St. Luke’s-Roosevelt Hospital Performs First Visually Guided Laser Catheter Ablation for Atrial Fibrillation in Northeast

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Procedure Designed to Treat Most Common Arrhythmia

Visually Guided Endoscopic Ablation System

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Recently Jonathan S. Steinberg, MD, Chief, Division of Cardiology at St. Luke's-Roosevelt Hospital Center in New York, used an investigational, endoscopically guided laser catheter to treat “short-circuiting” heart tissue that was causing a potentially dangerous arrhythmia. It was the first time this minimally invasive procedure has been performed in the Northeast.

The patient was treated as part of the ENABLE trial, a multi-center clinical investigation taking place at up to 25 hospitals throughout the country. Dr. Steinberg performed the investigational procedure called “Endoscopic Catheter Ablation”, on a patient that has suffered from periodic episodes of irregular heartbeat, dizziness and fatigue for more than a year.

Ronald Clate of New Jersey was diagnosed with atrial fibrillation, an electrical disturbance of the heart, often producing symptoms of a rapid and irregular heartbeat, caused by a “short circuit” involving the upper chambers of the heart. He would awake with dizziness, experience rapid heartbeat and ringing in his ears. His symptoms spontaneously stopped after one or two hours.

In the Cardiac Electrophysiology Laboratory, Dr. Steinberg inserted a slender catheter into a vein in Mr. Clate’s right leg. The catheter was threaded up into his chest and guided into a large vein in his heart, using the real time investigational endoscopic video camera, small amounts of traditional x-ray and ultrasound imaging. Once in the area with the “short-circuiting” tissue, called a pulmonary vein, Dr. Steinberg inflated a balloon and was able to visualize the target tissue for the first time. Once the target was located, he turned on the laser, which highlighted the area of treatment with visible light and released precisely controlled arcs of near-infrared light around the opening of the vein. Several bursts of laser energy were able to destroy an area of abnormal tissue while causing no significant damage to surrounding healthy heart muscle. Mr. Clate’s atrial fibrillation was stopped during the procedure as a result of the device. Dr. Steinberg treated all four pulmonary veins within the heart. Ronald Clate is doing fine.

“For the first time we can see directly into the heart and treat the areas that are allowing the heart to sustain the abnormal rhythm; possibly with more precision than with other techniques,” said Dr. Steinberg.

Atrial fibrillation is common arrhythmia where patients experience a rapid, uncontrolled beating of the atria, the two upper chambers of the heart. When the upper chambers “short circuit” they don’t completely fill with blood. This causes the lower chambers to beat erratically and pump lower than normal volumes of blood and oxygen to the brain, heart and the rest of the body. As a result, patients experience palpitations, chest discomfort and breathlessness. In severe cases, the person can become weak and faint, which can be life-threatening if the patient is at the wheel of a car. The disorder affects nearly 2.3 million Americans and can be caused by hypertension, congestive heart failure, myocardial infarction (heart attack), diseases of the heart valves, and infection. In 20 to 35 percent of cases, the cause is unknown.

Without treatment, the disorder can permanently damage the heart leading to eventual heart failure and death. Also, blood pooling in the heart can form clots that could lead to stroke. In fact, patients with Atrial Fibrillation have a risk of stroke that is 5 to 6 times higher than normal. These patients need carefully controlled anticoagulant (blood thinner) therapy to reduce this risk. The investigational device used in this procedure is referred to as the “Visually Guided Endoscopic Ablation System” and was developed by CardioFocus, Inc. of Marlborough, Massachusetts. For more information, call (508) 658-7200 or visit http://www.cardiofocus.com.

Contact:
Jeff Jacomowitz
St. Luke's-Roosevelt Hospital Center
(212) 523-6069
jjacomo @ chpnet.org

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