KUALA LUMPUR :One month after its introduction at the National Heart Institute (IJN), eight patients, including a former member of parliament and a doctor, have already benefited from an innovative catheter-based technique to treat a heart disorder.

Known as atrial fibrillation (AF), it is a rhythm disorder in which the two upper chambers of the heart (the atria) beat rapidly in an uncoordinated and seemingly chaotic disorder.

The catheter-based technique allows a minimally-invasive procedure to be performed in two hours, which can either reduce or eliminate AF.

IJN's electrophysiology team, Dr Razali Omar and Dr Azlan Hussin, were among the first physicians in the Asian region to use this new treatment, along with their counterparts in Hong Kong.

AF was not considered a life-threatening condition in the past. Now, however, it is categorised as the highest risk factor for, and cause of, stroke along with hypertension.

It accounts for 10 to 15 per cent of all strokes caused by inadequate blood flow to the brain.

"AF is a very common but, unfortunately, very serious rhythm disorder associated with severe symptoms and an increased risk of stroke. Up to now, treating AF has been with drug therapy, which is not always well tolerated or effective for all patients," said Dr Razali who is a consultant cardiologist.

According to Dr Razali, it was discovered a few years ago that AF originated in the upper chambers of the heart, frequently within the left atrium and very often from the pulmonary veins that carry oxygen-rich blood from the lungs.

Catheter ablation involves introducing a specially designed catheter into the heart. This is done by making a small incision in a vein and carefully manoeuvering the catheter through the vein and into the heart to burn off tissues that cause the condition.

This procedure involves the use of equipment such as introducers, guide wires and fluoroscopy (a real-time video x-ray monitor).

The catheter itself contains one or more electrodes in a special arrangement. These electrodes are the points through which the RF or heat energy will flow.

Advanced catheter technology allows the physician to control which electrodes are heated at any given time; using different combinations can help achieve desired ablation goals.

The main goal of the procedure, Dr Razali said, was to electrically isolate the pulmonary veins from the left atrial body so that the impulses responsible for the AF cannot be propagated to the left atrium. In some cases, the physician may also have to ablate selected sites within the left atrium that can initiate AF.

"The theory behind catheter ablation is that destroying small areas of cardiac tissue will either eliminate the source of the AF or cut off its electrical connection with the rest of the heart. The irregular impulse can no longer form and travel to the rest of the heart, thus eliminating the high atrial rates."

He said with this new technique the procedure was now safe and appeared to be quite effective for all types of AF patients.

By : Annie Freeda Cruez