EP procedure marks another step forward in cardiac program

November 20, 2006
A significant advancement in cardiac care at New Hanover Regional Medical Center will correct patients’ irregular heartbeats without open heart surgery or relying on chronic use of medications. Cardiologists at the medical center have begun to treat atrial fibrillation through a minimally invasive procedure called “catheter radiofrequency ablation” in which a catheter is used to destroy abnormal tissue. The procedure, which takes place in NHRMC’s two electrophysiology labs, can have patients back on their feet in two days as they return to a normal lifestyle. “Atrial fibrillation” occurs when the heart’s upper two chambers quiver instead of beating effectively, causing inefficient blood flow. Patients may feel weak, short of breath, or suffer from congestive heart failure. About 15 percent of strokes occur in people with this irregular heartbeat condition. An estimated 2.2 million Americans suffer from atrial fibrillation, according to the American Heart Association. Before recent advances in technology in NHRMC’s electrophysiology labs, patients in this region had to leave the area for treatment. “There are a lot of patients out there who need this treatment and would benefit from this treatment,” said Janet DeLucca, manager of the EP labs. “It’s something that we’ve not been able to offer before. It’s certainly an advancement for us.” She said this procedure is typically associated with large electrophysiology programs or academic centers. Implanting devices such as pacemakers or defibrillators, both of which treat abnormal heart rates, are common in the EP labs. So is an “ablation” procedure in which a catheter is threaded from the leg to the heart, where radiofrequency energy is applied to the AV, or atrioventricular, node, which transmits a heartbeat from the top to lower chamber. However, this procedure almost always leads to a pacemaker being installed to replace the damaged AV node. With the new technique, specifically trained cardiologists can thread a catheter to the left side of the heart and isolate the source of the irregular heartbeat, with the help of intracardiac ultrasound and 3D mapping technology, which is a recent technological advancement. The cardiologist can then pinpoint the area of treatment and destroy only abnormal tissue. In most cases, the patient will not need a pacemaker or a long regimen of medications. The procedure requires moderate sedation. Dr. Robert VerNooy, a Wilmington cardiologist who performed the first procedure at New Hanover Regional last month, said medications are still the first line of treatment for atrial fibrillation. “The drugs we have to treat A-fib are either not very successful, not well-tolerated, or associated with certain undesirable side-effects or toxicities,” he said. “In the last year, national cardiology guidelines have been updated to recognize this procedure – A-fib ablation - as the next choice. “A-fib ablation is now an established procedure shown to have a better chance of eliminating disabling symptoms of A-fib, improving quality of life, and eliminating the need for lifelong traditional antiarrhythmic drugs.” If you feel you may be a candidate for this procedure, contact your cardiologist. For assistance in finding a cardiologist, please call VitaLine at 815.5188.