{
  "material_id": "pfa-08",
  "slug": "choosing-pfa-centre",
  "language": "en",
  "canonical_url": "https://hub.bookimed.com/pulsed-field-ablation/choosing-pfa-centre/",
  "title": "Choosing a PFA centre: Cleveland Ohio and Harley Street compared",
  "hero": {
    "text": "Cleveland Clinic offers a Northeast Ohio electrophysiology-team assessment route and reports use of FARAPULSE and Affera/Sphere-9. London’s Harley Street Clinic documents Affera PFA with Oliver Segal and separates consultations from the Weymouth Street procedure site. Compare the device, clinical route and itemised cost—not a league table of success rates.",
    "fact_refs": [
      "fact:pfa:c7",
      "fact:pfa:c8",
      "fact:pfa:centre:ohio-team-route",
      "fact:pfa:exp:harley",
      "fact:pfa:exp:segal-access"
    ],
    "source_refs": [
      "source:1d1523d39ad0",
      "source:pfa:ohio-ep-service",
      "src:hca-pfa",
      "src:segal-practice"
    ],
    "id": "hero-answer"
  },
  "summary": {
    "text": "Choose a documented match between your AF type, the planned device, a named operator and a procedural location. A dated programme description is useful evidence of practice, but it is not a personal treatment offer. Trial percentages are not a ranking of these centres.",
    "fact_refs": [
      "fact:pfa:c7",
      "fact:pfa:c8",
      "fact:pfa:exp:segal",
      "fact:pfa:exp:segal-access",
      "fact:pfa:compose:fda-label"
    ],
    "source_refs": [
      "source:1d1523d39ad0",
      "src:segal-practice",
      "source:64edc5867c38"
    ],
    "id": "summary"
  },
  "takeaways": [
    {
      "text": "Ohio reports FARAPULSE and Affera/Sphere-9; Segal’s London practice documents Affera. ADVENT’s paroxysmal-AF comparison cannot be assigned to Affera or used to rank these centres.",
      "fact_refs": [
        "fact:pfa:c8",
        "fact:pfa:exp:segal",
        "fact:pfa:c2",
        "fact:pfa:c12"
      ],
      "source_refs": [
        "source:1d1523d39ad0",
        "src:segal-practice",
        "source:c2b1a75334d9",
        "source:d1efd743478e"
      ],
      "label": "Different platforms, different evidence",
      "id": "takeaway-0"
    },
    {
      "text": "Ohio routes you to an electrophysiology team; Segal’s practice identifies a named clinician and a Weymouth Street procedure site. Assessment is still required for either route.",
      "fact_refs": [
        "fact:pfa:centre:ohio-team-route",
        "fact:pfa:exp:segal-access"
      ],
      "source_refs": [
        "source:pfa:ohio-ep-service",
        "src:segal-practice"
      ],
      "label": "Team route or named practice",
      "id": "takeaway-1"
    },
    {
      "text": "Neither route has a verified PFA total here. Segal’s published £350 GBP appointment fee is consultation only (checked 8 October 2026); Ohio provides individual estimates.",
      "fact_refs": [
        "fact:pfa:exp:consultation-cost",
        "fact:pfa:provider:cleveland-estimator"
      ],
      "source_refs": [
        "src:segal",
        "source:b588e081d2e6"
      ],
      "label": "Compare treatment totals, not consultation fees",
      "id": "takeaway-2"
    }
  ],
  "sections": [
    {
      "id": "comparison",
      "heading": "Two documented programmes: the practical differences",
      "table": {
        "caption": "Programme evidence checked 8 October 2026; availability and individual treatment remain subject to assessment",
        "columns": [
          "Decision",
          "Cleveland Clinic — Northeast Ohio",
          "The Harley Street Clinic — London"
        ],
        "rows": [
          {
            "cells": [
              "Platform",
              "FARAPULSE and Sphere-9/Affera in the dated institutional report.",
              "Affera/Sphere-9 documented at Harley Street and in Segal’s practice."
