Why earlier action could improve outcomes for people with atrial fibrillation

A growing number of people across Asia Pacific are living with a common heart rhythm disorder that can raise the risk of stroke and heart failure.

A racing heartbeat, breathlessness during mild exertion or an unexplained drop in energy can be easy to dismiss. But for some people, these may be signs of atrial fibrillation (AFib) – an irregular heart rhythm that can raise the risk of stroke, heart failure and premature death.

AFib is becoming a growing healthcare concern across Asia Pacific. “As populations age and cardiovascular risk factors such as hypertension, obesity and diabetes continue to rise, the number of people affected is expected to grow,” said Dr Ahmed Abdelaal, Boston Scientific’s chief medical officer for the Asia-Pacific region.

“AFib can also significantly affect a patient’s quality of life, including their energy levels, ability to work, confidence in daily activities and emotional well-being.”

These patient and healthcare system pressures form the backdrop to a new Boston Scientific report, PFA in APAC, from Promise to Practice, which says earlier diagnosis, timely referrals and better access to newer treatments could help more patients across Asia Pacific benefit from advances in AFib care.

Drawing on the perspectives of electrophysiologists, or heart rhythm specialists, in Australia, China, Japan and South Korea, it examines how advances in AFib treatment could reach eligible patients earlier.

Established catheter ablation treatments for AFib include radiofrequency ablation and cryoablation, which use heat or cold energy. A newer option, and the focus of this report, is pulsed field ablation (PFA), which uses short electrical pulses to target the heart tissue responsible for abnormal rhythms.

Evidence suggests that, in patients with paroxysmal AFib, PFA has shown effectiveness comparable to conventional thermal ablation. It also offers shorter procedure times and safety-related advantages linked to reduced effects on surrounding tissue.

WHAT PFA COULD CHANGE

In the report, electrophysiologists identified several potential advantages of PFA, including easier integration into clinical workflows and higher patient satisfaction.

For patients, that could mean a smoother treatment experience. For healthcare teams, it may make treatment easier to deliver more consistently.

Yet the report suggests confidence in PFA is growing faster than its adoption. While 92 per cent of surveyed electrophysiologists expected PFA to become their preferred ablation approach within two years, only 26 per cent said it accounted for more than half of their AFib ablation cases.

The figures capture the report’s central tension: Confidence in a treatment does not automatically put it within reach of eligible patients early enough.

WHY CARE NEEDS TO START EARLIER

Timing is a recurring theme in the report. Eighty-one per cent of surveyed electrophysiologists said patients were typically referred for ablation only after multiple AFib recurrences, while 83 per cent said fewer than half of eligible AFib patients were referred for ablation within a year of diagnosis.

Evidence cited in the report suggests that a shorter time between AFib diagnosis and catheter ablation – preferably within a year – is associated with greater procedural success and a lower risk of the condition recurring.

“The key message is to diagnose earlier, refer appropriately and intervene at the right time,” said Dr Abdelaal.

**WHY ACCESS TAKES MORE THAN INNOVATION **

Earlier diagnosis and referral are only part of the challenge. Patients need healthcare systems that can deliver care when it is most effective.

“Access is also shaped by workforce capacity, infrastructure readiness, reimbursement and the availability of trained clinical teams,” said Dr Abdelaal.

Frontline clinicians play a key role, he added, because they see how treatment pathways work in practice. “Their perspectives help us understand whether an innovation has value and what is needed for it to reach patients,” he said.

Improving AFib care will require shared responsibility across clinicians, healthcare systems, policymakers and payers.

Clinicians can identify patients who may benefit from newer treatment options and guide the next steps in care. Healthcare systems can strengthen referral pathways, build workforce capacity and equip care teams to deliver treatments safely and consistently. Policymakers and payers can support policies and funding models that consider clinical outcomes, patient experience and long-term system value.

“At Boston Scientific, we see our role as supporting evidence generation, fostering dialogue and working alongside the electrophysiology community to better understand unmet needs and practical solutions,” said Dr Abdelaal.

“Sharing the findings from this report is one example of that approach, but working together to act on them will help more patients across Asia Pacific living with AFib benefit from advances in care.”

This advertorial should not be interpreted as an endorsement of any specific treatment approach for any individual patient.

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