technically retired, Rick Smith hasn’t necessarily slowed down. The Lehigh County resident remains fit and active, and still works one day a week as a trucker, claiming, “If you love what you do, you never work a day in your life.”
Smith’s heart had other plans for him when he started experiencing atrial fibrillation (AFib) within the past year, something he didn’t take lightly. AFib is a common type of irregular heart rhythm where the upper chambers of the heart beat irregularly and out of coordination with the lower chambers. It leads to symptoms like heart palpitations, shortness of breath, fatigue, or dizziness.
“I’ve had some minor heart issues in the past, but the AFib started more recently,” Smith recalled. Those minor issues, specifically, were premature ventricular contractions, or PVCs, which are extra heartbeats in the lower chambers of the heart, resulting in patients feeling a fluttering or pounding heartbeat in their chest.
Smith sought treatment from a local cardiologist, who implanted a loop recorder to monitor his heart’s rhythm. The small device sits under his chest and wirelessly transmits heart data to his doctor. “It’s not a pacemaker, it just records irregular stuff,” Smith explained.
But in early 2024, Smith’s doctors said his heart complications were not just PVCs and told him he had developed AFib.
“It took me a while to accept the fact that I had another heart issue. But that passed pretty quickly, and then I was just determined on doing what I had to do to make this right,” recalled Smith.
Smith had to decide when his local doctor recommended an ablation procedure to treat his AFib. Ablation is a procedure where problematic heart tissue is targeted to prevent erratic electrical signals. Through his local cardiologist, Smith learned about Penn Medicine’s new pulsed field ablation (PFA) technique,leading-edge method that offers a quicker recovery time and fewer side effects. Smith was sold, and in March of 2024 made the trip to the Hospital of the University of Pennsylvania.
‘If I were your brother or father, would you recommend PFA?’
At Penn, Smith met David Frankel, MD, the director of Penn’s cardiac electrophysiology laboratory. Penn has been a leader in pulsed field ablation, taking part in the 2020 pre-approval ADVENT clinical trial of the FARAPULSE Pulsed Field Ablation System. The randomized clinical trial was the first to directly compare the efficacy and safety of PFA against standard-of-care ablation.
As he sat with Frankel, Smith learned of his options for an ablation procedure. What makes PFA stand out from traditional treatments for AFib is its precision and safety. Unlike radiofrequency or cryoablation, which use heat or extreme cold to destroy problematic heart tissue, PFA uses short electrical pulses to selectively target the heart’s myocardium, the muscle layer responsible for erratic electrical signals.
Frankel explained, “PFA more specifically targets the myocardium we are trying to ablate, with less chance of damage to the esophagus and nerves, which has been a concern with older methods.”
This reduced risk, along with a shorter procedure time and faster recovery, made PFA the top choice for Smith to treat his afib, but he wanted Frankel’s assurance first. “I asked Dr. Frankel, ‘If I were your brother or father, would you recommend PFA?’ He said, ‘I’d definitely recommend it,’ and I felt comfortable with that,” Smith said.
Frankel explained why Smith was an ideal candidate for this advanced procedure. “Rick was a good candidate for PFA because it was his first AF ablation, and he didn’t have a history of atrial flutter,” Frankel said.
Reflecting on the entire experience, Smith felt grateful for the care he received at Penn. “I sent thank-you cards to the nurses, Millie, the scheduler, and Dr. Frankel. They really took care of me.”
Frankel added, “Our whole team is dedicated to ensuring patients like Rick receive the best care possible.”
Smith’s life mantra—“The days are long, but the years are short”—serves as a reminder for him to keep living life to the fullest, whether he’s behind the wheel of a truck or enjoying time with his wife of 42 years and their daughter.
For more information about pulsed field ablation at Penn, visit this related article with a more advanced clinical description of the procedure.
On the day of his procedure, Smith stayed overnight in the hospital and was released the following day. “They went up through my groin, so I had some stitches, and it hurt a bit when driving, but nothing too bad,” Smith recalled. “After a month, I’m feeling great. I’m back to doing everything I love, and back to working part time.”