New treatment prevents irregular heartbeats,
one cause of strokes

Doctors at UT Southwestern are successfully using radio waves to block the site that provokes the irregular heart rhythms associated with atrial fibrillation, until now considered a chronic, incurable condition.

In the procedure, doctors deliver energy through a catheter, creating a scar to stop irregular impulses from the pulmonary veins, where abnormal rhythms originate in many patients. The treatment, called pulmonary vein ablation, corrects the condition in about 70 percent of those who receive it while the remainder often experience fewer or less intense attacks.

"Atrial fibrillation has always been thought of as a chronic problem requiring ongoing therapy," said Dr. Robert Kowal, assistant professor of internal medicine. "But this new procedure has revolutionized the way we treat patients with this common condition, allowing us to restore patients to normal cardiac rhythm without dependence on any medications."

Dr. Kowal along with Dr. Mohamed Hamdan, associate professor of internal medicine, and Dr. Ali Kizilbash, assistant professor of internal medicine, performs the procedure at Parkland Memorial Hospital and the Dallas Veterans Affairs Medical Center.

Atrial fibrillation - the most common heart rhythm irregularity worldwide - affects 2 million Americans, striking men slightly more often than women. The condition affects the upper chambers of the heart, and its prevalence increases with age. The most common symptom is palpitations, or a rapid heartbeat, and about 15 percent of strokes are attributed to atrial fibrillation. Other symptoms include shortness of breath, profuse sweating, chest pain, dizziness, exercise intolerance, fainting and extreme fatigue.

The new procedure is most effective in patients who have paroxysmal atrial fibrillation, or relatively brief episodes of irregular heartbeats, that can last from a few seconds to several hours or even days. The episodes may be the precursor of more chronic forms of atrial fibrillation, Dr. Kowal said.

In the mid-1990s French researchers discovered that the four openings of the pulmonary veins in the left atrium were the main triggers for paroxysmal atrial fibrillation. Since that time, several surgical approaches have been implemented to treat the sporadic condition, but radio-frequency ablation is the first percutaneous, or nonsurgical, procedure that offers a cure.

During the procedure - which can last up to six hours - doctor insert a soft, thin catheter through a large vein or artery in the groin directing it to the heart and the precise area that triggers the problem. These points are then electrically seared to isolate them from the heart.

Patients usually return home within two days after the procedure and resume routine daily activities after about a week.

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Media contact: Amy Shields
Phone: 214-648-3404
e-mail: amy.shields@utsouthwestern.edu

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