
  • ● Aging
Symptoms

Symptoms

  • ● Palpitations or rapid heartbeat
  • ● Fatigue or weakness
  • ● Dizziness or light-headedness
  • ● Shortness of breath
  • ● Chest discomfort
  • ● Fainting spells (in severe cases)
  • ● Some patients may be asymptomatic
Operation

The Atrial Fibrillation (AF) Pulsed Field Ablation (PFA) Procedure

Pulsed Field Ablation (PFA) is an advanced, minimally invasive treatment for atrial fibrillation. It uses high-amplitude electric fields delivered in microsecond pulses to selectively and irreversibly disrupt abnormal heart tissue without damaging surrounding structures.

Approved by the U.S. FDA, PFA is suitable for patients with persistent or permanent AF. Our center was the first private hospital in Hong Kong to introduce this technology in February 2023.

Advantages of PFA include:

  • ● Minimally invasive approach
  • ● High precision with minimal injury to nearby tissues
  • ● Rapid pulmonary vein isolation (≈3 minutes per vein)
  • ● Shorter procedure time
  • ● Reduced need for general anesthesia

Advantages of PFA include:

The procedure is performed in the Cardiac Catheterization & Intervention Laboratory (CCIL) under either general anesthesia (GA) or monitored anesthesia care (MAC). During the procedure, electrodes and monitoring devices are attached to track heart rhythm, blood oxygen levels, and blood pressure.

Catheters are inserted through veins in the groin and carefully guided into the heart using X-ray imaging. Once in position, electrical pulses are delivered through the catheters to ablate the abnormal heart tissue causing arrhythmia.

The entire procedure usually takes approximately three hours. After completion, patients are observed in the hospital for 12 to 24 hours to monitor recovery and ensure no immediate complications arise.

Notice

Postoperative Care

  • ● You may be discharged the day after the procedure.
  • ● Keep the wound clean and dry. If the dressing becomes wet, please replace it. Showers are allowed after 2 days.
  • ● Avoid vigorous activities, heavy lifting, or exercise for the first 7 days.
  • ● Bruising around the wound is common and usually resolves within 2–3 weeks.
  • ● If you notice bleeding, swelling, infection, or severe pain around the wound site, return to the hospital or visit the emergency department immediately.
  • ● Follow-up appointments will be arranged. Family members are encouraged to attend to discuss treatment outcomes and next steps.

For further information, please consult your attending doctor or cardiologist. 

The above information is for reference only. As each patient’s condition may vary, please consult your doctor for individual assessment and advice.