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Procedure beats drugs in heart rhythm therapy

January 26, 2010 12:00:00 AM PST
Atrial fibrillation, or "A-fib," is a common heart rhythm problem associated with an increased long-term risk of stroke, heart failure and even death. A new study shows how using a heated catheter may be more effective than drug therapy in treating an intermittent form of this condition."My heart would just start racing and I would kinda lose my breath and usually it only lasted for a couple of seconds but as I got older they got progressively worse and more frequent," said Robin Drabant.

Drabant dealt with "A-fib" since she was a teenager.

Almost two years ago, Robin had a catheter ablation procedure much like the ones Dr. David Wilber from Loyola University Medical Center performs. During the procedure, spikes of electrical impulses, or "A-fib," show Wilber the rapid beating in the muscle sleeves around the pulmonary veins.

"The goal is to destroy the muscle around the pulmonary veins in order to prevent those transmissions of electrical impulses to the rest of the heart," explained Wilber.

Wilber and co-authors conducted a randomized trial with 167 patients in 19 hospitals between October 2004 and 2007. All patients had a form of A-fib that stops and starts on its own, 106 had catheter ablation and 61 were treated with antiarrhythmic drugs. The study appears in this week's JAMA, Journal of the American Medical Association.

"Sixty and 70 percent of patients treated with catheter ablation never had another episode after the treatment but about 30 percent did. In contrast, patients treated with drug therapy had somewhere between a 80 and 90 percent recurrence of arrhythmias over that time frame," said Wilber.

"I can just say from my experience, it was the best decision I've ever made. I wish I'd made it years before because my quality of life is just so much more improved," Drabant said.

"Drugs have been the mainstay for a long time. They've not been effective. We now have something that's very clearly and very objectively demonstrated to be far more effective not only in controlling atrial fibrillation and the symptoms but improving quality of life," said Wilber.

"I'm a normal 36-year-old and very glad I did it," Drabant said.

Researchers say the study was halted early because of the positive results of the catheter ablation.


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