March 20, 2002
Penn Electrophysiologists Document
a Cure for Atrial Fibrillation That Makes Pacemakers,
Drugs Unnecessary
Cardiac Rhythm
Specialists for the University of Pennsylvania Health
System have documented the effectiveness of a new
technique to cure atrial fibrillation (A-Fib). 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 a session 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) disrupts
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 afibrillation 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 Beshai, MD; Joseph W. Poku, MD,
and David Lin, MD, all of the Penn heath system.
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The University of Pennsylvania Health System and
School of Medicine are distinguished not only by their
historical significance -- first hospital (1751), first
medical school (1765), first university teaching hospital
(1874), first fully integrated academic health system
(1993) -- but by their leadership in the practice of
medicine in the 21st Century. Among all American medical
schools, Penn ranks second in funding from the National
Institutes of Health, perhaps the single most important
barometer of research strength.
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