            ],
            "fact_refs": [
              "fact:pfa:c8",
              "fact:pfa:exp:harley",
              "fact:pfa:exp:segal"
            ],
            "source_refs": [
              "source:1d1523d39ad0",
              "src:hca-pfa",
              "src:segal-practice"
            ],
            "id": "comparison-row-0"
          },
          {
            "cells": [
              "Clinical route and location",
              "Electrophysiology-team assessment, Desk J2 - 2, 9500 Euclid Avenue. PFA operator/campus assignment still required.",
              "Oliver Segal practice; consultations at 14 Devonshire Street or by phone/video; procedures at The Harley Street Clinic, Weymouth Street."
            ],
            "fact_refs": [
              "fact:pfa:centre:ohio-team-route",
              "fact:pfa:exp:segal-access"
            ],
            "source_refs": [
              "source:pfa:ohio-ep-service",
              "src:segal-practice"
            ],
            "id": "comparison-row-1"
          },
          {
            "cells": [
              "Cost evidence",
              "Individual estimate route; no PFA amount retrieved. London K5761 is not an Ohio tariff.",
              "£350 GBP new or follow-up consultation, checked 8 October 2026. Not the ablation cost; hospital and treatment fees need individual quotes."
            ],
            "fact_refs": [
              "fact:pfa:provider:cleveland-estimator",
              "fact:pfa:exp:consultation-cost",
              "fact:pfa:provider:hca-payment-components"
            ],
            "source_refs": [
              "source:b588e081d2e6",
              "src:segal",
              "source:908d38f09193"
            ],
            "id": "comparison-row-2"
          },
          {
            "cells": [
              "Journey planning",
              "The assessment address is documented; do not book travel on the assumption that it confirms the procedural venue.",
              "Initial phone/video consultations are described. Follow-up visits are offered by Segal’s practice, with periodic ECG/heart-monitor follow-up described for AF ablation; no fixed PFA-specific or remote aftercare schedule verified."
            ],
            "fact_refs": [
              "fact:pfa:centre:ohio-team-route",
              "fact:pfa:exp:segal-access",
              "fact:pfa:final:segal-care",
              "fact:pfa:final:segal-consult",
              "fact:pfa:final:segal-care",
              "fact:pfa:final:segal-consult"
            ],
            "source_refs": [
              "source:pfa:ohio-ep-service",
              "src:segal-practice",
              "source:pfa:final:segal-care",
              "source:pfa:final:segal-consult",
              "source:pfa:final:segal-care",
              "source:pfa:final:segal-consult"
            ],
            "id": "comparison-row-3"
          }
        ]
      }
    },
    {
      "id": "ohio",
      "heading": "Cleveland Clinic: Northeast Ohio assessment route",
      "paragraphs": [
        {
          "text": "The May 19, 2025 institutional report describes routine atrial PFA using Boston Scientific FARAPULSE and Medtronic Sphere-9 with Affera mapping and ablation. Sphere-9/Affera can switch between pulsed-field and radiofrequency energy. This is dated institutional practice evidence, not confirmation of current device inventory or an individual doctor’s PFA volume.",
          "fact_refs": [
            "fact:pfa:c7",
            "fact:pfa:c8"
          ],
          "source_refs": [
            "source:1d1523d39ad0"
          ],
          "entity_refs": [
            "provider:cleveland-clinic",
            "program:cleveland-atrial-pfa"
          ],
          "id": "ohio-paragraphs-0"
        },
        {
          "text": "Start with Northeast Ohio arrhythmia appointments on 800.659.7822. The official electrophysiology service gives an assessment destination at Desk J2 - 2, 9500 Euclid Avenue, Cleveland. It describes a multidisciplinary AF team. This identifies a clinical route, not the campus or operator assigned to your PFA.",
          "fact_refs": [
            "fact:pfa:centre:ohio-team-route",
            "fact:pfa:c9"
          ],
          "source_refs": [
            "source:pfa:ohio-ep-service",
            "source:ef846da4af4b"
