Marshfield Clinic first in Wisconsin to use new heart arrhythmia technology – Wausau Pilot & Review

A New Dawn for Cardiac Care in Wisconsin

In a landmark development for healthcare in the Badger State, Marshfield Clinic Health System has announced it is the first institution in Wisconsin to successfully utilize a revolutionary new technology for treating heart arrhythmias. This pioneering step places the health system at the vanguard of cardiac electrophysiology and offers new hope to thousands of patients suffering from irregular heartbeats, most notably Atrial Fibrillation (AFib). By adopting this state-of-the-art approach, Marshfield Clinic is not only enhancing patient safety and treatment outcomes but is also setting a new standard of care for the entire region, ensuring that world-class medical innovation is accessible right here in the heart of Wisconsin.

The introduction of this technology represents one of the most significant advancements in the field in over a decade. It addresses the core challenge of traditional treatments: how to effectively correct the heart’s faulty electrical pathways without inadvertently harming adjacent, healthy tissues. This breakthrough procedure offers a more precise, efficient, and significantly safer alternative, promising to transform the patient experience and redefine the long-term management of complex heart rhythm disorders. For Wisconsinites living with the daily uncertainty of an arrhythmia, this news signifies a pivotal moment—a shift from management to a more definitive and safer resolution.

Understanding Atrial Fibrillation: The Silent Epidemic

To fully grasp the magnitude of Marshfield Clinic’s achievement, it is essential to understand the condition this new technology is designed to combat. Heart arrhythmias are common, but among them, Atrial Fibrillation stands out for its prevalence and its potentially devastating consequences.

What is Atrial Fibrillation (AFib)?

The human heart is an intricate electrical pump, beating in a steady, coordinated rhythm to circulate blood throughout the body. In a healthy heart, electrical signals originate in the sinoatrial (SA) node and travel in an organized fashion, causing the heart’s four chambers to contract in perfect sequence. In a patient with Atrial Fibrillation, this orderly process breaks down. Chaotic, rapid electrical impulses originate in the upper chambers of the heart (the atria), causing them to quiver, or “fibrillate,” instead of contracting efficiently.

This electrical storm leads to an irregular and often very fast heart rate. Patients may experience a range of symptoms, including heart palpitations described as a fluttering or racing sensation in the chest, profound fatigue, shortness of breath, dizziness, and chest pain. For some, AFib is asymptomatic and is only discovered during a routine physical. However, the absence of symptoms does not diminish the danger. The inefficient pumping of blood can lead to pooling in the atria, which dramatically increases the risk of blood clot formation. If a clot travels to the brain, it can cause a severe, often debilitating stroke. In fact, AFib is responsible for a five-fold increase in stroke risk and is also a leading contributor to heart failure and other cardiovascular complications.

The Scope of the Problem in Wisconsin and Beyond

Atrial Fibrillation is not a rare condition; it is the most common heart rhythm disorder in the world. The Centers for Disease Control and Prevention (CDC) estimates that as many as 6 million people in the United States currently live with AFib, a number projected to double to 12 million by 2030 as the population ages. The burden is felt acutely in states like Wisconsin, with its significant rural and aging demographic.

The impact of AFib extends far beyond the physical symptoms. It carries a heavy psychological toll, with patients often living in constant fear of their next episode or the risk of a stroke. The economic burden is also staggering, accounting for billions of dollars in healthcare costs annually due to hospitalizations, chronic medication management, and treatment of complications like stroke and heart failure. Providing effective, long-term solutions for AFib is one of the most pressing challenges in modern cardiology.

The Evolution of Arrhythmia Treatment: A Journey to Precision

The medical community’s approach to treating AFib has evolved significantly over the decades. The ultimate goal has always been to restore a normal heart rhythm, reduce symptoms, and, most importantly, lower the risk of stroke.

From Medication to Ablation: The Standard Approach

The first line of defense against AFib has traditionally been medication. This includes drugs to control the heart rate (rate control) and antiarrhythmic drugs to restore and maintain a normal rhythm (rhythm control). Blood thinners are also prescribed to mitigate the risk of stroke. While medications are effective for many, they are not a cure. They often come with significant side effects, can lose their efficacy over time, and require lifelong adherence. For patients whose symptoms persist or who cannot tolerate the medications, a more invasive but definitive procedure known as catheter ablation becomes the next logical step.

