Physicians at The Mount Sinai Medical Center in New York became the first in the US to ablate atrial fibrillation (AF) using a visually-guided laser balloon catheter. The procedure was performed on 15 September by Vivek Y Reddy, professor of Medicine and director of the Cardiac Arrhythmia Service at Mount Sinai Heart, and his colleague, Srinivas R Dukkipati, director of Mount Sinai’s Experimental Electrophysiology Laboratory.
The procedure marks the first time the device – the “Endoscopic Ablation System” manufactured by CardioFocus – has been used in human clinical trials in the US. Reddy is the principal investigator for the national study.
“This new device has the potential to make AF ablation more reliable, more reproducible, and more consistent for patients with paroxysmal (intermittent) atrial fibrillation,” said Reddy. “The technology which is currently available leads to widely variable success rates, depending largely on physician skill and experience with the procedure. This visually-guided system with a rotating laser design has the potential to simplify AF ablation and make it available to more patients than ever, before their paroxysmal AF becomes chronic (continuous) AF.”
Valentin Fuster, director of Mount Sinai Heart and chair of the European American Guidelines on atrial fibrillation, said, “Such an advance in the treatment of atrial fibrillation is another small step forward to cure the disease without the need for chronic medication.”
The new balloon catheter device used by the Mount Sinai Heart team features a built-in camera that allows the physicians to directly see the heart tissue that needs to be ablated. They can then guide an internal laser in a continuous arc around the origin of the vein, creating more uniform scar tissue. “By directly seeing the tissue that we are ablating, there is less chance of a gap in the encircling ablation line,” said Dukkipati.
The patient was a 58-year old man with a history of paroxysmal AF. He had been treated with a number of drugs which failed to control the AF, so he continued to have symptoms including palpitations, and shortness of breath. Therefore, he elected to undergo a catheter ablation procedure to eliminate his symptoms. The procedure was performed in a cardiac catheterisation laboratory and did not require surgery or cardiopulmonary bypass.
Reddy and Dukkipati joined Mount Sinai Heart in August 2009 to focus on building the institution’s services for treating heart-rhythm disorders. Last month, they were the first in the US to perform left atrial appendage occlusion as an alternative to Coumadin therapy on an AF patient using a non-surgical, catheter-based suture delivery system.