Understanding Paroxysmal Atrial Fibrillation(PAF)
- Fox News’ John Roberts recently underwent an FDA-approved ablation treatment for Paroxysmal Atrial Fibrillation(PAF), a type of irregular heartbeat that occurs sporadically. Since the procedure, he’s not back at work and is urging others to be proactive regarding their health.
- According to the National Heart, Lung, and Blood Institute, “Atrial fibrillation is a type of arrhythmia, or irregular heartbeat. The type of atrial fibrillation that you have depends on how often atrial fibrillation occurs and how it responds to treatment.”
- As for Paroxysmal atrial fibrillation, the NIH describes it as, “You may experience a brief event — a paroxysm — of atrial fibrillation. It may pass without symptoms, or you may feel it strongly. The event usually stops in less than 24 hours but may last up to a week. Paroxysmal atrial fibrillation can happen more than once. You may need treatment, or your symptoms may go away on their own.”
- Roberts’ doctor used the Farapulse system, known as the FARAPULSE Pulsed Field Ablation System, which is, according to a Boston Scientific press release, “indicated for the isolation of pulmonary veins in the treatment of drug-refractory, recurrent, symptomatic, paroxysmal (i.e., intermittent) atrial fibrillation (AF) and is a unique new alternative to standard-of-care thermal ablation treatment.”
- When it comes to your health, be a little pushy. You know your body better than anyone else. When you see a doctor for a problem, don’t hesitate to make sure that your question is fully answered and that you are comfortable with the plan moving forward. From a doctor’s perspective, every problem should have a diagnosis, a treatment, a plan for follow-up, and a plan for what happens next if the treatment doesn’t work.
Roberts, 67, who previously worked as the Fox News Chief White House Correspondent between 2017 and 2021, was back on screen Monday morning with a “humble heart,” after urging his fans to be proactive and “never be afraid to ask questions” when it comes to your health.
Read MoreAll the action in the Trump trial and the protests at Ivy League colleges coming up on @AmericaRpts
— John Roberts (@johnrobertsFox) April 22, 2024
Happy to be back with a healthy and humble heart!
Prior to his procedure being done, John Roberts wrote in an April 17 social media post, “Good idea – here goes: After having AFib since early ‘22, and failing antiarrythmics, it was clear I needed an ablation. In the past year, I had 449 episodes of AFib – some of which lasted for hours. For me, they are quite debilitating – weakness, shortness of breath – difficulty climbing a flight of stairs.
“I am fortunate that at this point, my AFib is ‘paroxysmal,’ meaning it comes and goes. But paroxysmal AFib can often lead to ‘persistent’ AFib, which has a much lower success rate in treatment. I couldn’t risk that happening, given how profound the effects were. My quality of life would have been pretty s****y. I have been speaking to Dr. [Oussama] Wazni at @ClevelandClinic since the fall of ’22.”
Roberts said Dr. Wazni advised him at the time to wait for the FDA’s approval of a new ‘pulsed field ablation’ catheter, explaining further, “It has a much higher safety profile than radio frequency or cryogenic. The effectiveness is about the same as RF, but there is almost zero risk of damage to the esophagus or phrenic nerve.
“The duration of the procedure is also significantly shorter, so there is less time under anesthesia. There are two PFA catheters that have been approved by the FDA – one from Medtronic called ‘PulseSelect’ and one from Boston Scientific ‘Farapulse.'”
Good idea – here goes:
After having AFib since early ‘22, and failing antiarrythmics, it was clear I needed an ablation. In the past year, I had 449 episodes of AFib – some of which lasted for hours. For me, they are quite debilitating – weakness, shortness of breath -… https://t.co/dX1V4lVcBG
— John Roberts (@johnrobertsFox) April 17, 2024
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His doctor used the Farapulse system, known as the FARAPULSE Pulsed Field Ablation System, which is, according to a Boston Scientific press release, “indicated for the isolation of pulmonary veins in the treatment of drug-refractory, recurrent, symptomatic, paroxysmal (i.e., intermittent) atrial fibrillation (AF) and is a unique new alternative to standard-of-care thermal ablation treatment.”
Roberts continued, “The success rate of initial ablation with this approach is about 80%. Some folks find it easy to live with AFib – others I have heard from have similar experiences to me, and are always anticipating the next dreaded episode. My suggestion is to find yourself a good ElectroPhysiologist – who will work with you to determine the best course of action.
“Inform yourself about the procedure. I watched dozens of videos of patients who went through it, read dozens of medical articles and watched various videos of how the systems and procedures work. And always be a strong advocate for yourself. Never be afraid to ask questions. After all, it is YOUR life.”
A day prior to his lengthy X post, Roberts got candid about his upcoming procedure, saying he “should” be back to work on Monday, and shared a selfie of himself outside of the “world-renowned Cleveland Clinic” to help rid him of AFib.
Roberts said he’s had issues with his heart health since “that whole ‘COVID thing.'”
And although Roberts did get back to his normal work schedule on Monday, he hasn’t offered any more information on how the procedure went. However, we presume the surgery was a success.
The good Lord willing, I should see you Monday on @AmericaRpts https://t.co/oDEoINzxxZ
— John Roberts (@johnrobertsFox) April 16, 2024
John Roberts’ On Advocating For Your Own Health
Roberts’ recent warning to fans about being their own advocate wasn’t the first time the journalist urged others to be proactive about their health.
He previously told SurvivorNet, “You’ve got to keep pushing and pushing and pushing. You have to be your own best advocate when it comes to getting good medical care.”
