New Technique Eliminates Use of Heart Medications

A revolutionary catheter technique used in the treatment of the most prevalent type of irregular heartbeat is changing the lives of patients who have undergone the procedure at St. Luke’s-Roosevelt Hospital Center in New York City.

Ablation therapy using radiofrequency energy has successfully cured patients with atrial fibrillation, the most common type of heart rhythm abnormality. “It has enabled people who would have previously been placed on heart drugs for life to be completely off medical therapy after the procedure,” said Jonathan Steinberg, MD, an electrophysiologist and Chief of Cardiology at St. Luke’s-Roosevelt. “Atrial fibrillation (AFib) is particularly prevalent among the elderly or those with cardiovascular disease. However, it can also be a troubling problem for younger patients without heart disease.”

John McFee, a 36-year-old pharmacist and former New York City police lieutenant, had symptoms that felt like squirrels running around his chest, which started as palpitations about three years ago and gradually got worse, giving him a lot of pain and anxiety. “I was told to stay off alcohol and caffeine, tried to reduce stress and was put on a beta-blocker, but nothing helped,” he said. He left the NYPD after suffering hip injury and had to have hip replacement. After the ablation procedure by Dr. Steinberg in April he has been totally off his heart medications and is feeling well. “I feel like a new man!” exclaimed Mr. McFee.

AFib affects approximately two percent of the adult population and is the most common arrhythmia (any deviation from, or disturbance of, the normal heart rhythm; arrhythmia may be benign, symptomatic, life threatening or even fatal) that requires hospital admission. Risk of stroke in AFib patients makes the disease and its aftermath potentially devastating. The use of anticoagulatants can decrease the risk but not all patients are suitable candidates for these because of the risk of serious bleeding. Although surgery may be curative, it is not an acceptable solution for most patients, and is associated with the risk of complications and even death.

Symptoms include palpitations, very rapid heart rate and dizziness. In the case of Lenny Tylman, 46, a medical practice administrator and who has family history of heart disease, he also suffered dizziness, chest pain and shortness of breath -- attacks of arrhythmia -- which required three trips to the emergency room and cardioversion (shocking the heart back into normal rhythm). He had radio-frequency ablation in March and feels terrific.

Catheter ablation techniques have been designed and successfully applied to a variety of patients with AFib targeting the pulmonary vein musculature, the frequent source of irregular heart beats. Two catheters are used, a mapping catheter, which identifies the source of AFib and the ablation catheter, which delivers the radiofrequency energy that zaps it until the electrical impulses are completely disconnected.

“This is a revolutionary advance in atrial fibrillation therapy,” said Dr. Steinberg. “Ablation can be achieved in about 99 percent of targeted veins, and when successful will relieve patients of heart rhythm problems without having to undergo extensive open-heart surgery. The ablation procedure has a small risk, about two percent. Fortunately, serious complications are infrequent due to advances in radiofrequency energy delivery and targeting.”

Hans Muller, whose heart problem was discovered only three to four years ago, thinks he may have had the problem for up to 15 years. In 1982, he was diagnosed with diabetes, an important risk factor for heart disease. “My heart would race so fast even when I was at home relaxing or lying in bed,” said the 61-year-old who makes a living buying and selling steel. After undergoing a different type of procedure last October, he returned in May for radiofrequency ablation and is now off Rhythmol.

“Most people diagnosed with atrial fibrillation are usually advised to go on heart medications, which they would likely take for the rest of their lives. For many, the cost of heart pills over a lifetime can add up to a small fortune,” said Dr. Steinberg. “This new mode of treatment is effective in achieving a complete cure and will likely be cost-effective compared to previous types of therapy.”

The cardiology programs at St. Luke’s-Roosevelt Hospital Center are part of the services offered by Continuum Heart Institute, which combines the strengths of the cardiac programs at Beth Israel Medical Center, St. Luke’s-Roosevelt Hospital Center and Long Island College Hospital for clinical, technological and innovative excellence. For more information about heart disease, atrial fibrillation, and radiofrequency ablation and for referral to a heart specialist, please call the Referral Service at 800-420-4004.