New Tools for Atrial Fibrillation

I have blogged about atrial fibrillation many times as it is a constant feature in the practice of cardiology.  An estimated 2.2 million patients in the United States alone have this problem.  It has been difficult to prove in some patients and very difficult to follow.  The facts are extraordinary.

If you have atrial fibrillation and go out of it by any means, the likelihood is that at one point in time, you will be back in it.  If a physician places you on a drug, there is only a 50% chance that it will keep you in normal rhythm.  If you have a procedure to terminate it, the range of one year success is variable from 50%-70%.  We do not even have a way to figure out what your rhythm or rate control success is on a long term basis.

Until now — Medtronic, a major device company–has released a novel device. A study associated with the device has been published in Circ Arrhythm Electrophysiol. 2010; 3:141-147.  This study documents the usefulness of this unique device.

The device records and stores data obtained from the heart without the need for leads into the heart such as a pacemaker would have.  It is implanted in a simple procedure under your skin near your heart and is able to sense the electrical activity of your heart without wires into your heart.  The procedure takes roughly ten minutes to place the device, and about the same amount of time to remove it.  This can be done in an outpatient setting.  The device will last up to three years so it provides a long term view of a patient’s atrial fibrillation and whether drug or ablation therapy is working for the patient.

This device also allows the diagnosis of patients who have intermittent symptoms that are virtually impossible to figure out using 24 hour holter monitors.  The sensitivity of the device for atrial fibrillation was 96% and it was correct in identifying the problem 85% of the time.  This device will also “download” its information wirelessly from a remote location so patients can send reports without going to the doctor’s office and patients can send reports if they sense something that troubles them.

Devices such as this will lead to a new paradigm of treatment for atrial fibrillation, as we can now have long term data which was unable to be obtained previously.  This will lead to better treatments and to a better understanding of the disease process.  If you cannot study it you can’t make progress, and we now have a tool to help.

Tags: Ablation Therapy, atrial fibrillation, Holter Monitor
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