New Treatment for Irregular Heartbeat

Hybrid procedure better treats atrial fibrillation

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Atrial fibrillation can be difficult to treat because medications can stop working. But researchers have developed a new hybrid procedure they believe can better help patients. Though rarely deadly, atrial fibrillation can cause difficult symptoms such as chest pain and fatigue.

The new hybrid procedure unveiled by researchers at the Washington University School of Medicine helps to better block erratic electrical signals that cause atrial fibrillation, a common heart arrhythmia. The procedure is currently available at only a handful of U.S. medical centers.

The hybrid procedure combines minimally invasive surgical techniques with advances in catheter ablation, which applies scars to the heart’s inner surface to block signals causing the heart to misfire. The dual approach gives doctors access to both the inside and outside of the heart at the same time, helping to more completely block the erratic electrical signals that cause atrial fibrillation.

When drugs are no longer effective, physicians usually recommend catheter ablation, which involves threading long, thin tubes through a vein in the groin, then into the heart. Tips of the catheters can be heated, allowing doctors to perform a series of burns on the heart’s inner surface.

Ablation therapy is considered successful when it creates scar tissue that isolates the irregular electrical signals and blocks them from spreading over the heart and causing fibrillation. Following the procedure 70 percent of patients have no symptoms after one year. An ablation sometimes needs to be required a second or third time.

Although success rates for catheter ablation are better than medication, catheter ablation does not always work. Some patients may require a second or third procedure to achieve a successful result.

For hard-to-treat patients, doctors have recommend the Cox-Maze surgical procedure, which is 90 percent effective, but more invasive. The hybrid procedure attempts to combine the success rates of the Cox-Maze procedure with the minimally invasive nature and shorter recovery times associated with catheter ablation. The key is blocking signals that cause the erratic rhythm from both inside and outside the heart at the same time. Utilizing both procedures together allows that to happen.

The procedure is performed through three small incisions under each of a patient's armpits, where a small camera is inserted into one of the incisions. After the surgeon has performed the ablations on the outside of the heart, the electrophysiologist uses the catheters inside the heart to attempt to induce a fibrillation.

A clinical trial is planned to compare the new hybrid procedure to catheter ablation in patients with persistent atrial fibrillation. However the procedure is currently available at a limited number of medical facilities.

Reviewed by: 
Review Date: 
June 30, 2011
Last Updated:
July 6, 2011