Intermountain Press Release

Salt Lake City —Cardiologists specializing in heart rhythm disorders at LDS Hospital have reached a milestone that only a handful of medical centers in the country have achieved: 1,000 cardiac atrial fibrillation ablation procedures.

The LDS Hospital Atrial Fibrillation team, which has pioneered the minimally-invasive atrial fibrillation procedure utilizing 3-D mapping of the human heart, performed the 1,000th procedure on a Green River, Wyoming, man who's doing well and is now back home.

Atrial fibrillation is the most common heart rhythm disorder in the nation and affects up to one in four adults at some point in the lives. Atrial fibrillation is characterized by a rapid irregular heart beat that results in fatigue, difficulties in breathing, and chest discomfort. Atrial fibrillation is one of the leading causes of stroke in the United States.

Ablation is a procedure performed either during an electrophysiology study, in which the source of a patient's heart arrhythmia is mapped, localized, and then destroyed (i.e., ablated.) Generally, ablation is accomplished by applying radiofrequency (RF) energy, applying electrical energy, or freezing the offending area through a catheter, thus creating a small scar that is electrically inactive and thus incapable of generating heart arrhythmias.

The team at LDS Hospital has developed a new technique to perform this procedure that is now being used around the world. This approach is novel in that the LDS Hospital team has found that incorporating 3-D mapping of all the major structures in and around the heart utilizing a high power short duration ablation approach can dramatically shorten the procedure time, improve success rates by making sure the areas in the heart that are causing atrial fibrillation are effectively eliminated, and decrease potential complications by making sure that the ablation stays within the heart and does not cause any damage to other organs in the body.

"Catheter ablation allows cardiologists specializing in heart rhythm disorders to locate the source of the fibrillation in the heart and treat the condition wish a catheter," he says. "No surgery or stitches are involved and the patient goes home the next morning with just two band-aids."

Atrial fibrilation ablations are extremely complex and technically challenging procedures that very few hospitals in the United States perform. "We are among only a handful of major centers in the country that have performed 1,000 procedures. This is a great tribute to our entire team here at LDS Hospital and their commitment to providing the very best care for our patients," says cardiologist John Day, M.D., who performed the first atrial fibrilation ablation case at LDS Hospital in April 2004.

Medical management of atrial fibrillation is usually unsuccessful in preventing this heart rhythm disorder, says Dr. Day. "Most patients can be cured from atrial fibrillation without the need for ongoing medications to keep their hearts in rhythm," says Dr. Day.

Studies have shown that the outcomes of atrial fibrillation ablation procedures improve dramatically (atrial fibrillation cure rate increases and the potential complication rate decreases) the more experience that a center develops. Based on a recently published study, good outcomes with this procedure did not begin until a center had performed 100 of these procedures. "Thus, 1,000 cases represents an extremely high experience rate with optimal procedural outcomes that only a few hospitals have achieved in the U.S.," says Dr. Day.

Patients with atrial fibrillation can have a range of symptoms. They are caused by the rapid heart rate, and the loss of coordination between the atria and ventricles. People who have atrial fibrillation often complain of:

• palpations (an unusual awareness of the heartbeat)
• becoming fatigued easily
• shortness of breath
• and lightheadedness

In addition, people with underlying coronary artery disease can develop angina (chest pain and pressure) from the rapid heart rate; and people with underlying cardiomyopathy (weakening of the heart muscle) can have an acute episode of heart failure. In fact, if the heart rate associated with atrial fibrillation is rapid enough and persists long enough (that is, for at least several months), some patients well develop cardiomyopathy and heart failure as a direct consequence.

Other members of the LDS Hospital atrial fibrillation team include J. Peter Weiss, M.D., and Brian Crandall, M.D.