An Open Letter to the Attendees of HRS 2025 – The community of innovators that brought my beats back from the brink

Hello to all of you brilliant minds!

This is only going to be weird if you all make it weird (and from the sidelines, you folks in the world of electrophysiology are all a little bit weird in the best kind of ways!)

My name is Matt – and you all are my people. I’ve yet to meet most of you, I hope to someday. Let me explain why.

For context, let me begin here. I am a son. I am a husband. I am a father. Most of all, I am simply a human being. I haven’t been able to be my best version of any of those this last decade. The funky beats of chronic cardiac arrhythmias kept me from it in many ways. Some stats:

Matt (M) Age: 39 Tampa, FL
Diagnosis: Right Ventricular Cardiomyopathy w/ recurrent episodes of ventricular tachycardia and near-syncope

History: Drug refractory, highly symptomatic arrhythmias including: High Burden PVC (3.3~ million annual), 1,400+ recorded episodes of triplets, non-sustained ventricular tachycardia, or sustained ventricular tachycardia last year, atrial fibrillation, premature atrial contractions, and supraventricular tachycardia
Medications: Going to just say all of them for simplicity.
Procedures: 7 scheduled attempts, 2 cancelled in pre-op holding for lack of spontaneous presence (It was the right call to make both times, but those days were the hardest. When you walk into the hospital with hope and have to leave to start the search all over again – gut punches for sure.), 4 thermal ablation attempts with 3 moderately successful outcomes in reduction of overall burden, total elimination of atrial fibrillation. Along the way, I was outfitted with my Boston Scientific Resonate ICD (which subsequently discharged a few times one wild day when I was out cleaning up the pond on my property). Let’s talk about the 5th attempt.

Enter – Pulsed Field Ablation with Farapulse for ventricular arrhythmia

I am at my worst at the start of December 2024. I had been traveling a bit, taking on perhaps a bit more than I should have given my health (but I was saving health system supply chains in America millions – and they needed it, so I pressed on). Called my team at the Pepin Heart Institute in Tampa, explained the situation, they looked over my device interrogation and we ultimately arrived at Pulsed Field Ablation with Farapulse December 9th, 2024.

To be certain, my daughter is a bit of a theatre girl, and she has a term on the stage that she calls “nerv-excited”. That was me.

I had never heard of PFA and I had just but 6 days from the time I called in to my family at Pepin Heart to soak up as much data as I could about the procedure. I was both pumped and I’m not lying when I tell you there was a little sweat. 4 go-arounds in the EP lab already, Farapulse is FDA approved for atrial fibrillation, but our destination is the ventricles. So, “nerv-excited” indeed is an appropriate representation of my state of mind.

December 9th, 2024 changed my life. I woke from Pulsed Field Ablation after Farapulse was doing the electroporation boogie in the right ventricular outflow tract of my heart. For the first time in just about a decade, NSR (for days y’all)

I cannot begin to explain to you how transformative this procedure has been in my life. Just over a decade ago and almost precisely as my battle with arrhythmia began,  Dr. Steven Mickelson was just starting the work that would ultimately change everything for me and my family. 

The Renegades of Rhythm Management

In the decade that would follow the beginning of his pioneering research – it is indeed Dr. Mickelson as well as all of you that transformed my life. Innovators. Pioneers. Rule-Breakers that challenge the norms. The collaboration within the professional community of arrhythmia care is bar none the best in healthcare and it is why I am so immensely excited about everything I have seen coming out from HRS 2025. 

Nothing against you Dr. Mickelson. But if you could have called me a decade ago and said “Hang in there buddy, December 9th 2024 – we’ve got you covered”. I am telling you I would have been able to handle these last 10 years just maybe a tad bit better. No sweat though, I know that is not realistic. What is realistic is letting all of my friends and family that also suffer from arrhythmia (there are over 10 million of us in America) know what an amazing community you all are and what amazing new technologies are coming. They need to know. They need it because they need to hold on to hope. So here is a list of a good many of the things that have me all sorts of jazzed!

Now, even though Dr. Mickelson didn’t call me a decade ago, he gets a pass. Here is a man who led the innovation at the start of likely the most game-changing technology of the last decade in atrial fibrillation management. I am not sure exactly how it happened, but I want to believe that one of his friends said “What about the ventricles?” and Dr. Mickelson said “Hold my beer.”

All I know is he is at HRS 2025 with Field Medical, his new company, and that company is designing a catheter for focal ventricular ablation that just received FDA Tap Pilot Acceptance (to the regulators involved – do your job but do it faster) and they also just received $40 million in Series A funding. Keepin’ the electroporation boogie rolling and I am simply here for it. 

This leads me to the matters at hand. The Beats That Matter – the funky beats of millions of Americans that are suffering the insidious and unseen consequences of arrhythmia.

