New Study Underway for Common Heart Condition

More than 2 million Americans have a type of irregular heartbeat called atrial fibrillation. There are about 160,000 new cases of “a-fib” each year, and the number is increasing, due in part to the aging population and the obesity epidemic.

In a-fib, electrical signals that regulate the heartbeat become erratic. Instead of beating regularly, the upper chambers of the heart quiver. Not all the blood gets pumped out, so clots can form. If not treated properly, a-fib can lead to strokes and heart failure. Typical symptoms of atrial fibrillation include heart palpitations, dizziness, chest pain, fatigue, shortness of breath, fainting and lightheadedness. Medications can maintain a normal heart rate or rhythm. Treatments also are used to “thin the blood” in order to prevent blood clots. But when drugs don't work or cause unacceptable side effects, alternative treatments include surgery or catheter ablation. While drugs have been available for more than 30 years, ablation is a relatively new treatment.

Catheter ablation involves burning selected spots of tissue inside the heart. This eliminates the sources of errant electrical signals that are triggering the atrial fibrillation.

A nationwide clinical trial is evaluating a new pressure-sensing catheter device that's intended to improve outcomes of patients treated for a-fib. Loyola University is among the centers participating in the trial. The investigational device tells the physician the precise direction of the catheter and how hard it is pushing against the heart wall. This information is graphically displayed on a 3-D mapping and navigation system.

The device is called the SmartTouch Contact Force Sensing Catheter. In the clinical trial, patients who undergo ablation with the pressure-sensing catheter will be compared with a group of similar patients who have undergone ablation with conventional catheters. In the ablation procedure, an electrophysiologist inserts a catheter (thin flexible tube) in a groin artery and guides it through blood vessels to the heart. The tip of the catheter delivers radiofrequency energy that heats and destroys tissue that sends out erratic electrical signals.

One challenge to this procedure is pressing the catheter firmly enough against the wall of the heart so that sufficient tissue is destroyed, without pushing so hard that the catheter makes a hole in the heart. This requires a very fine balance, which is difficult to achieve, even for an experienced operator.

If proven safe and effective, the pressure-sensing catheter potentially could improve patient outcomes and the durability of ablation treatments.

Tagged as: health and wellness, clinical trials, heart health and Loyola University Chicago

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Dr. Anita Varkey is medical director of the general medicine clinic at Loyola Outpatient Center at Loyola University Health System. Dr. Varkey is an internist, researcher and professor who specializes in primary care, preventive medicine and women's health. "TCWell" focuses on health and wellness issues.