Procedure Can 'Cure' Atrial Fibrillation
Radiofrequency Technique More Effective Than Drugs
July 15, 2003 -- Zapping the heart with radiofrequency energy is more effective than drugs at stopping atrial fibrillation -- the most common heart rhythm problem.
In a new study comparing both atrial fibrillation treatments, researchers say patients who had the radiofrequency procedure -- called "pulmonary vein ablation" -- were half as likely to die and had one-third the rate of recurrence compared with those taking medication.
"Patients now have the chance of having their atrial fibrillation cured and their quality of life improved," lead researcher Carlo Pappone, MD, PhD, of San Raffele University Hospital in Milan, tells WebMD.
His study involved nearly 1,200 atrial fibrillation patients, half of whom chose to have the ablation procedure while the other half continued medication to control their heart rhythm. About 200 were then followed for between five months and four years.
Pappone reports that 6% of the ablated patients died in that time, compared with 14% treated with drugs. In fact, survival among the ablation-treated patients was similar to people without a heart condition.
And whereas 65% of the drug-treated patients had an atrial fibrillation recurrence, only 25% of those treated with ablation suffered the same fate. Pappone says the ablated patients typically enjoyed a quality of life similar to that of people without the heart condition.
The ablation procedure attempts to cure atrial fibrillation and is a less invasive technique than the surgery used since the 1970s.
In atrial fibrillation, the heart rhythm can race to 350 to 600 times per minute. A normal heart rhythm is between 60 and 100 beats. The condition, affecting some 2 million Americans and 3 million others worldwide, can cause heart failure or stroke.
During the ablation procedure, a soft, flexible tube with an electrode at its tip is inserted into a large vein or artery, usually in the groin, and threaded to the precise locations of the heart producing atrial fibrillation, where it destroys that tissue with radiofrequency pulses. First used successfully in France in 1994, it is currently done primarily on patients with severe symptoms and hard-to-control atrial fibrillation.
But with results called "striking" in an accompanying editorial to his study, published in the July 16 issue the Journal of the American College of Cardiology, Pappone says doctors may advocate the procedure for those with milder but still life-affecting forms of atrial fibrillation.
"Generally speaking, the vast majority of patients with atrial fibrillation are good candidates for a pulmonary vein ablation procedure," he tells WebMD. "This innovative, non-pharmacological kind of treatment to cure atrial fibrillation allows patients to become drug free in a relatively short time, greatly enhancing their quality of life."
But the procedure is not without its risks -- including a slight chance of triggering a stroke or other complications, says Eric N. Prystowsky, MD, director of the the Clinical Electrophysicology Laboratory at St. Vincent Hospital in Indianiapolisis.