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Today we launched the new AFFERA system for the treatment of cardiac arrhythmias

Czech arrhythmologists are now using the Affera system to treat heart rhythm disorders. Two Prague institutions - IKEM and the Na Homolce Hospital - have been involved in its development and clinical testing since 2018. Today, for the first time ever, doctors have used it in practice.

The unique AFFERA system helps to map and treat cardiac arrhythmias. Experts from the Na Homolce Hospital and IKEM have been involved in its development and clinical testing since 2018. The system is unique in that it is a full-fledged three-dimensional mapping system that uses a special catheter with a grid electrode at the end. It is a spherical nitinol mesh that, when stretched, has a diameter of 9 mm and 9 microelectrodes on its surface that can sense electrical signals as well as tissue temperature. This catheter is used to create a three-dimensional map of the relevant cavity, such as the left atrium and the pulmonary veins, and then either a higher energy radiofrequency current or pulsed field energy is applied through that electrode. The choice depends on the site where the ablation (destruction of abnormal tissue in the heart that is responsible for causing or maintaining the cardiac arrhythmia) is performed and the surgeon's decision.

"Experience to date has shown that ablation is very effective because larger lesions are created very quickly within 3-5 seconds. In our testing, we used radiofrequency current to ablate the atrial flutter, where a bridge of tissue in the right atrium of about 3.5 cm in length is interrupted, within 1-2 minutes of total time. Just for comparison, ablation of this bridge with a conventional catheter can take 30 minutes and can be difficult to complete successfully due to tissue swelling," says Prof. Josef Kautzner, MD, CSc, Head of the IKEM Cardiac Centre, about the new system. FESC. He also pointed out that the use of the pulsed field is also completely safe and the efficiency can be comparable in many places.

A new system for ablating ventricular arrhythmias in patients with heart disease, such as a large scar after a myocardial infarction or after cardiac inflammation, holds great promise. Preliminary experience from clinical testing suggests that ablation in this indication is fast and effective. "It is natural for all arrhythmologists to want catheter ablations to be as effective and safe as possible. And it's great that technological developments are helping us to do just that. The new method, pulsed-field ablation, which we have been working on intensively for several years and have had excellent results with, uses ultra-short pulses of nanoseconds in length with high voltages that create virtually no thermal effect. We have performed more than 200 procedures with the new Affera system in clinical trials at Homolka, which represents the largest number of patients treated with this new method worldwide. Together with the unique properties of potential mapping, it represents an important step in achieving significantly more effective therapy for cardiac arrhythmias, said Prof. Petr Neužil, CSc, FESC, Head of the Cardiology Department.

The Czech Republic is one of the leading countries in the world in the number of ablations per million inhabitants. Thanks to the new non-thermal catheter ablation technology, which is highly selective, the situation will improve even further.