Emory Performs Linear Left Atrial Ablation For First Time In Georgia

Emory University
Monday, 22 December 2003

Donald Burkett of Blue Ridge, Georgia, says symptoms he experienced due to the irregular heart rhythm known as atrial fibrillation (a-fib) made him feel miserable. "I've always been very active and a competitive runner, but I had such extreme fatigue that I didn't want to do anything. And I had some bad reactions to the medications I was on, " Burkett, 54, a law enforcement officer explains. After undergoing an innovative, minimally invasive procedure called a linear left atrial ablation at Emory Crawford Long Hospital (ECLH) Carlyle Fraser Heart Center last week, his heart was immediately beating at a steady, even rate for the first time in three years. "I feel great," he says.

Walter Hughes, 56, a telephone office system installer in Mt. Aire, Georgia, had a similar experience. Over the past six months, his erratic heartbeat left him tired and constantly worried about his heart. " I couldn't enjoy my life or do anything without being concerned about the atrial fibrillation, " he notes. Like Burkette, Hughes was one of the first people in Georgia to undergo linear left atrial ablation - and his heart is now beating in a normal, regular rhythm.

According to the American Heart Association, about two million Americans suffer from atrial fibrillation, a heart arrhythmia that can cause palpitations, fatigue and increase the risk of stroke. Available for the first time in Georgia at the ECLH Carlyle Fraser Heart Center, linear left atrial ablation increases the likelihood of achieving a cure for this condition.

"Atrial fibrillation is by far the most common sustained arrhythmia we see and creates a tremendous amount of symptoms and disability in patients. By being able to treat it and potentially cure it, we can not only improve the quality of life for many patients but also reduce the number of medications they have to take and trips to the hospital," says Emory Heart Center electrophysiologist Angel Leon, MD, Director of Cardiology at ECLH. Dr. Leon performed the first left linear ablation in Georgia in mid-December.

To perform an ablation, an electrophysiology study is first performed to map the source of a patient's heart arrhythmia. Then thin, flexible tubes are introduced through a blood vessel and directed to the heart muscle where a burst of radiofrequency energy is delivered to destroy tissue that has been found to trigger abnormal electrical signals or to block abnormal electrical pathways causing irregular heart rhythms.

Although many other kinds of heart arrhythmias have proved to be curable by standard catheter ablation techniques, atrial fibrillation has been one of the most difficult arrhythmias to treat this way. Instead, a-fib patients are often placed on blood thinners and other heart medications that can produce a host of side effects and are not always an effective therapy for atrial fibrillation.

The problem, Dr. Leon explains, is that the electrical abnormalities associated with atrial fibrillation are more generalized than those seen in other more easily ablated arrhythmias. However, the new linear left atrial ablation technique helps overcome this difficulty. It incorporates the state-of-the-art CartoXP system made by Biosense to map the heart's electrical system and then targets specific areas within the left atrium near the openings of the four pulmonary veins for ablation.

"It appears that atrial fibrillation originates in the pulmonary veins in many patients and that isolating these veins using catheter-based ablation techniques can prevent atrial fibrillation from occurring," Dr. Leon says. "Although other techniques have been used to target the pulmonary veins by isolating spots around the muscle fibers that come out of the pulmonary veins, linear left atrial ablation is designed to create lines around different areas in the atrium to eliminate a-fib. This approach reduces the risk of damage to the pulmonary veins and increases the likelihood of success."

For more information, or to contact Emory University, see their website at: whsc.emory.edu