Health
Research results may change the way patients with atrial fibrillation are treated-ScienceDaily
The results of the world’s largest study of atrial fibrillation (AFib) procedures show that a simple approach is usually best for ablation, which is the procedure by which a doctor destroys or removes heart tissue to correct an arrhythmia. is showing. Findings may change the way patients with AFib are treated.
Researchers at the University of Tulane and partner institutions have found that using advanced imaging techniques to more aggressively target the affected area of the heart that causes arrhythmias does not improve patient outcomes. The results show that some patients are at increased risk of stroke.Of the DECAAF II exam published in JAMA..
“Simpleness is key, especially in advanced stages,” said Dr. Nasir Marouch, Principal Research Author, Director of Cardiovascular Research Institute, University of Tulane and Arrhythmia Detection Research Innovation (TRIAD). I am saying. medicine. “Too much ablation doesn’t help patients today. It increases their risk. This is a discovery that changes practice from our study.”
AFib occurs when the upper and lower atrium of the heart is out of sync and the heart beats irregularly. It affects more than 2.7 million Americans and is a major risk factor for stroke. If AFib cannot be controlled with medication, doctors perform steps to remove the fibrous or lesions of the heart with heat or cold to create scars that disrupt the electrical signals that cause arrhythmias.
In this study, researchers followed 843 AFib patients receiving ablation treatment in 44 hospitals in 10 countries, including the United States, Germany, France, and Australia. All patients underwent magnetic resonance imaging (MRI) scans to quantify the amount of lesion tissue in the heart. (According to the results of the original DECAAF study, people with a high proportion of diseased tissue are at increased risk of recurrence of arrhythmias.)
Half of the patients received standard treatment-in pulmonary vein isolation (PVI) treatment, the doctor removes the area of the upper left chamber of the heart where the four pulmonary veins meet.
In another group, doctors used MRI scans to create detailed 3D maps of all affected areas along the left atrium of the heart. They performed conventional PVI treatment and used digital maps to more aggressively and accurately excise lesion tissue outside the traditional treatment area.
All study patients received a smartphone EKG device to monitor heart rhythm daily after treatment, and researchers followed them up at intervals of 3, 6, and 12 months.
The researchers found no significant difference in the recurrence of arrhythmias between the two groups. However, the more aggressively treated group experienced a higher percentage of reduced safety in 6 patients (1.5%) suffering from stroke.
According to Marrouche, the study shows that AFib patients with widespread fibrosis have too many scars for aggressive resection therapy to be effective using traditional tools. .. Researchers also suspect that it wasn’t just the degree of fibrosis that affected the results of the study. In assessing hundreds of procedures by world-leading electrophysiologists, they found little uniformity in the way doctors perform ablation interventions. This can also contribute to different results.
“The procedure for atrial fibrillation has become too complex in the last few years. We are currently removing hundreds of thousands of atrial fibrillations annually and using continuous or continuous AFib more. We strive to perform atrial fibrillation, “says Marrouche. “But our study shows that it is not necessary, especially in patients with high myopathy. Simple resection is an alternative to large-scale resection to treat difficult-to-control fibrous areas. You can effectively treat these patients. “
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material Provided by Tulane University.. Note: Content can be edited in style and length.
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