New technology used to treat abnormal heart rhythms: Arizona Arrhythmia Consultants in Scottsdale among few with clinical trials of catheter (Arizona Republic)
After two prior procedures didn't cure his abnormal heart rhythms, West Valley resident Robert Taugner hopes a new treatment at Scottsdale Healthcare means the end of daily medications and the return to three-mile power walks.
I'm too young to take medicines the rest of my life, says Taugner, 60, a retired police officer whose heart condition has affected his endurance as well as ability to pass employment physicals.
All that may change, thanks to the new Thermocool ablation catheter used on Taugner at Scottsdale Healthcare Osborn's advanced electrophysiology lab. Like others, the catheter uses heat to destroy abnormal heart muscle that causes cardiac arrhythmias, or abnormal heart rhythms. However, the Thermocool catheter is different because it sprays cooled saline.
It's safer and more effective with higher success rates and less complications, says Cardiac Electrophysiologist Vijay Swarup, MD, who performed the first Thermocool ablation procedure in Arizona at Scottsdale Healthcare Osborn in November.
Hospital at forefront
Scottsdale Healthcare was one of 20 hospitals in the nation and one of only five in the West to be picked by Biosense Webster (a J&J Company) for early phase I launch of Thermacool catheter. The catheter was recently approved by the FDA for treating atrial flutter, a rhythm in the right upper chamber of the heart that is regular but too fast.
Currently, the hospital is one of 12 sites in the nation, and the first in the West, to enroll patients in the first FDA trial using the new catheter to cure atrial fibrillation. An irregular rhythm in the left upper chamber of the heart, atrial fibrillation is the most common arrhythmia, says Dr. Swarup, who is the principal investigator.
More than 2.2 million Americans have Atrial Fibrillation, and 160,000 more are diagnosed each year. In addition to causing heart palpitations, fatigue and pain that can be debilitating, the condition dramatically increases a person's risk of stroke, because blood clots form in the irregularly beating chambers of the heart. According to Dr. Swarup, atrial fibrillation has traditionally been treated with medications, which are only effective in about half of patients. Ablation, however, can provide a curative option for patients such as Taugner, whom Dr. Swarup notes are often miserable with symptoms such as shortness of breath, fatigue and palpitations. "We have treated more than 500 such patients with catheter ablation in the last three years at Scottsdale Healthcare and have achieved very favorable results", says cardiologist Vijay Swarup, M.D. of Arizona Arrhythmia Consultants.
Improved technology
Catheter ablation aims to counteract irregular electrical impulses in heart muscle by delivering tiny bursts of intense radiofrequency waves to the areas of disorganized or abnormal electrical activity. The radiofrequency energy heats (Zaps) the targetted areas of heart tissue, a process called ablation. Depending on which areas will be targeted for ablation, doctors guide the tiny devices (Catheters) into position and deliver the radiofrequency pulses with painstaking precision. With traditional catheters, excessive heat where the catheter touches the heart tissue often causes doctors to decrease the catheter's radiofrequency power to avoid charring or perforation of the cardiac tissue. According to Dr. Swarup, charred tissue can cause blood clots, which in turn can cause strokes.
The new Thermocool catheter aims to eliminate such issues because its showerhead-like tip which sprays saline, prevents the cardiac surface from becoming too hot. This enables enough heat to be delivered deep in the tissue to effectively destroy abnormal muscle, while lowering risks of charring. The catheter is the first of its type to be open loop, meaning cooling solution is used outside of the catheter rather than circulated within the catheter, according to Todd Gumm, local representative for Biosense Webster, the Johnson & Johnson company that developed the Thermocool catheter.
Additionally, the new catheter has a smaller tip, making it more precise. It also can create deeper and larger lesions, making it potentially more effective in ablation procedures such as Taugner's that involve the left side of the heart, where tissue is thicker.
"It's likely to replace other ablation catheters for treatment of arrhythmias of the left heart", says Dr. Swarup, noting that the Thermocool device has rapidly gained about 80 - 90 percent market share for ablation of left-sided heart arrhythmias in Europe. "We expect it to be really successful."
