PITTSBURGH, Oct. 17 -- Cardiologists at UPMC Health System are the first in the U.S. to study a new treatment for atrial fibrillation, a condition in which the heart beats irregularly and very rapidly.
Called radiofrequency catheter ablation, the procedure combines sophisticated imaging techniques with virtual reality, allowing doctors to create a map of the inside of the heart and short circuit abnormal electrical impulses which cause the irregular beats.
An estimated two million Americans have atrial fibrillation and about 15 percent of strokes are attributable to the disorder.
"Until now there has not been an effective non-drug treatment for atrial fibrillation," said David Schwartzman, M.D., assistant professor of medicine in the division of cardiology and director of the Atrial Fibrillation Consultation and Advanced Therapies Center at UPMC Health System. "The outcome of this approach has been, for the most part, dismal because of drug inefficacy and/or adverse side effects. With our aging population, the prevalence of this disease has increased steadily and will continue to do so."
Physicians insert a catheter into the upper chamber of the heart (atrium) and using intracardiac echocardiography and a new magnetic imaging technique called CARTOŠ, they can determine the exact location of the tip of the catheter at all times. They then use this information to map the inside of the heart and reconstruct a real-time three- dimensional view of the heart on a high-resolution computer monitor with no x-ray exposure.
Guided accurately to within .09 mm by the three-dimensional images, the physicians use radiofrequency energy to create a series of lesions in the atrium.
"There are a large number of circuits in the atria and these lesions create barriers to conduction between the different areas and stop irregular heart beats," Dr. Schwartzman said. "This procedure is minimally invasive."
The procedure usually takes 3 to 5 hours during which time patients are under light sedation. Patients are monitored overnight and discharged from the hospital the following day.
"The technique has been used in approximately 30 patients at three centers in Europe over the past six months," Dr. Schwartzman said. "Thus far atrial fibrillation suppression has been achieved in more than 75 percent of the patients."
Dr. Schwartzman is leading a multicenter, FDA-approved trial in the United States of the procedure. The study is funded by Biosense, Inc., manufacturer of the CARTOŠ system.
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