Procedure May Provide Map for AFib Treatment

Scientists may have figured out a way to stop the heart from producing the irregular heartbeats caused by atrial fibrillation.

There’s new hope for the millions of Americans that have atrial fibrillation (AFib).

A team at The Ohio State University Wexner Medical Center, using hearts from organ donors, were able to devise a method to clearly map the heart, and ultimately interrupt its ability to produce irregular heartbeats.

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The clear mapping of the heart allows experts to find new areas to perform helpful ablations.

During an ablation, tiny cuts or burns are made to form scar tissue that can disrupt the heart’s electrical circuitry and stop irregular beats.

Read more: Atrial fibrillation (AFib): What’s my outlook? »

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What is AFib?

AFib is an abnormal heart rhythm or arrhythmia that occurs when disordered or rapid electrical signals cause the upper chambers (atria) of the heart to contract too quickly and chaotically (fibrillate).

When fibrillation occurs, it causes blood flow to become irregular and blood can collect in the atria without being pumped into the lower chambers of the heart, which is what happens in a healthy heart.

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According to the Centers for Disease Control and Prevention (CDC), someone goes to the hospital every 42 seconds due to AFib.

AFib can lead to blood clots, heart failure, stroke, and chronic fatigue.

About 2 percent of Americans under age 65 have AFib, while about 9 percent of those 65 and older have the condition.

Dr. Michael Miller, a cardiologist at the University of Maryland Medical Center, told Healthline that traditional treatments for AFib include low-voltage shocks (electrical cardioversion) and medications to convert the abnormal heart rhythm or reduce an excessively fast heart rate.

Despite the treatments, symptoms can persist.

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“In these cases, the abnormal electrical activity is mapped out and the affected region is ablated or destroyed,” he said. “Catheter relation is successful in approximately 75 percent of cases but up to 10 percent may experience complications.”

Read more: Atrial fibrillation treatments »

An AFib breakthrough?

Typically, it is difficult for doctors to know where to ablate the heart as it beats erratically 24 hours a day.

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Vadim Fedorov, Ph.D., an associate professor who studies anti-arrhythmic treatments, and his team, devised a way to better image the heart.

The organ is injected with dye and placed in a dish with four high-speed optical cameras around it. A camera normally can capture about 200 recordings, but this technology records 40,000 images in 3-D.

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The improved imaging lets doctors find ideal areas for ablations.

“While this technique may pave the way for more precise ablation procedures for atrial fibrillation, and improve their success rates, [currently at about 70 percent] the approach has not been validated in real-life humans with atrial fibrillation,” Dr. Regina Druz, a cardiac imaging doctor from New York, told Healthline.

She noted that the hearts used in the study were donated by patients that received transplants, and they probably had structural issues that come with cardiac disease.

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She says that Fedorov’s technique may find fewer clinical applications in actual patients with AFib because their hearts are not structurally damaged.

Fedorov could not be reached for comment.

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Druz also notes that recent evidence has indicated that AFib is an inflammatory disease that can be modified with lifestyle interventions.

“Over the years, we saw a drastic reduction in atrial fibrillation caused by rheumatic heart disease, as antibiotics and vaccinations took care of that,” Druz added. “However, atrial fibrillation burden remains high due to explosion of obesity, diabetes, and sedentary lifestyle.”

“Patients need to be provided with comprehensive lifestyle counseling, and helped to lose weight, reduce their blood pressure, normalize their cholesterol and blood sugar, as all those are triggers and risk factors for cardiac disease, including atrial fibrillation,” she said.

While the imaging tools developed at Ohio State may add great precision to mapping out regions for ablation, it’s important to recognize that ablation is used to treat persistent symptoms only, Miller noted.

“Patients who have risk factors for stroke should remain on anticoagulant therapy [blood thinners] because the risk of stroke has not been shown to be reduced following ablation therapy,” he said.

Read more: Surgery for atrial fibrillation »