          ],
          "id": "ohio-paragraphs-1"
        },
        {
          "text": "The current official profile identifies Oussama Wazni as Section Head of Cardiac Electrophysiology and Pacing and lists Cleveland Clinic Main Campus. That establishes leadership and a profile location—not a promise that he will perform your PFA. The assessment team must confirm your procedural site and treating electrophysiologist.",
          "fact_refs": [
            "fact:pfa:centre:wazni-role",
            "fact:pfa:centre:ohio-team-route"
          ],
          "source_refs": [
            "source:pfa:wazni-role",
            "source:pfa:ohio-ep-service"
          ],
          "id": "ohio-paragraphs-2"
        }
      ]
    },
    {
      "id": "london",
      "heading": "London: Oliver Segal and The Harley Street Clinic",
      "paragraphs": [
        {
          "text": "HCA’s 8 December 2025 announcement places Affera/Sphere-9 at The Harley Street Clinic and identifies Oliver Segal as a consultant cardiologist and electrophysiologist there. The system combines mapping with PFA and radiofrequency delivery. This is institutional programme evidence, not an independent claim of superior outcomes.",
          "fact_refs": [
            "fact:pfa:exp:harley",
            "fact:pfa:exp:segal"
          ],
          "source_refs": [
            "src:hca-pfa",
            "src:segal-practice"
          ],
          "id": "london-paragraphs-0"
        },
        {
          "text": "Oliver Segal’s official practice site describes pulsed-field catheter ablation using Affera 3D mapping. It states that procedures take place at The Harley Street Clinic, Weymouth Street. Consultations are described separately at 14 Devonshire Street, with telephone or video options. This is a documented clinician/practice link, not an independently measured performance rating.",
          "fact_refs": [
            "fact:pfa:exp:segal",
            "fact:pfa:exp:segal-access"
          ],
          "source_refs": [
            "src:segal-practice"
          ],
          "entity_refs": [
            "person:oliver-segal"
          ],
          "id": "london-paragraphs-1"
        },
        {
          "text": "Open the official practice site linked here or call 020 3553 9370 to request an assessment. Confirm the proposed operator, device, procedural address and available date in the written treatment offer. A consultation location or remote appointment is not itself the procedural venue, and no PFA slot has been checked for this guide.",
          "fact_refs": [
            "fact:pfa:exp:segal-access"
          ],
          "source_refs": [
            "src:segal-practice"
          ],
          "entity_refs": [
            "person:oliver-segal"
          ],
          "id": "london-paragraphs-2"
        }
      ]
    },
    {
      "id": "device-population",
      "heading": "Match the device to the AF population, not a headline success rate",
      "paragraphs": [
        {
          "text": "ADVENT randomized patients with drug-refractory paroxysmal AF to FARAPULSE PFA or pooled radiofrequency/cryoballoon ablation. At one year it established noninferiority for its composite effectiveness and serious device/procedure-event endpoints, not superiority. It did not test Affera/Sphere-9 or compare these two programmes. A programme’s device announcement establishes access evidence, not a local success rate.",
          "fact_refs": [
            "fact:pfa:c2",
            "fact:pfa:c5",
            "fact:pfa:c12",
            "fact:pfa:c8",
            "fact:pfa:exp:harley"
          ],
          "source_refs": [
            "source:c2b1a75334d9",
            "source:d1efd743478e",
            "source:1d1523d39ad0",
            "src:hca-pfa"
          ],
          "id": "device-population-paragraphs-0"
        },
        {
          "text": "The US FDA FARAWAVE indication includes pulmonary vein isolation for drug-refractory, recurrent, symptomatic paroxysmal AF. It also includes pulmonary vein and posterior-wall isolation for drug-refractory, symptomatic persistent AF with episodes lasting less than one year. These are specific US device indications, not a universal PFA eligibility rule or a UK authorisation statement.",
          "fact_refs": [
            "fact:pfa:compose:fda-label"
