A clinical trial at Cedars-Sinai Medical Center may offer new hope for patients with Paroxysmal Atrial Fibrillation (PAF). According to scientists at the medical center, correctly identifying patients with PAF, pinpointing specific "trigger" areas in their hearts and non-surgically eliminating those triggers using radiofrequency energy (ablation) may offer a permanent cure for this type of cardiac arrhythmia. According to Dr. P.K. Shah, M.D., Director of the Division of Cardiology at Cedars-Sinai Medical Center in Los Angeles, "The ability to cure Atrial Fibrillation in selected patients could not only eliminate the need for long-term therapy with drugs that often produce side effects, but would also eliminate the increased risk of stroke that often accompanies Atrial Fibrillation."
LOS ANGELES (October 9, 1998) - A clinical trial currently under way at Cedars-Sinai Medical Center may offer a permanent, non-surgical cure for patients who experience recurrent episodes of Paroxysmal Atrial Fibrillation (PAF) which is not controlled by medications. These patients are generally young (in their 40s or 50s), have apparent normal heart function, and no readily identifiable heart disease. As a result, they often go undiagnosed -- and untreated -- for years.
According to Rahul Doshi, M.D., Fellow, Cedars-Sinai Division of Cardiology -Electrophysiology, two key components of the study focus on early identification of patients with PAF (rapid, premature and irregular activity within the heart), and then locating the area or areas within the heart that "trigger" episodes of rapid or premature electrical activity.
"Key to this study is identifying which patients are appropriate candidates for ablation," says Dr. Doshi. This involves obtaining a complete medical history and physical, and then using diagnostic tools such as echocardiograms and continuous holter monitoring. For holter monitoring, EKG electrodes are connected to the patient and to a recorder for 24 to 72 hours. The patient can do this at home, returning at the end of the specified time period, so doctors can print out and review the recorded heart activity. "This shows if a patient is experiencing episodes of atrial fibrillation and frequent extra beats that might trigger it," says Dr. Doshi.
Once a patient has been identified as an appropriate candidate for the ablation procedure, treatment takes place in the Electrophysiology Laboratory. Electrode catheters are inserted into the heart to monitor and record electrical activity and to 'map' where the extra beats are originating. Once the site -- or sites -- have been pinpointed, Radiofrequency energy is delivered through the electrode to 'burn' (ablate) the trigger area, permanently eliminating future arrhythmias from that area. "This offers a real cure -- permanent," says Dr. Doshi.
According to P.K. Shah, M.D., Director of the Division of Cardiology at Cedars-Sinai Medical Center in Los Angeles, "the ability to cure Atrial Fibrillation in selected patients could not only eliminate the need for long-term therapy with drugs that often produce side effects, but would also eliminate the increased risk of stroke that often accompanies Atrial Fibrillation."
Cedars-Sinai is the only Southern California facility involved in a clinical trial of this type, and one of only a few facilities in the world to offer the procedure. Scientists involved in the Cedars-Sinai clinical trial hope to raise awareness among other cardiologists, primary care physicians and the general public. For referral information, please call the Cedars-Sinai Medical Center, Division of Cardiology and Section of Electrophysiology, 310-855-4251.
Available For Interviews:
Chun Hwang, M.D., Clinical Trial Lead Investigator and Visiting Scientist,
C. Thomas Peter, M.D., Director of Electrophysiology at Cedars-Sinai
Peng-Sheng Chen, M.D., Director of Pacemaker and Device Clinic and Electrophysiology Research at Cedars-Sinai
For media information and to arrange an interview, please call 1-800-396-1002 (this number is not for publication).