Treating atrial fibrillation (AF), the most common type of arrhythmia, with what was previously a last-resort therapeutic approach will help reduce the risk of death and stroke in the long-run. From the University of California - Davis Health System, scientists show how cardiac ablation in addition to medication can be beneficial for AF patients.
Catheter-based cardiac ablation is currently only recommended for when drugs prescribed to treat AF aren’t working or are poorly tolerated. Nearly three million Americans have AF, a condition where the heart beats irregularly when the upper chambers of the heart, the atria, quiver while sending blood into the lower chambers of the heart, the ventricles.
Patients with AF may experience lightheadedness, fatigue, shortness of breath, and chest pain, indicating their increased risk of blood clots, heart failure, stroke, and death. Drugs prescribed to treat AF control the heart rate and rhythm and minimize the risk of blood clot formation, but the new study shows that cardiac ablation may be beneficial in the early stages of the disease as well.
"Less than 2 percent of patients undergo ablation early in the course of [AF] when the procedure can be most beneficial," explained lead author Uma Srivatsa. "Our study shows that ablation may be considered as a primary treatment for everyone with the condition."
Cardiac ablation is a process where long, flexible tubes called catheters enter the body through a blood vessel in the groin and travel up to the heart to deliver their energy, in the form of either heat or extreme cold. This energy scars or destroys the heart tissue responsible for quivering in the atria. Conducting cardiac ablation with a catheter through a groin blood vessel makes a less invasive procedure than if it were done via open heart surgery.
In the past, studies of cardiac ablation showing that the procedure was not safe or beneficial enough to conduct in the early stages of AF produced inconsistent results. Additionally, after a closer look at their methodology, researchers found that many studies limited the diversity of their study subjects and conducted controversial data collection.
In contrast, the new study evaluates AF treatment outcomes over a long period of time, collecting data from a large population of multi-ethnic participants with similar health statuses, eliminate confounding variables. Researchers compared two study groups of four thousand diverse AF participants. One group was treated with ablation, and one was not. Other AF factors were nearly the same.
After 30 days, the group who received cardiac ablation were less likely to die and less likely to have a stroke.
The present study was published in the journal Circulation: Arrhythmia and Electrophysiology.