          ],
          "source_refs": [
            "source:64edc5867c38"
          ],
          "entity_refs": [
            "method:pfa-catheter"
          ],
          "id": "device-population-paragraphs-1"
        },
        {
          "text": "The Cleveland report documents two systems, while Segal’s practice describes Affera. Do not transfer FARAWAVE labelling or trial outcomes to a different system, operator or centre. Obtain an assessment that names your AF type, intended device and ablation plan; no clinic ranking or local success percentage is established by these records.",
          "fact_refs": [
            "fact:pfa:c8",
            "fact:pfa:exp:segal",
            "fact:pfa:compose:fda-label"
          ],
          "source_refs": [
            "source:1d1523d39ad0",
            "src:segal-practice",
            "source:64edc5867c38"
          ],
          "entity_refs": [
            "program:cleveland-atrial-pfa",
            "person:oliver-segal",
            "method:pfa-catheter"
          ],
          "id": "device-population-paragraphs-2"
        }
      ]
    },
    {
      "id": "care-pathway",
      "heading": "Complete the emergency and follow-up handover",
      "paragraphs": [
        {
          "text": "Cleveland’s AF Center describes a general PVI follow-up visit at 3–4 months with its nursing staff and physician; testing may include ECG, echo, CT or blood work. Its PFA patient guide separately describes visits at one, three and six months, then every six months. These are different source contexts, not a single booked schedule.",
          "fact_refs": [
            "fact:pfa:final:ohio-care",
            "fact:pfa:compose:cleveland-followup"
          ],
          "source_refs": [
            "source:pfa:final:ohio-care",
            "source:70d0511f82f6"
          ],
          "id": "care-pathway-paragraphs-0"
        },
        {
          "text": "For Segal’s practice, the published AF-ablation aftercare route includes monitoring during recovery and periodic heart monitors and ECGs if AF does not recur after medication withdrawal. His consultations page offers 30-minute follow-up visits; the practice appointment number is 020 3553 9370. This is general AF-ablation and practice information, not a fixed PFA-specific schedule or confirmation of remote postoperative visits. Medication withdrawal must follow the treating team’s current plan, not be inferred from this description.",
          "fact_refs": [
            "fact:pfa:final:segal-care",
            "fact:pfa:final:segal-consult",
            "fact:pfa:exp:segal-access"
          ],
          "source_refs": [
            "source:pfa:final:segal-care",
            "source:pfa:final:segal-consult",
            "src:segal-practice"
          ],
          "id": "care-pathway-paragraphs-1"
        },
        {
          "text": "The Harley Street Clinic lists an intensive care unit. That is not evidence of a specific PFA emergency-transfer protocol. A patient-specific urgent contact and travel clearance remain part of the discharge plan; neither a general appointment number nor remote initial consultation establishes out-of-hours care.",
          "fact_refs": [
            "fact:pfa:final:harley-site",
            "fact:pfa:exp:segal-access"
          ],
          "source_refs": [
            "source:pfa:final:harley-site",
            "src:segal-practice"
          ],
          "id": "care-pathway-paragraphs-2"
        }
      ]
    },
    {
      "id": "cost-scope",
      "heading": "Published consultation versus individual treatment cost",
      "paragraphs": [
        {
          "text": "Ohio offers an estimate route based on insurance and past charges; a PFA calculation has not been run here. Segal’s published new and follow-up appointment fees are each £350 GBP, checked 8 October 2026, with no expiry stated. His profile does not provide an ablation tariff. HCA bills specialist consultations and treatment separately from hospital charges. These figures cannot establish which programme is cheaper.",
          "fact_refs": [
            "fact:pfa:provider:cleveland-estimator",
            "fact:pfa:exp:consultation-cost",
            "fact:pfa:provider:hca-payment-components"
          ],
          "source_refs": [
            "source:b588e081d2e6",
            "src:segal",
