Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New technology improves heart rhythm treatment

19.07.2012
CONFIRM study results point to a doubling of success in treating heart rhythm disorder

Researchers from UC San Diego, the University of California Los Angeles and Indiana University report having found, for the first time, that atrial fibrillation or irregular heart rhythms is caused by small electrical sources within the heart, in the form of electrical spinning tops ("rotors") or focal beats. Importantly, they found a way of detecting these key sources, then precisely targeting them for therapy that can shut them down in minutes with long lasting results.

The team, which included cardiologists, physicists and bioengineers, report the findings in the July issue of the Journal of the American College of Cardiology as the CONFIRM trial (Conventional Ablation for Atrial Fibrillation
With or Without Focal Impulse and Rotor Modulation).

Currently, many patients treated for atrial fibrillation with standard therapies will experience a recurrence due to the difficulty of finding the source of the arrhythmia. The new findings will help cardiologists better target and treat arrhythmias.

The CONFIRM study examined 107 patients with atrial fibrillation referred for a non-surgical catheter ablation procedure. During this procedure, doctors thread a wire with a metal-tipped catheter inside the body, from a vein in the groin, to apply heat to the area of the heart that is producing the arrhythmia to stop it.

In one group of patients, the team used the new technique to help perform precise burns, called Focal Impulse and Rotor Modulation (FIRM) that were aimed directly at the fundamental source of the arrhythmia – tiny electrical disturbances in the heart called rotors or focal sources that look like mini tornadoes or spinning tops.

Remarkably, this new procedure shut down atrial fibrillation or very significantly slowed it in 86 percent of patients in an average of only 2.5 minutes.

In comparison, conventional catheter procedures were performed in a second group of patients. Since this approach is less targeted, it involved hours of treatment over larger regions in the heart and often did not shut down the atrial fibrillation.

To track outcomes, patients received an implanted ECG monitor that very accurately assessed their heart rhythms over time. Researchers found that after two years, the FIRM-guided group had an 82.4 percent freedom from atrial fibrillation episodes, compared to only 44.9 percent freedom in the group that received standard therapy.

The new targeted method demonstrated an 86 percent improvement over the conventional method in the study.

"We are very excited by this trial, which for the first time shows that atrial fibrillation is maintained by small electrical hotspots, where brief FIRM guided ablation can shut down the arrhythmia and bring the heart back to a normal rhythm after only minutes of ablation," said lead author Sanjiv Narayan, MD, PhD, professor of medicine at UC San Diego Sulpizio Cardiovascular Center, director of Electrophysiology at the San Diego Veterans Affairs Medical Center and visiting professor at the UCLA Cardiac Arrhythmia Center.

"The results of this trial, with an 80 percent ablation success rate after a single procedure, are very gratifying. This is the dawn of a new phase of managing this common arrhythmia that is mechanism-based," said Kalyanam Shivkumar, MD, PhD, director of the UCLA Cardiac Arrhythmia Center, and professor of medicine and radiological sciences at UCLA.

This study also represents a successful example of technology transfer from U.S. researchers supported by U.S. research funding to a small U.S. enterprise. The science behind this work was funded by grants to Narayan from the National Institutes of Health, including a grant awarded as part of the American Recovery and Reinvestment Act, and by the Doris Duke Charitable Foundation.

These discoveries, owned by the Regents of the University of California, were then licensed to a local startup company, Topera Medical, which has recently obtained FDA clearance for the mapping system it developed (RhythmViewTM) from this early science. Narayan is a co-founder with equity interest in Topera. Wouter-Jan Rappel, PhD, holds equity interest in Topera. John Miller, MD, has received modest honoraria from Topera. Shivkumar is an unpaid advisor to Topera, and the other authors report no relationship with Topera.

Other authors included John Miller, MD, chief of electrophysiology at Indiana University; David Krummen, MD, associate professor of medicine with UC San Diego Sulpizio Cardiovascular Center and associate director of electrophysiology at the San Diego Veterans Affairs Medical Center; Wouter-Jan Rappel, PhD, University of California San Diego Department of Theoretical Biological Physics; and Paul Clopton from the San Diego Veterans Affairs Medical Center Department of Statistics.

Kim Edwards | EurekAlert!
Further information:
http://www.ucsd.edu

More articles from Health and Medicine:

nachricht Oxygen can wake up dormant bacteria for antibiotic attacks
08.12.2016 | Penn State

nachricht NTU scientists build new ultrasound device using 3-D printing technology
07.12.2016 | Nanyang Technological University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

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

Im Focus: Significantly more productivity in USP lasers

In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.

Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...

Im Focus: Shape matters when light meets atom

Mapping the interaction of a single atom with a single photon may inform design of quantum devices

Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

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

14.10.2016 | Event News

 
Latest News

Closing the carbon loop

08.12.2016 | Life Sciences

Applicability of dynamic facilitation theory to binary hard disk systems

08.12.2016 | Physics and Astronomy

Scientists track chemical and structural evolution of catalytic nanoparticles in 3-D

08.12.2016 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>