Early, More Aggressive Treatment is Better for Patients with Atrial Fibrillation

​SALT LAKE CITY, UT – Patients who have a common heart condition called atrial fibrillation do better with early, aggressive intervention, according to a new study from researchers at the Intermountain Medical Center Heart Institute.

“Historically, patients with atrial fibrillation have been treated using less aggressive and less invasive methods, such as medicines or non--‐surgical procedures at the beginning of the disease process,” said researcher Jared Bunch, MD, cardiac electrophysiologist at the Intermountain Medical Center Heart Institute. “We found that we can achieve better outcomes for our patients if we perform an ablation procedure earlier in the treatment process. ”

Atrial fibrillation affects more than 2.7 million Americans and is the most common serious heart rhythm abnormality in people over the age of 65. It occurs when the upper chambers of the heart (the atria) beat irregularly instead of beating effectively to move blood into the ventricles. During the ablation procedure a physician inserts thin, flexible wires through a vein into the heart and then delivers a burst of heat to disable the tissue causing the problem.

The study examined 684 atrial fibrillation patients who received care through Intermountain Healthcare clinics and hospitals and had one year or more of follow-up following catheter. Patients who experienced longer wait times from their initial diagnosis of atrial fibrillation to their ablation procedure experienced worse outcomes, including higher rates of recurrent atrial fibrillation and cardiac mortality, compared to patients with shorter times.

Findings of the new study were presented at the American Heart Association’s annual Scientific Session in Los Angeles on Monday, Nov. 5, 2012.

“Before this study, when patients asked if there is harm in waiting for an ablation, there was no data to suggest a significant risk in waiting as long as the atrial fibrillation did not become more frequent or persistent,” said Dr. Bunch. “We now have that data to present to these patients that suggest early intervention may improve outcomes and as such we can more completely discuss their best treatment options for atrial fibrillation.”

The study also found that ablation performed earlier after atrial fibrillation diagnosis provides better outcomes regardless of the type of atrial fibrillation present. For example, patients with atrial fibrillation that comes and goes versus those patients that need their heart shocked to stop the atrial fibrillation both benefit from earlier ablation treatment.

Catheter ablation procedures have historically been a last treatment option, preceded with medications and non-surgical procedures. The data presented in this study have national and global implications for the treatment of atrial fibrillation and improving the patient outcomes.

The Intermountain Medical Center Heart Institute is one of the premier cardiac centers in the country. Intermountain Medical Center is the flagship facility for the Intermountain Healthcare system.

Members of the Intermountain Medical Center Heart Institute research team include: Heidi T. May; Tami L. Bair; David L Johnson; J. Peter Weiss; Brian G. Crandall; Jeffrey S. Osborn, Jeffrey L. Anderson; J. Brent Muhlestein; Donald L. Lappe; and John D. Day.