            "source:908d38f09193"
          ],
          "id": "cost-scope-paragraphs-0"
        },
        {
          "text": "For comparison, Cleveland Clinic London—not Cleveland Ohio and not Harley Street—publishes a separate K5761 PFA hospital package from £18,080 GBP, checked 8 October 2026: day case with echocardiogram, excluding consultant, anaesthetist and required postoperative treatments or consultations. Use that only for the London institution’s own estimate.",
          "fact_refs": [
            "fact:pfa:provider:cost-v2:ccl-k5761-price",
            "fact:pfa:provider:cost-v2:ccl-package-exclusions"
          ],
          "source_refs": [
            "source:pfa:cost:v2:ccl"
          ],
          "id": "cost-scope-paragraphs-1"
        }
      ]
    },
    {
      "id": "next-action",
      "heading": "Start with an assessment, then compare written offers",
      "paragraphs": [
        {
          "text": "Use the Ohio arrhythmia route or Segal’s official practice route above. Compare the resulting offers on device, AF population, named operator, actual procedural venue, itemised cost, emergency cover and follow-up ownership. Bookimed can help obtain treatment programmes or arrange a second opinion; it does not provide medical advice or guarantee either route is available through Bookimed.",
          "fact_refs": [
            "fact:pfa:c9",
            "fact:pfa:exp:segal-access",
            "fact:pfa:compose:bookimed-coordination"
          ],
          "source_refs": [
            "source:ef846da4af4b",
            "src:segal-practice",
            "source:pfa:bookimed-coordinator"
          ],
          "entity_refs": [
            "provider:cleveland-clinic",
            "person:oliver-segal",
            "service:bookimed-coordination"
          ],
          "id": "next-action-paragraphs-0"
        }
      ]
    }
  ],
  "providers": {},
  "sources": [
    {
      "id": "source:1d1523d39ad0",
      "url": "https://consultqd.clevelandclinic.org/pulsed-field-ablation-current-state-and-where-its-heading",
      "title": "Cleveland Clinic Consult QD (May 2025): institutional PFA use and systems"
    },
    {
      "id": "src:segal-practice",
      "url": "https://www.oliversegal.com/",
      "title": "www.oliversegal.com — "
    },
    {
      "id": "source:64edc5867c38",
      "url": "https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P230030S012",
      "title": "FDA FARAPULSE supplement P230030S012 (January 12, 2026): approved indications"
    },
    {
      "id": "source:pfa:ohio-ep-service",
      "url": "https://my.clevelandclinic.org/departments/heart/depts/cardiac-electrophysiology-pacing",
      "title": "Cleveland Clinic: electrophysiology team, assessment address and appointments"
    },
    {
      "id": "src:hca-pfa",
      "url": "https://www.hcahealthcare.co.uk/about-us/news-and-press-releases/hca-uk-becomes-first-and-only-independent-healthcare-provider-to-introduce-medtronics-affera",
      "title": "www.hcahealthcare.co.uk — hca-uk-becomes-first-and-only-independent-healthcare-provider-to-introduce-medtronics-affera"
    },
    {
      "id": "source:c2b1a75334d9",
      "url": "https://pubmed.ncbi.nlm.nih.gov/37634148/",
      "title": "ADVENT (2023): randomized PFA versus pooled thermal ablation — primary abstract"
    },
    {
      "id": "source:d1efd743478e",
      "url": "https://clinicaltrials.gov/api/v2/studies/NCT04612244",
      "title": "ClinicalTrials.gov NCT04612244: ADVENT protocol and reported results"
    },
    {
      "id": "src:segal",
      "url": "https://www.hcahealthcare.co.uk/finder/specialists/dr-oliver-segal",
      "title": "www.hcahealthcare.co.uk — dr-oliver-segal"
    },
    {
      "id": "source:b588e081d2e6",
      "url": "https://my.clevelandclinic.org/patients/billing-finance/patient-price-lists",
      "title": "Cleveland Clinic: patient price lists and individual estimates"
    },
    {
      "id": "source:908d38f09193",
      "url": "https://www.hcahealthcare.co.uk/paying-for-medical-treatment",
      "title": "HCA: payment policy and self-pay estimates"
    },
    {
      "id": "source:pfa:final:segal-care",
      "url": "https://www.oliversegal.com/treatments/af-ablation",
      "title": "Oliver Segal: AF ablation and general AF-ablation follow-up"
    },
    {
