Andrea Natale Focuses on Patient-Centered Technological Advances in Cardiac Ablation

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World-renowned cardiac expert Dr. Andrea Natale, M.D., F.H.R.S., F.A.C.C., F.E.S.C., is committed to improving patient experience and outcomes in the field of cardiology and electrophysiology. Dr. Andrea Natale is currently the Executive Medical Director of the Texas Cardiac Arrhythmia Institute at St. David’s Medical Center in Austin, Texas, and the National Medical Director of Cardiac Electrophysiology for HCA Healthcare. 

A pioneer in devising and implementing new technology to achieve successful outcomes for his patients, Dr. Natale is the first U.S. electrophysiologist to perform specific specialist cardiac ablations to improve the outcomes for sufferers of arrhythmias such as atrial fibrillation. He continues to work tirelessly to support research in electrophysiology, including developing specialist equipment such as cardiac catheters and robotic devices. 

The Texas Cardiac Arrhythmia Institute (TCAI) at St. David’s Medical Center in Austin, Texas, is among the foremost cardiac centers globally and is dedicated to spearheading the latest advances in the treatment of arrhythmias like atrial fibrillation. Dr. Andrea Natale is one of the preeminent experts in the field of cardiology and electrophysiology. As such, he leads a number of clinical trials that the TCAI team hopes will allow them to develop new procedures and enhanced technologies for the treatment of cardiac arrhythmias. 

Atrial Fibrillation

Atrial fibrillation is a cardiac arrhythmia that often leads to serious complications for the patient if left untreated. In atrial fibrillation (AF), disordered electrical signals cause the atria, which form the heart’s upper two chambers, to contract chaotically, leaving blood to pool. 

The sinoatrial (SA) node, located at the top of the right atrium, generates an electrical signal that causes the atria to contract; the signal then passes through the atrioventricular (AV) node to the ventricles in the bottom half of the heart, causing them to contract.

The SA node is the heart’s pacemaker, and the electrical signals generated would usually make the heart pump about 60 to 100 times per minute. A disturbance at any point along this pathway causes arrhythmias or irregular beat patterns in the heart.

Left untreated, AF can lead to blood stagnation and thrombus (blood clot) formation and eventually cause significant damage to organs, including the brain. By far, the greatest threat of AF is the risk of stroke—patients with AF are more likely to suffer a stroke caused by a blood clot formed in the left atrium that slowly makes its way to the brain. 

Technological Advances in Treatment

Catheter ablation of atrial fibrillation is very commonly performed in cardiac electrophysiology, but it is also a complex procedure that depends on the skill and expertise of the operator. Over the last 10 years, there has been considerable research into ablation technology to improve both safety and patient outcomes. Much of the new technology—such as catheters with contact feedback, or temperature-guided irrigated ablation—have improved the efficacy of cardiac ablation slightly. However, there are still significant advances being made in electrophysiology. 

Dr. Andrea Natale has been instrumental in researching a ground-breaking technology to treat atrial fibrillation: the lattice-tip focal ablation catheter, which has the ability to switch between radiofrequency (RFA) and pulsed-field ablation (PFA). Although the one-shot PFA catheters currently in use are effective in pulmonary vein isolation, they cannot perform flexible lesion sets. The new lattice-tipped cardiac ablation catheter currently in trials has the advantage of being able to deliver both radiofrequency ablation or PFA lesions.

Dr. Andrea Natale recently participated in the first-in-human trials of a new expandable cardiac catheter in Europe. The aim of the study was to evaluate and verify the efficacy of an innovative lattice-sphere catheter which aims to improve procedural effectiveness across a wide range of cardiac arrhythmias. 

“This new transformative technology enables a faster and more precise process for how we deliver energy during complex ablation procedures… The treatment provides a safer option for patients, as it may prevent collateral damage to surrounding tissue to ensure the best possible outcomes.” – Dr. Natale

The cardiac ablation catheter currently in trials has a latticed sphere on the tip, which expands and allows focused RFA and/or PFA to ablate cardiac tissue thermally using radiofrequency or via irreversible electroporation (IRE). The lattice tip on the new cardiac catheter has the advantage of allowing doctors to map the heart in high resolution and, therefore, finely tailor the ablation process using RFA or PFA for patient-specific accuracy. Dr. Natale is hopeful that the new lattice-tipped cardiac catheter will be in use during patient procedures at the Texas Cardiac Arrhythmia Institute in 2022.

About Dr. Andrea Natale

Originally from Italy, Dr. Andrea Natale received his medical degree from the School of Medicine and Surgery at Università degli Studi di Firenze and went on to specialize in cardiology at the Catholic University School of Cardiology in Rome, Italy. He is board-certified in the USA in cardiovascular disease and clinical cardiac electrophysiology. He has been practicing medicine in Italy and the USA for over 35 years. 

For a decade, Dr. Andrea Natale was the Medical Director of the Cleveland Clinic’s Center for Atrial Fibrillation and served in the Taskforce for Atrial Fibrillation at the U.S. Food and Drug Administration (FDA). At the beginning of his medical career, Dr. Andrea Natale was on the faculty at Duke University as Director of the EP Laboratories. 

Awards for Innovation and Research

Dr. Natale was awarded the Frist Humanitarian Award in 2012 in recognition of his achievements in cardiology and electrophysiology to the benefit of his patients. He was recognized not only because of the breakthrough advances he has pioneered in the field but also because of his tireless dedication to improve outcomes for his patients every day. He is unfailingly concerned about the comfort and experience of those he treats and goes above and beyond in his commitment to the community he serves, without drawing undue attention to his efforts. The Frist Humanitarian Award is presented each year to an individual who embodies the humanitarian spirit and philanthropic work of the late Dr. Thomas F. Frist. The awards recognize employees, physicians, and volunteers at hospitals across the country who go the extra mile to ensure the welfare and happiness of patients in their communities. 

Also named one of the “50 Best Cleveland Clinic Doctors. Ever” in 2011 and among the best doctors in Austin by Austin Monthly Magazine for the last six years, Dr. Andrea Natale’s patients travel nationally and internationally to see him. 

Dr. Natale has published an extensive number of research articles that can be found in a wide selection of academic and medical journals. He is Editor-in-Chief of the Journal of Interventional Cardiac Electrophysiology and sits on the board of a prestigious medical journal. He founded the Journal of Atrial Fibrillation, an open-access journal with the mission of empowering doctors and patients to educate themselves about arrhythmias. 

Dr. Natale also received the 2017 Eric N. Prystowsky Advocate for Patients Award during the “Get In Rhythm Stay In Rhythm” Atrial Fibrillation Patient Conference in Dallas, Texas. This award goes to doctors who have given excellent service to their patients and who have made significant contributions to bettering the lives of patients with atrial fibrillation. Doctors are nominated to receive this award by patients they have treated who consider their physician the best advocate for patients with AF. 

As Dr. Natale himself says:

Patients are my main source of inspiration. I try to spend as much time as possible talking to them and listening to their thoughts and problems. By doing so, they help me find new ideas on how to improve their life, my practice and also the answers to bring these ideas to life. 

Innovation and research are keen interests of Dr. Andrea Natale, and his accolades also extend to that arena. He has spent the past 30 years supporting patients with atrial fibrillation to lead long and healthy lives by restoring their normal heart rhythms, and he has improved the quality of life for patients worldwide. As part of his research into innovations in electrophysiology, Dr. Natale has been behind the development of some of the most successful catheter-based treatments for atrial fibrillation. 

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