Conventional Ablation Techniques: The Double-Edged Sword of Thermal Energy

Catheter ablation has been the gold standard procedure for AFib for nearly two decades. The procedure is performed by an electrophysiologist, a cardiologist specializing in the heart’s electrical system. A thin, flexible tube (a catheter) is guided through a blood vessel, typically in the groin, and up to the heart. The goal is to identify the areas in the atria—most commonly around the pulmonary veins—that are firing the erratic electrical signals causing the AFib.

Once identified, the electrophysiologist uses energy to create small, precise scars. This scar tissue does not conduct electricity and therefore forms a barrier that blocks the faulty signals, allowing the heart’s natural pacemaker to resume control. The energy used to create these scars has historically been thermal, meaning it relies on extreme temperatures:

• Radiofrequency (RF) Ablation: This method uses heat, delivering radiofrequency energy to the tip of the catheter to cauterize and destroy the targeted heart tissue.
• Cryoablation: This method uses extreme cold. A specialized “cryoballoon” is inflated at the opening of the pulmonary veins, and a refrigerant is used to freeze and scar the tissue.

Both RF and cryoablation have proven highly effective in treating AFib, providing lasting relief for a majority of patients. However, their reliance on thermal energy is their greatest liability. The heat or cold can spread beyond the intended heart muscle, potentially damaging critical surrounding structures. The esophagus, which runs directly behind the heart, the phrenic nerve, which controls the diaphragm, and the pulmonary veins themselves are all at risk. While rare, these complications can be severe, leading to significant morbidity. This inherent risk has been the driving force behind the search for a safer, more targeted method of ablation.

A New Era in Cardiac Care: Marshfield Clinic Adopts Pulsed Field Ablation

The “new technology” now in use at Marshfield Clinic addresses the fundamental limitations of thermal ablation head-on. This revolutionary approach is known as Pulsed Field Ablation (PFA), and it represents a paradigm shift in the field of electrophysiology.

Introducing the Groundbreaking Technology: How PFA Works

Pulsed Field Ablation does not rely on extreme temperatures. Instead, it uses a series of very short, high-voltage electrical pulses to create a therapeutic effect. This process, known as irreversible electroporation, targets the cell membranes of the heart muscle cells (cardiomyocytes). The electrical fields create microscopic pores in these membranes, leading to cell death in a controlled and predictable manner. The ablated tissue is then naturally replaced by scar tissue, forming the necessary electrical block.

The true genius of PFA lies in its remarkable *tissue selectivity*. Different types of cells have different thresholds for succumbing to electroporation. Heart muscle cells are uniquely susceptible to this process, while other tissues—such as the delicate nerve cells of the phrenic nerve or the smooth muscle cells of the esophagus and blood vessels—are far more resilient. This allows the electrophysiologist to ablate the necessary heart tissue with surgical precision while leaving the surrounding critical structures virtually untouched. It effectively removes the risk of collateral damage that has long been the primary concern with thermal ablation.

The Patient Advantage: Safety and Efficacy Redefined

For patients, the adoption of PFA at Marshfield Clinic translates into a host of tangible benefits that fundamentally improve the treatment experience:

• Unprecedented Safety Profile: The near-elimination of risk to the esophagus, phrenic nerve, and pulmonary veins is the most significant advantage. This dramatically reduces the chance of rare but life-altering complications, providing peace of mind for both the patient and the physician.
• Increased Procedural Efficiency: PFA procedures are often significantly faster than their thermal counterparts. The delivery of energy is rapid and effective, which can reduce the total time a patient is under anesthesia, potentially lowering the risk of procedure-related complications and improving workflow in the cardiac catheterization lab.
• High Efficacy: Major clinical trials for FDA-approved PFA systems have demonstrated excellent outcomes, with high rates of freedom from AFib at one year, comparable or even superior to the best results from thermal ablation.

Marshfield Clinic’s Pioneering Role and Commitment to Innovation

By becoming the first healthcare system in Wisconsin to perform a procedure with this cutting-edge PFA technology, Marshfield Clinic Health System has solidified its reputation as a leader in cardiovascular medicine. Adopting a technology of this caliber is a complex and resource-intensive undertaking, requiring significant investment in new equipment and, crucially, a deep commitment to specialized training for its team of electrophysiologists, nurses, and technicians.

