A pioneering cardiac ablation technique offered at UCLA can help
patients with potentially dangerous ventricular arrhythmias on the surface of
the heart.
Approaching from outside rather than inside the heart, the procedure gives
these patients a minimally invasive alternative to heart surgery.
“Previously, cardiologists could address arrhythmias with minimally invasive
ablation techniques only from inside the heart,” says Kalyanam Shivkumar, M.D.,
Ph.D., director of the UCLA Cardiac Arrhythmia Center and electrophysiology
programs. “But irregular heart rhythms can originate anywhere, even on the
heart’s surface. The closer the cardiologists can get to the origin of the
arrhythmia, the more effective treatment will be.”
Several million Americans
suffer from ongoing fatigue or regular shortness of breath due to changes in
electrical function of the heart muscle that cause rapid or abnormal rhythms.
While many arrhythmias are benign, nearly 250,000 people die suddenly each year
due to these rhythm disturbances.
Ventricular arrhythmias, those arising from the lower chambers of the heart,
are particularly dangerous and increase risk of sudden death due to cardiac
arrest. Atrial fibrillation, a common heart problem originating in the upper
chambers of the heart, carries increased risk of stroke when untreated.
Endocardial ablation, which uses heat to destroy abnormal tissue inside the
heart, is the standard of care for both atrial and ventricular arrhythmias. The
procedure uses X-ray guidance to thread a wire, or catheter, through a blood
vessel in the groin to the interior of the heart and cauterize the site with
radiofrequency.
However, about 30 percent of ventricular arrhythmias
originate in tissue on the outside of the heart and cannot be treated
effectively with endocardial ablation. So UCLA physicians helped perfect an
alternative called epicardial ablation and about five years ago became the first
to use the procedure on the West Coast. UCLA is one of the most experienced
centers in the world offering this innovative technique.
Epicardial ablation involves threading a wire beneath the rib cage to reach
the exterior of the heart and applying energy via catheters that can destroy
problem tissue with either heating or freezing. The outpatient treatment carries
low risk of complications and most patients resume normal activities within a
few days.
Dr. Shivkumar, and his cardiology colleagues Noel G. Boyle, M.D., David
Cesario, M.D., and Osamu Fujimura, M.D., are investigating innovative techniques
for managing cardiac arrhythmias without medication.
download the complete newsletter