The Mental Health Burden of Arrhythmia in America

Full stop – we do not talk about it enough. Online, there is a never ending stream of arrhythmia patients that are searching every day for hope. They are searching for answers. Their families post on support groups. They feel panic. They feel anxiety. They often feel misunderstood. Managing arrhythmia in daily life is a lot like driving on a highway, in the pouring rain, in heavy traffic, with your clutch slipping every time you shift gears. We are on high alert. Indeed, our minds often are under a near constant allostatic load. Mine certainly was.

Since my arrhythmias began, I have spent much of my time amongst this online community. They provided me with support. Their stories were mine. My story was theirs. Since my heart has been healed in the most miraculous way, I have spent even more time amongst this community. I cannot describe to you how overwhelming it is for me to know that so much of my family, and I don’t know all of these beautiful warriors yet, but I want to know as many of them as possible. They need to know your help is on the way.

They need to know that all of their beats matter

The body and mind are certainly miraculous in the way they work. But they were designed to operate in very specific ways. The mind of a human being that is suffering from symptomatic, chronic, and persistent arrhythmia is one that is always on guard, always at the ready, ready to “fight the bear”. The big problem is that our minds were never designed to be in an allostatic state for extended periods of time. We must work towards achieving true homeostasis for our community at large (or at least as close as we can get). We must do that by providing resources. We must educate. We must instill confidence. We must let our friends and family members who suffer from arrhythmias in their daily life know that we are here for them. In the same breath, we must do more for the caregivers who give so much of themselves to take care of us all.

You really want to unleash American energy? Calm the minds and restore balance in the hearts of the more than 10 million American warriors who are at the ready, on guard, fighting off the bear that they deal with every single day. The dads, the moms, the sons, the daughters – all of them. Let’s get to work! Lets make the beats matter.

The good news in arrhythmia?

You brilliant and caring pioneers that are the more than 10,000 humans in San Diego at HRS are already doing the work that needs to be done. What is absolutely clear, however, is that in order for you to accomplish what needs to be done to help our community we are simply going to need more resources. We need conversations to be happening at the federal level, we need government agencies to get quicker and we need for them to sometimes just get out of the way. 

So, what can we do for you all to get the resources you need?

We’re going to need an army

In the modern world, to bring all of the powers that be to the table, to make the decisions that need to be made, for the common sense benefit of a population in need – it takes a lot of people and it takes them being really loud. Both fortunately and unfortunately, just about 5% of our population is suffering from those insidious funky beats of arrhythmia.

I intend to bring these people together. All of them.

I intend first to let them know the exciting things already coming down the pipeline. I intend to continually let them know what you are doing in regular cadence going forward. The community we are going to build is going to be the hub of hope. A place where both we as patients and our caregivers understand each and all. We are going to educate each other on mental health support for our own community. 

And in a pinch, when you need something big, like say having CMS provide a bit more context to “inherently non-surgical” as it relates to whatever the heck that means on performing ablations in an ASC. It seems there is a new head at CMS these days and the prior administration made the wrong move. But that was November. Good thing its April. Last I checked, as I’ve been blessed to travel much of this beautiful country – my funky beats kept blaring in the plains of Oklahoma all the same. So our friends in rural America deserve affordable access to the best care as well, doesn’t that sound like a beautiful thing to do? I know some of you folks in Washington could use the PR right now.

Dr. Oz, if you find yourself reading this, I suggest you revisit this. It seems your predecessor’s counter-position to both HRS and the ACC makes absolutely no sense. Unless there is evidence to the contrary, it is the position of the entire professional community that serves my friends and family that suffer from arrhythmia, that making this decision will both expand access and reduce costs. Listen to these folks more.

Done. Sign it. Start expanding access and reducing costs tomorrow. Move on to the next line item to fix.

5% of the population needs you to do this. Their families need you to do it as well.

The Path Forward

Before walking this path, I spent the weekend with my family on vacation. In years past, before my Pulsed Field Ablation, I was a truly broken man. I worked. But I struggled. I needed to provide but gosh those days were hard to get through. On the outside, it had to be the same old show for Matt. But on the inside, I was exhausted. I kept having to fight this damned bear. I had lost hope and it was starting to feel like these beats of mine didn’t matter much any anymore

But for people. Dr. Mickelson gets a wild hair. In the years that followed, you all continued to gather and innovate. I thank God you did.

The peace that I have in my life to simply enjoy every single moment with my wife and daughter this past weekend. Your community gave the gift of a lifetime to me.

We will come together and support one another. We are going to reduce both the physical and mental burdens of arrhythmia together. When your patients need support and you are busy taking care of another one of our friends, they’ll have a place to get what they need until you can get to them. Together, we are going to make sure that you all get every bit of the resources you need to care for us. The collective beats of the over 10 million Americans dealing with arrhythmia are Beats That Matter.

In good health (and beautiful normal sinus rhythm),

Matt