'A huge change': New Mexico completes its first ever Farapulse procedure

Growing up in El Paso, Joe Udell used to spend much of his free time racing bikes. From the age of 14, he rode nearly every weekend in El Paso and neighboring Ciudad Juárez. This weekend passion would turn into a lifelong one of competing in bike races.

Now 65 and living in Santa Fe, Udell has been retired from competitive racing for the past decade. He still rides bikes, but at a much slower pace.

“I don’t miss turning myself inside out for the competitions,” he said.

After a lifetime of vigorous physical activity, the last thing Udell expected to deal with would be an irregular heartbeat. But last year, he began to notice some strange sensations.

“When your heart beats at 150, 180 beats (per minute) when you’re sitting on the sofa, that’s not right,” he said. “It felt like my heart was going to jump out of my chest.”

Concerned, Udell saw his doctor, who fitted him with a holter monitor to keep track of his heart rhythm.

In addition to the monitor, Udell also changed his thyroid medicine and adjusted his magnesium intake, but neither had any affect on his heartbeat. In March, he was referred to a specialist at the Heart Hospital of New Mexico at Lovelace Medical Center, and Dr. Sean Mazer, an electrophysiologist with the New Mexico Heart Institute/Lovelace Medical Group.

“It’s common for people who do endurance athletics for a long time to develop (an arrhythmia),” Mazer said.

An arrhythmia is a disturbance in the heart’s electrical function, causing the sinoatrial node, the body’s natural pacemaker, to malfunction and fire abnormally, leading to the irregular heart rhythm.

The pair began discussing a treatment plan and looked at options like medication to treat the irregular heartbeat. Given Udell’s active lifestyle, the pair decided against medication , citing the possibility of side effects. The next treatment option was procedural. Normally, surgery to treat a heart arrhythmia would take five to six hours after perhaps a monthslong wait for the procedure, according to Mazer.

That may have been the norm before but maybe not in the future, thanks to new medical technology. Approved by the U.S. Drug and Food Administration in January, the Farapulse pulsed field ablation system is a breakthrough in the field of heart arrhythmia treatment. Built by Boston Scientific, the Farapulse system utilizes an over-the-wire catheter, which is a catheter with two lumens, one larger for the guidewire and a smaller wire that can orient itself into several shapes, including a basket and flower, to deliver the pulse field applications. The applications are electric pulses that target misfiring cardiac muscles, restoring a normal heartbeat rhythm.

The procedure consists of inserting the catheter into a blood vessel in a person’s thigh and running it into the pulmonary veins in the heart. Once inside the veins, the front end of the catheter opens up into the shape of a basket and uses an electrical pulse field to shock portions of the veins, correcting the misfiring sensors and helping to regulate the heartbeat. The catheter performs four pulse field applications in the form of the basket against the interior of the pulmonary veins, then reorientates its shape into a flower and performs four more electrical pulse field applications.

The eight total applications each last roughly 2.5 seconds and create scars within the veins that help block signals to the heart that lead to an arrhythmia.

The revolutionary procedure had never been performed before in New Mexico. After several conversations, however, Udell and Mazer concluded that it would be the best path forward.

“Joe and I had a conversation the morning of the procedure, and (he) liked the idea of the procedure because it was a bit faster and he could recover quicker,” Mazer said. “Both of us know that there’s a risk being first in anything, but I think access to the technology and the faster healing was the selling point.”

The uncertainty of being the first in New Mexico to have the procedure done only hit Udell for a brief second, he said, but it quickly faded when we realized he was going to be monitored by a room full of people.

“The way I looked at it was everybody in the room was going to be on high alert,” Udell said, “so I figured I was going to get as good or even better care as I would have with any other procedure.”

On the morning of April 15, Udell arrived at the Heart Hospital and entered the operating room in the electrophysiology lab.

“We put a bunch of stickers on him that allowed us to see the catheter inside his heart, and then he goes off to sleep under general anesthesia,” Mazer said.

The procedure lasted about an hour and a half. The team then pulled the catheter from Joe’s body, stitched the entry point cut on his leg and, an hour later, removed the stitch. Around 12:30 p.m., Udell went home to recover.

Udell, who was eager to get back on his bike, waited seven days before climbing onto his stationary bike at home. When he did, he said, it was like he had a new lease on life.

“I felt brand new, just to get the legs moving again and the sense that my heart rate way manageable, I felt invigorated,” he said.

With the first Farapulse procedure under their belt, Mazer and the rest of the electrophysiology staff at the Heart Hospital have completed an additional 13 procedures.

For Mazer, who has been practicing electrophysiology since the 1990s, the new technology will allow him and his team to help more New Mexicans.

“My whole career has been about innovation, and part of being a electrophysiologist is constantly improving your tools,” he said. “Procedures like Joe’s are a huge change, and it’s important that the technology has improved so we can treat more people.”

Gino Gutierrez is the good news reporter at the Albuquerque Journal. If you have an idea for a good news story, you can contact him at goodnews@abqjournal.com or at 505-823-3940.