Treating A-fib
It can make you feel dizzy and maybe faint. You can become so tired that you can’t work or enjoy your life. In many cases it can lead to strokes, heart failure and death. The culprit: atrial fibrillation, the most common form of irregular heartbeat. More than two million Americans have atrial fibrillation, often called A-fib. Doctors diagnose about 160,000 new cases each year.
Erratic electrical activity in the heart causes it to beat either too slowly or too quickly. Instead of beating regularly, the upper chambers of the heart quiver. Not all the blood gets pumped out; clots can form that can lead to potentially life-threatening conditions.
“For low-risk patients with only minor symptoms, no treatment may be necessary,” said David Wilber, MD, FAHA, FACC, George M. Eisenberg Professor of Cardiovascular Sciences, Loyola University Chicago Stritch School of Medicine, and division director, cardiology. “We refer to that as ‘watchful waiting’. For patients with intermittent symptoms, we usually first try to manage A-fib with medications to slow the heart rate, maintain normal rhythm and reduce the risk of blood clots. If the drugs don’t work, we’ll often proceed to catheter ablation.”
During an ablation, an electrophysiologist (a cardiologist who specializes in treating the heart’s electrical activity) guides a catheter (thin flexible tube) through blood vessels to reach the heart. The tip of the catheter delivers radiofrequency energy that heats and destroys small areas of heart tissue that are responsible for the erratic electrical signals.
According to results from a recent international study lead by Dr. Wilber, catheter ablation works dramatically better than drug treatments for patients with paroxysmal (intermittent) atrial fibrillation. One year after undergoing the procedure, 75 percent of A-fib patients were free of symptoms, compared to 21 percent of those treated with drugs. Results were so convincing that the Food and Drug Administration halted the trial early in order to allow more people access to the treatment.
“Data from this large, multi-center trial reinforces that once patients have had an unsuccessful treatment with drugs, ablation is associated with fewer episodes, less symptoms and a better quality of life than continued attempts to treat the heart rhythm problems with more medications.”
Last year, Loyola became the first Chicago-area hospital to perform ablations with a magnetically guided catheter that's much more precise and flexible than manual catheters. In the new system, the electrophysiologist is in a control room outside the patient’s lab and uses a computer to map out the catheter's next move. The computer executes the move by adjusting the magnetic field.
“The new guidance system makes a skilled cardiologist even better,” said Joseph Akar, MD, PhD, a Loyola electrophysiologist and assistant professor, cardiology, LUC Stritch School of Medicine. “It extends the physician’s range of skills and will help us get more consistent results.”
Drs. Wilber and Akar are part of an extensive Loyola interventional cardiology team that treats all heart- and vascular-related disorders, from arrhythmia to heart failure requiring a transplant. For more information, please visit www.LoyolaMedicine.org/heart or call (888) LUHS-888.
LOYOLA UNIVERSITY HEALTH SYSTEM
