Ablation May Decrease Heart-Related Deaths

Ablation decreased heart related deaths in adults with atrial fibrillation

(RxWiki News) Getting the heart to beat normally is the goal of treatment for patients with atrial fibrillation. One particular treatment may decrease death in patients with atrial fibrillation by doing just that.

Patients with atrial fibrillation, known as AFib, may feel their heart flutter or beat very quickly. AFib increases the risk of stroke and other heart problems.

People with AFib may be treated with medication or techniques like ablation that stop the irregular heartbeat. Ablation destroys the small areas in the heart that send abnormal electrical signals that cause the irregular heartbeat.

A research team recently found the number of deaths from heart problems significantly decreased in patients who underwent ablation.

"Seek medical care if you have an irregular heartbeat."

The research was conducted by Hamid Ghanbari, MD, MPH, of the Cardiovascular Center at the University of Michigan in Ann Arbor, and colleagues.

The research included 3,058 adults who received heart ablation through a catheter — a small wire placed in the heart to deliver a sound wave. The sound wave destroyed the heart tissue causing the irregular heartbeat.

The study included men and women who were 58 years old on average. The patients had either paroxysmal AFib (AFib that comes and goes) or persistent AFib (always present).

The patients had a clinic visit three months after their ablation procedures, then every six to 12 months for about 10 years. The research team kept track of whether the patients' AFib returned after the ablation, as well as how often and for how long they had AFib. The researchers noted whether they were treated with medication to control their abnormal heartbeat or had a repeat ablation.

The research team recorded how long the patients lived and whether they died of heart problems or other causes. For patients who died, the study authors obtained the causes of death from death certificates.

Results of the study showed that, after ablation, patients either had AFib episodes less than 20 percent of the time or more than 80 percent of the time. Greater frequency or length of time in AFib was associated with patients who had the persistent type of AFib, larger left heart atrial (top) chamber size and older age.

During the 10-year study, 3.6 percent of the study participants died.

Patients with a normal heartbeat after ablation had a 60 percent lower risk of heart-related death than those with an irregular heartbeat.

Some factors indicated an increased risk of heart problems after ablation. Every 10 years of age raised risk by 40 percent, the study authors noted.

Patients with coronary (heart) artery disease had more than twice the risk, and patients with a history of heart or blood vessel disease had more than four times the risk of heart problems after ablation than those who did not have these risk factors.

After examining all causes of death, the researchers did not find a significant decrease in death after ablation.

The authors noted that a limitation of their study was that the frequency of AFib may have been underestimated because this data was obtained by patient evaluation and monitoring at visits, not continually. They also noted that the cause of death noted on the death certificates may not always have been accurate.

“The study findings show the benefit of catheter ablation extends beyond improving quality of life for adults with atrial fibrillation," Dr. Ghanbari said in a press release. "If successful, ablation improves life span."

In an editorial published in Heart Rhythm, Jason G. Andrade, MD, of the Montreal Heart Institute in Canada, and co-authors said Dr. Ghanbari and team's findings should be confirmed in clinical trials.

The editorial authors said that, while ablation was associated with decreased heart-related deaths, the results did not necessarily mean ablation was the cause of the decreased death rate.

Patients who are chosen for ablation may be those who are more likely to do well after the procedure, and patients who respond to treatment with a return to normal heartbeat may be generally healthier people, the authors noted.

The editorial commentary authors said the results of the recent study are encouraging but not proof that ablation was the cause of the decrease in heart-related deaths.

The research was published in the July issue of Heart Rhythm. The Birkhill Family Foundation provided funding for the study.

Review Date: 
July 30, 2014