Back in 2018, Roberts discovered he had an artery that was 90% blocked, meaning he needed a stent, an expandable metal mesh tube inserted in an artery to keep the pathway opened.
Later on, after passing out at home and feeling faint while driving his daughter somewhere, he sought help from his cardiologist and learned his stent needed to be repositioned. He ultimately had a pacemaker installed to steady his irregular heartbeat.
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Understanding Paroxysmal atrial fibrillation (PAF)
According to the National Heart, Lung, and Blood Institute, “Atrial fibrillation is a type of arrhythmia, or irregular heartbeat. The type of atrial fibrillation that you have depends on how often atrial fibrillation occurs and how it responds to treatment.”
In the case of Roberts, he has Paroxysmal atrial fibrillation, which the NIH describes as, “You may experience a brief event — a paroxysm — of atrial fibrillation. It may pass without symptoms, or you may feel it strongly. The event usually stops in less than 24 hours but may last up to a week. Paroxysmal atrial fibrillation can happen more than once. You may need treatment, or your symptoms may go away on their own.
“When this kind of atrial fibrillation occurs and it alternates with a heartbeat that is slower than normal, it is called tachy-brady syndrome.”
Meanwhile, persistent atrial fibrillation “occurs when the abnormal heart rhythm you experience lasts for more than a week.” This is something that may normalize on it’s own, however, treatment may be needed to regulate the heartbeat, according to the institute.
It’s important to understand that atrial fibrillation can increase a person’s risk for heart failure, a condition that causes the heart to not pump blood as well as it should. Heart failure does not mean that your heart has actually “failed” or stopped beating; it’s just that it is having some issues pumping blood. As a result, fluid backs up in the body, and the organs in the body do not get as much blood as they need.
The heart is the muscle at the center of your circulation system, pumping blood around your body as your heart beats. This blood sends oxygen and nutrients to all parts of your body, and carries away unwanted carbon dioxide and waste products. When chronic heart failure lasts for a long period of time (typically, more than six months), it can impact organs like the kidneys, liver, and lungs.
As for the treatment Roberts underwent, a journal published in the National Library of Medicine on Pulsed Field Ablation for Atrial Fibrillation explains in it’s abstract, “Catheter ablation is a widely used, effective and safe treatment for AF. Pulsed field ablation (PFA), as a novel energy source for cardiac ablation, has been shown to be tissue selective and is expected to decrease damage to non-cardiac tissue while providing high efficacy in pulmonary vein isolation.
“The FARAPULSE ablation system (Boston Scientific) follows the idea of single-shot ablation and is the first device approved for clinical use in Europe. Since its approval, multiple high-volume centres have performed increasing numbers of PFA procedures in patients with AF and have published their experiences. This review summarises the current clinical experience regarding the use of PFA for AF using the FARAPULSE system. It provides an overview of its efficacy and safety.”
Leading Experts Urge Us to Be Proactive
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told us in a previous interview, “because finding a doctor who is up to the latest of information is important.”
RELATED: Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options. Also, in some instances the specific course of treatment is not clear cut. That’s even more reason why understanding the potential approaches to your disease is crucial.
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At the National Cancer Institute, there is a patient referral service that will “guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments,” Rosenberg says.
Cancer Research Legend Urges Patients to Get Multiple Opinions
Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. “So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.
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Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn’t listening to you, or isn’t giving you good advice
- You have trouble understanding your doctor
- You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
- Your insurance company wants you to get another medical opinion
- Your cancer isn’t improving on your current treatment
Bottom line, being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can, so that you know that you did your best to take control of your health.
Advocating for Yourself While Navigating the Medical World
Pushing For A Correct Diagnosis
When it comes to your health, be a little pushy. You know your body better than anyone else. When you see a doctor for a problem, don’t hesitate to make sure that your question is fully answered and that you are comfortable with the plan moving forward. From a doctor’s perspective, every problem should have a diagnosis, a treatment, a plan for follow-up, and a plan for what happens next if the treatment doesn’t work.
As a patient, if you don’t feel like each of these four things has been accomplished, just ask! Even if it requires multiple visits or seeing additional providers for a second opinion, always be your own advocate.
When it comes to your health, be a little pushy. You know your body better than anyone else. When you see a doctor for a problem, don’t hesitate to make sure that your question is fully answered and that you are comfortable with the plan moving forward. From a doctor’s perspective, every problem should have a diagnosis, a treatment, a plan for follow-up, and a plan for what happens next if the treatment doesn’t work.
Be Pushy, Be Your Own Advocate, Don’t Settle
Dr. Murrell says not every patient will “fit into” the mold, so it’s important to “educate yourself and be your own health care advocate.”
“Every appointment you leave as a patient, there should be a plan for what the doc is going to do for you, and if that doesn’t work, what the next plan is,” Dr. Murrell said. “And I think that that’s totally fair. And me as a health professional – that’s what I do for all of my patients.”
“Always Get a Second Opinion” – San Diego Resident Lynn Brooks’ Survivor Story
Questions for Your Doctor
If you find yourself considering seeking a second or third medical opinion, here are some questions to kickstart the conversation with your doctor:
- Is there any other testing available for the type of cancer I have?
- Are there any other treatment options available for my type of cancer?
- Why or why do you not recommend those other options?
- I would like to seek a second opinion on my diagnosis and treatment options. Is there another doctor or facility you recommend?
- Do you want the second opinion to be sent to you?
- Can I have a copy of all my records that I can share with this second physician?
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.