      "id": "source:pfa:final:segal-consult",
      "url": "https://www.oliversegal.com/consultations",
      "title": "Oliver Segal: consultations and follow-up appointments"
    },
    {
      "id": "source:ef846da4af4b",
      "url": "https://my.clevelandclinic.org/services/arrhythmia-treatment",
      "title": "Cleveland Clinic: arrhythmia assessment service"
    },
    {
      "id": "source:pfa:wazni-role",
      "url": "https://providers.clevelandclinic.org/provider/oussama-wazni/4268336",
      "title": "Cleveland Clinic: Oussama Wazni — clinical role and Main Campus profile"
    },
    {
      "id": "source:pfa:final:ohio-care",
      "url": "https://my.clevelandclinic.org/departments/heart/depts/atrial-fibrillation-center",
      "title": "Cleveland Clinic AF Center: assessment and general PVI follow-up"
    },
    {
      "id": "source:70d0511f82f6",
      "url": "https://my.clevelandclinic.org/health/treatments/pulsed-field-ablation",
      "title": "Cleveland Clinic: pulsed field ablation, recovery and precautions"
    },
    {
      "id": "source:pfa:final:harley-site",
      "url": "https://www.hcahealthcare.co.uk/locations/hospitals/the-harley-street-clinic",
      "title": "HCA: The Harley Street Clinic, official hospital location"
    },
    {
      "id": "source:pfa:cost:v2:ccl",
      "url": "https://clevelandcliniclondon.uk/patients/payments/self-pay/electrophysiology-interventional-cardiology",
      "title": "https://clevelandcliniclondon.uk/patients/payments/self-pay/electrophysiology-interventional-cardiology"
    },
    {
      "id": "source:pfa:bookimed-coordinator",
      "url": "https://us-uk.bookimed.com/page/bookimed-medical-coordinator",
      "title": "Bookimed medical coordinators: services and limits"
    }
  ],
  "cta": {
    "heading": "Coordinate a centre assessment",
    "body": "Bookimed can help coordinate provider matching and a second opinion. Your treating team must confirm suitability, the care pathway and availability.",
    "label": "Request assessment coordination",
    "sticky_text": "Compare documented treatment pathways",
    "url": "https://us-uk.bookimed.com/order-create/question-about-medical-entity/?illnessId=150&type=messenger-priority&lref=eyJwYWdlVVJMIjoiaHR0cHM6Ly9odWIuYm9va2ltZWQuY29tL3B1bHNlZC1maWVsZC1hYmxhdGlvbi9jaG9vc2luZy1wZmEtY2VudHJlLyIsInRvcGljIjoiQ2hvb3NpbmcgYSBQRkEgY2VudHJlOiBDbGV2ZWxhbmQgT2hpbyBhbmQgSGFybGV5IFN0cmVldCBjb21wYXJlZCIsImludGVudCI6IlBGQSBjZW50cmUgYXNzZXNzbWVudCBjb29yZGluYXRpb24ifQ%3D%3D&utm_source=bookimed_hub&utm_medium=referral&utm_campaign=pfa_learning&button=pfa-08_assessment_sticky",
    "description": "Bookimed can help coordinate an assessment. Provider listings do not guarantee availability through Bookimed or an individual treatment price."
  },
  "date_label": "Created",
  "evidence_date": "2026-10-08",
  "relations": [
    {
      "label": "Paroxysmal AF after medication fails",
      "url": "https://hub.bookimed.com/pulsed-field-ablation/paroxysmal-af-after-medication-fails/",
      "group": "Understanding AF and treatment choice"
    },
    {
      "label": "Pulsed field ablation: how treatment works",
      "url": "https://hub.bookimed.com/pulsed-field-ablation/",
      "group": "Understanding AF and treatment choice"
    },
    {
      "label": "PFA compared with radiofrequency and cryoballoon",
      "url": "https://hub.bookimed.com/pulsed-field-ablation/pfa-vs-radiofrequency-cryoballoon/",
      "group": "Understanding AF and treatment choice"
    },
    {
      "label": "PFA for persistent and paroxysmal AF",
      "url": "https://hub.bookimed.com/pulsed-field-ablation/pfa-persistent-vs-paroxysmal-af/",
      "group": "Outcomes and care"
    },
    {
      "label": "PFA safety and serious complications",
      "url": "https://hub.bookimed.com/pulsed-field-ablation/pfa-safety-serious-complications/",
      "group": "Outcomes and care"
    },
    {
      "label": "After PFA: monitoring, medicines and travel",
      "url": "https://hub.bookimed.com/pulsed-field-ablation/after-pfa-monitoring-medicines-travel/",
      "group": "Outcomes and care"
    },
    {
      "label": "PFA costs and an individual estimate",
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    "name": "Pulsed field ablation guide",
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