Mount Sinai Doctors Healing One of Their Own With Advanced Atrial Fibrillation Therapy

In December 2020, Sergio Lira, MD, PhD—a professor of Immunology at the Icahn School of Medicine at Mount Sinai—was working out when he began to feel lightheaded. Out of concern, he scheduled testing with his cardiologist, Sumeet Mitter, MD, at The Mount Sinai Hospital. A stress test went without a hitch, but Dr. Mitter also took an electrocardiogram (EKG) and noticed an atrial flutter. Also called atrial fibrillation or AFib—an atrial flutter occurs when the upper chambers of the heart beat too quickly.

There are two ways to treat atrial fibrillation: the first method is to control the heart rate, the second to control heart rhythm. Medications such as anti-arrhythmics, anticoagulants, beta-blockers, digoxin, and calcium channel blockers are commonly used. In Dr. Lira’s case, Dr. Mitter prescribed a course of anticoagulant therapy.

“I asked about alternatives to anticoagulant therapy because I love to travel,” Dr. Lira says. “I didn’t want to think about the consequences of getting hurt during a trip, because when you take anticoagulants you have a higher risk of serious bleeding.” So Dr. Mitter referred him to Vivek Reddy, MD, Director of Cardiac Arrhythmia Services for The Mount Sinai Hospital and the Mount Sinai Health System. Dr. Reddy is also The Leona M. and Harry B. Helmsley Charitable Trust Professor of Medicine in Cardiac Electrophysiology at the Icahn School of Medicine at Mount Sinai. One of the nation’s premier electrophysiologists, Dr. Reddy conducts research that is changing the way cardiac patients are treated and cured.

“I knew of Dr. Reddy already because of his exceptional physiology lab. And even though most visits at the time were telemedicine because of COVID-19, Dr. Reddy made the time to meet with me,” Dr. Lira says. “He explained all the options available to me—one of which was a clinical trial.”

The Advent Trial is a national clinical trial that uses a new technology to perform cardiac catheter ablation. Ablation commonly uses radiofrequency to produce extreme heat or cold to destroy heart tissue that causes irregular heartbeats. The Advent Trial uses pulsed field ablation, with a device known as Farapulse, which creates an electrical field that only destroys the heart cells that cause arrhythmia and spares the surrounding tissue. Data from European trials show that pulsed field ablation is a safer and more efficient method for treating arrhythmia.

Mount Sinai was the first to start this trial in New York City, and Dr. Lira was one of the first three patients enrolled in the study.

“I was aware that Dr. Reddy was one of the main proponents of pulse field ablation in the scientific literature, and that he had championed its approval in Europe,” Dr. Lira says. “As a physician myself, I was thrilled to participate in this clinical trial, to help extend the benefit of this novel therapeutic modality to other patients in the US.”

On March 1, 2021, Dr. Lira underwent the procedure. He went home the next day, and his recovery has been smooth. “It was a fantastic experience, and everyone treated me very nicely. And Dr. Reddy is not only a great doctor, but a gentleman. I was delighted to participate in the study.”

The Advent trial is supported by the manufacturer of the pulse field ablation system, Farapulse Inc. Dr. Reddy owns stock in Farapulse; and has served as a consultant for Farapulse.