The technique targets and isolates the triggers, or "hot spots," on pulmonary veins leading to the heart, preserving the heart's natural electrical circuitry and eliminating the need for a pacemaker or medication.

Francis E. Marchlinski, MD, director of Cardiac Electrophysiology for the University of Pennsylvania Health System, discusses the findings at an 8:30 a.m. session today of the American College of Cardiologists meeting in Atlanta.

"This procedure can eliminate atrial fibrillation completely and patients can resume their lives without relying on mechanical devices or any form of medication, including blood-thinners," Marchlinski says.

Atrial fibrillation is a serious condition, often associated with aging, which results when electrical discharges in one of the atria (upper chambers of the heart) disrupt the normal, organized electrical activity, or "sinus rhythm," generated by the heart's sinus node.

Patients with this arrhythmia often suffer a rapid heartbeat, palpitations, weakness, shortness of breath and fatigue, although sometimes the condition manifests no symptoms. The arrhythmia may begin with occasional or regular bouts of an irregular heart beat, but it generally worsens over the years.

Traditional ablation procedures for this arrhythmia deliver an electrical charge that permanently blocks the electrical connection that transmits the impulse from the atria to the heart's lower ventricles. A pacemaker is then required to maintain an adequate heart rate.

The older procedure does not cure fibrillation, but merely prevents the fast heart rate that frequently accompanies atrial fibrillation, and patients still require blood-thinning medication.

The Penn procedure is more specific in targeting the triggers for atrial fibrillation rather than blocking the main electrical road to the heart. During the ablation process, Penn electrophysiologists infuse drugs that promote the firing of so-called "hot spots" in the pulmonary veins. Once those triggers are identified with the use of sophisticated electrical recording techniques, a catheter-based ablation procedure isolates the abnormal fibers that cause them.

The Penn team has developed what it believes are the optimal recording strategies and pacing techniques for identifying the affected veins rapidly and confirming the effectiveness of the isolation procedure.

"We've been working on this problem for the last five years, and we're excited by the effectiveness and low complication rates associated with our current technique," Marchlinski says.

Others who assisted Marchlinski include David. J. Callans, MD; Erica S. Zado; Andrea J. Russo, MD; Edward P. Gerstenfeld, MD; Sanjay Dixit, MD; Robert W. Rho, MD; Vickas Patel, MD; John Veshai, MD; Joseph W. Poku, MD, and David Lin, MD, all of the Penn heath system. - By Ellen O'Brien


[Contact: Ellen O'Brien]

20-Mar-2002