Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Surgeons develop simpler way to cure atrial fibrillation

Physicians have an effective new option for treating atrial fibrillation, a common irregular heart rhythm that can cause stroke. Heart surgeons at Washington University School of Medicine in St. Louis have developed and tested a device that radically shortens and simplifies a complex surgical procedure that has had the best long-term cure rate for persistent atrial fibrillation.

The simplified procedure is termed Cox-maze IV, and the surgeons believe it can replace the older "cut and sew" Cox-maze III in which ten precisely placed incisions in the heart muscle created a "maze" to redirect errant electrical impulses.

"This technology has made the Cox-maze procedure much easier and quicker to perform," says Ralph Damiano Jr., M.D., the John Shoenberg Professor of Surgery and chief of cardiac surgery at the School of Medicine and a cardiac surgeon at Barnes-Jewish Hospital. "Instead of reserving the Cox-maze procedure for a select group of patients, we would urge use of this device for virtually all patients who have atrial fibrillation and are scheduled for other cardiac surgery."

The device is a clamplike instrument that heats heart tissue using radiofrequency energy. By holding areas of the heart within the jaws of the device, surgeons can create lines of ablation, or scar tissue, on the heart muscle. In the older Cox-maze III procedure, the lines of ablation were made by cutting the heart muscle, sewing the incisions back together and letting a scar form. The ablation lines redirect the abnormal electrical currents responsible for atrial fibrillation, an irregular heart rhythm in which the upper heart chambers or atria wriggle like a bag of worms.

The Cox-maze procedure was developed at the University in 1987. In their latest clinical study, reported in the February issue of the Journal of Thoracic and Cardiovascular Surgery, University surgeons showed that Cox-maze IV is just as effective as Cox-maze III for curing atrial fibrillation, yet takes one-third the time to perform.

"The older Cox-maze procedure was a very complicated operation, and very few surgeons were willing to do it," Damiano says. "So we started working on new technology and helped develop an effective ablation device that simplifies the procedure. Not only is Cox-maze IV shorter, but with the new device the procedure is also much safer because there's a much lower risk of bleeding."

Atrial fibrillation affects more than 2.2 million people in the United States and can cause fatigue, shortness of breath, exercise intolerance and palpitations. Compared to those without atrial fibrillation, those with the disorder are five times more likely to suffer from stroke and have up to a two-fold higher risk of death. For some patients, medications can control the abnormal heart rhythms and the risk of clotting associated with atrial fibrillation, but unlike the Cox-maze procedure, the drugs do not cure the disorder.

Damiano says their most recent study of Cox-maze IV is unique because the surgeons carefully matched the age, sex and cardiac conditions of a group of patients who underwent Cox-maze III in the past with patients undergoing Cox-maze IV. "This is the first documentation of the effectiveness of the ablation devices compared to the incisions of the Cox-maze III," Damiano says. "This operation is very effective, and we now use the Cox-maze IV technique exclusively."

Lall SC, Melby SJ, Voeller RK, Zierer A, Bailey MS, Guthrie TJ, Moon MR, Moazami N, Lawton JS, Damiano RJ. The effect of ablation technology on surgical outcomes after the Cox-maze procedure: A propensity analysis. Journal of Thoracic and Cardiovascular Surgery 2007 Feb;133(2):389-96.

Ralph Damiano received consulting and lecture fees from Atricure and Medtronic and grant support from Atricure.

Funding from the National Institutes of Health supported this research.

Washington University School of Medicine's full-time and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.

Gwen Ericson | EurekAlert!
Further information:

More articles from Medical Engineering:

nachricht Gentle sensors for diagnosing brain disorders
29.09.2016 | King Abdullah University of Science and Technology

nachricht New imaging technique in Alzheimer’s disease - opens up possibilities for new drug development
28.09.2016 | Lund University

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Etching Microstructures with Lasers

Ultrafast lasers have introduced new possibilities in engraving ultrafine structures, and scientists are now also investigating how to use them to etch microstructures into thin glass. There are possible applications in analytics (lab on a chip) and especially in electronics and the consumer sector, where great interest has been shown.

This new method was born of a surprising phenomenon: irradiating glass in a particular way with an ultrafast laser has the effect of making the glass up to a...

Im Focus: Light-driven atomic rotations excite magnetic waves

Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion

Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

How nanoscience will improve our health and lives in the coming years

27.10.2016 | Materials Sciences

OU-led team discovers rare, newborn tri-star system using ALMA

27.10.2016 | Physics and Astronomy

'Neighbor maps' reveal the genome's 3-D shape

27.10.2016 | Life Sciences

More VideoLinks >>>