“Bringing Pulsed Field Ablation to our patients is a momentous occasion for our entire cardiac program and for the people of Wisconsin,” said a representative from Marshfield Clinic’s cardiology department. “Our mission has always been to provide the highest quality of care, and that means relentlessly pursuing innovation that directly translates to better, safer outcomes for our patients. PFA is not just an incremental improvement; it’s a transformative technology that allows us to treat Atrial Fibrillation more effectively and with a level of safety we could only dream of a few years ago. We are incredibly proud to be the first in the state to offer this to the communities we serve.”

The Ripple Effect: What This Means for Wisconsin and the Midwest

The significance of this development extends far beyond the walls of Marshfield Clinic. It is a catalyst that will elevate the standard of cardiac care across the entire region.

Raising the Standard of Care Across the State

When a respected institution like Marshfield Clinic adopts a new gold standard, it creates a powerful ripple effect. It sets a new benchmark for patient expectations and puts pressure on other healthcare systems to follow suit. This healthy competition ultimately benefits all patients in Wisconsin, who will increasingly have access to the latest and safest medical technologies without needing to travel out of state to major coastal medical centers. It democratizes access to elite medical care, bringing it closer to home for rural and urban populations alike.

A Hub for Advanced Cardiac Treatment in the Heartland

This move strategically positions Marshfield Clinic as a destination center for complex arrhythmia management. Patients and referring physicians from across Wisconsin, as well as neighboring states like Minnesota, Michigan, and Iowa, will now see Marshfield as a hub for the most advanced electrophysiology procedures available. This not only enhances the clinic’s reputation but also strengthens the state’s overall standing as a center for medical excellence and innovation.

The Future of Electrophysiology is Here

Pulsed Field Ablation is widely regarded as the future of the field, and its adoption is just the beginning. The technology is rapidly evolving, with ongoing research exploring its use for other types of arrhythmias and further refining its application. By getting in on the ground floor, Marshfield Clinic is not just a user of this technology but is now part of the vanguard shaping its future use. This leadership role can attract top medical talent, foster research opportunities, and ensure that the clinic remains at the forefront of cardiovascular medicine for years to come.

The Patient Journey and Eligibility: Who Can Benefit?

With this exciting new option available, many patients with AFib will be wondering if they are a candidate for the procedure.

The Ideal Candidate for the New Procedure

Pulsed Field Ablation is primarily intended for patients with symptomatic Atrial Fibrillation who have not responded adequately to or cannot tolerate antiarrhythmic medications. This includes patients with both:

• Paroxysmal AFib: Episodes that start and stop on their own.
• Persistent AFib: Episodes that last for more than seven days and require intervention to stop.

A comprehensive evaluation by an electrophysiologist at Marshfield Clinic is necessary to determine if PFA is the most appropriate course of treatment. This evaluation typically includes a review of the patient’s medical history, an electrocardiogram (ECG), an echocardiogram to assess heart structure and function, and possibly other heart monitoring tests.

What to Expect: The Procedure and Recovery

For an eligible patient, the journey begins with a detailed consultation where the procedure, its benefits, and any residual risks are discussed. The procedure itself is minimally invasive and performed in a specialized cardiac catheterization lab under general anesthesia.

The electrophysiologist guides the PFA catheter to the heart, and using advanced 3D mapping systems, precisely targets the areas around the pulmonary veins. The delivery of the PFA energy is remarkably quick, often taking just a few seconds for each application. Because of the efficiency of the technology, the overall procedure time is typically shorter than traditional ablation procedures.

Following the procedure, patients are monitored overnight in the hospital and are usually discharged the next day. Recovery is generally quick, with most patients able to return to their normal, non-strenuous activities within a few days. The full therapeutic effect of the ablation can take a few weeks to set in as the ablated tissue heals, but the long-term outlook is exceptionally positive, with a high likelihood of a life free from the burden of AFib.

Conclusion: A Heartbeat of Innovation in America’s Dairyland

Marshfield Clinic Health System’s successful implementation of this new heart arrhythmia technology is more than just a medical first for Wisconsin; it is a profound statement of commitment to patient safety and clinical excellence. By embracing Pulsed Field Ablation, the clinic has taken a decisive step into the future of electrophysiology, offering a treatment that is not only highly effective but also dramatically safer than its predecessors.

This milestone brings a new level of hope and a higher quality of life within reach for thousands of individuals across the state who are impacted by Atrial Fibrillation. It ensures that the citizens of Wisconsin have access to the very best cardiac care available anywhere in the world, right here at home. In the ongoing fight against heart disease, this pioneering move represents a strong, steady, and innovative new heartbeat in America’s Dairyland.