St. John’s Clinic cardiologists offer breakthrough treatment for irregular heart rhythm
June 1, 2005

St. John’s Clinic cardiologists are the first in the region to offer a new treatment for atrial fibrillation (irregular heart rhythm).  Catheter-based pulmonary vein isolation procedure is proving successful for many patients with the heart disorder that affects about 2.2 million people.

What is atrial fibrillation?

Atrial fibrillation is an abnormal heart rhythm originating in the atria (top chambers of the heart). Instead of the impulse traveling in an orderly fashion through the heart, many impulses begin and spread through the atria, causing a rapid and disorganized heartbeat.

How does the new procedure work?

Electrophysiolgists (subspecialists within cardiology) Shang-Chuin Lee, MD and Stanley Wiggins, MD perform the ablations in an electrophysiology lab within St. John’s Hospital’s cardiac catheterization lab. The doctor inserts several catheters into venous blood vessels (the neck and groins usually) and advances them into the right and left atrium of the heart. These catheters are used for mapping (searching for the electrical impulses that fire abnormally, causing atrial fibrillation) and the delivery of energy (ablation) to the area.

Intracardiac ultrasound, performed by a catheter transducer inserted from a venous blood vessel into the heart, is used throughout the procedure to view the structures of the heart and evaluate pulmonary blood flow. Three dimensional electromagnetic mapping of pulmonary veins and left atrium also performed with a special catheter and software system recently purchased by St. John’s.

“The ablation is performed by delivering energy from a catheter to the area of the atria that connects to the pulmonary vein, producing a circular electrical barrier. The barrier will then block any impulses firing from within the pulmonary vein from reaching the atrium, thus preventing atrial fibrillation from occurring. The process is repeated to all four pulmonary veins,” explained Lee.

Patients usually go home after a one-night hospital stay and feel relief from symptoms immediately. In nationwide studies, pulmonary vein isolation procedure has an 80 to 85 percent overall success rate.

Lee and Wiggins started performing the procedure for patients at St. John’s with good results in April of this year. Dr. Lee comes to St. John’s from the Mayo Clinic where he has extensive experience in atrial fibrillation ablation and Dr.Wiggins has been at St. John’s for almost 13 years.

Until now, atrial fibrillation has primarily been treated with medicine. Medicine success rate, however, is only about 40-50 percent and has undesirable side effects.

Symptoms of AF may include one or more of the following:

• heart palpitations – a sudden pounding, fluttering or racing feeling in your chest

• lack of energy or feeling over-tired

• dizziness – feeling lightheaded or faint

• chest discomfort – pain, pressure or discomfort in the chest

• shortness of breath – having difficulty breathing while doing normal activities or at rest

Many people live for years with atrial fibrillation without symptoms, but it is now known that chronic atrial fibrillation can lead to future problems.

People with chronic atrial fibrillation are five to seven times more likely to have a stroke than the general population. Other risks include blood clots to other parts of the body and increased risk of heart failure and death.

“We now know the longer you have atrial fibrillation, the more frequent it becomes and the harder it is to treat,” said Wiggins. “There’s an immediate relief of symptoms following pulmonary vein ablation. This has been one of the biggest break through ever in the history of electrophysiology.”

For media information, contact St. John’s Media Relations at 417-820-2426 or cscott@sprg.mercy.net.