Zapping Faulty Heartbeats

Technique brings hope — and dramatic results — to patients with atrial fibrillation

An innovative procedure, tested and perfected at the U-M Cardiovascular Center, completely cures the overwhelming majority of patients with atrial fibrillation — the most common form of irregular heartbeat. Called radiofrequency catheter ablation, it delivers tiny bursts of intense energy that destroy areas of disorganized electrical activity in heart muscle and connecting veins, while sparing nearby tissue.

In recent presentations at the American Heart Association's Scientific Sessions 2003 meeting and an article published in Circulation, U-M cardiologists reported that more than 85 percent of U-M Health System patients with intermittent atrial fibrillation were cured after a single session of catheter ablation. After the procedure, these patients no longer needed medications to stabilize their heartbeat and cut their risk of clotting and strokes. Complication rates were extremely low.

Fred Morady and Hakan Oral Photo: Martin Vloet

"We have treated more than 500 patients in the last three years and have achieved very favorable results," says cardiologist Hakan Oral, M.D., an assistant professor of internal medicine in the U-M Medical School. "It's still a technically challenging procedure, but we hope to continue to simplify and improve it, and train others to perform it."

More than 2.2 million Americans have atrial fibrillation. In addition to causing heart palpitations, fatigue and pain that can be debilitating, the condition greatly increases the risk of stroke and can cause heart enlargement.

The U-M Health System is one of only a handful in the world where catheter ablation is performed. In addition to treating patients with paroxysmal atrial fibrillation, U-M cardiologists treat patients with a much more debilitating and harder-to-treat form of the disorder called persistent AF.

Oral and Fred Morady, M.D., a professor of internal medicine in the U-M Medical School, hope to make more cardiologists and patients aware of radiofrequency catheter ablation's importance in the treatment of atrial fibrillation. Recent developments, including new ablation strategies and the ability to make three-dimensional digital maps of the heart and its electrical signals, have enhanced the procedure, according to Oral. Morady points to increased success at ablating areas in the left atrium wall, rather than just the juncture between the pulmonary veins and the left atrium.

The U-M team's research is funded by the Ellen and Robert Thompson Atrial Fibrillation Research Fund. Other members of the U-M Cardiovascular Center's atrial fibrillation research team include Christoph Scharf, M.D., Aman Chugh, M.D., Burr Hall, M.D., Peter Cheung, M.D., Eric Good, D.O., Mehmet Ozaydin, M.D., Srikar Veerareddy, M.D., and Frank Pelosi Jr., M.D. (Residency 1999).

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Read an expanded version:
www.med.umich.edu/opm/newspage/2003/atrialfibrillation.htm

For patient information on atrial fibrillation:
www.med.umich.edu/1libr/aha/aha_atfibril_car.htm