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VOL. 126 | NO. 17 | Wednesday, January 26, 2011

New Procedure Keeps Memphis on Cardiac Cutting Edge

By Aisling Maki

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A cardiac procedure newly approved by the U.S. Food and Drug Administration to treat patients suffering from atrial fibrillation, a common type of cardiac arrhythmia, has just become available in Memphis.

Baptist Memorial Health Care Corp. said Dr. Eric Johnson, a cardiologist with Baptist and the Stern Cardiovascular Foundation, recently performed the city’s first cryoballoon procedure, developed by Medtronic Inc.

The procedure uses a new technology called ArcticFront Cardiac CryoAblation, which blocks the conduction of atrial fibrillation in heart tissue using a coolant through a catheter, which makes the catheter more stable, providing better therapy for the patient.

“Typically we do this as an outpatient with an overnight stay,” said Johnson, a cardiac electro physiologist who treats irregular or rapid heart rhythms. “The difference between the previous procedure and the new procedure is that people seem to recover faster and there seems to be less post-procedure pain and less of an inflammatory response associated with CryoAblation.”

The procedure has been used in Europe for some time, and it has been performed in clinical trials in the Unites States.

“The success rate has increased and the duration of the procedure time has decreased as people have gotten more experienced with it,” said Johnson.

The FDA approved the procedure last month, and Johnson, who was in the first post-FDA approval training class that took place recently in Minneapolis, said he was among the first group of 10 to 12 cardiologists nationwide to perform the procedure.

Johnson already has more than a dozen cryoballoon procedures scheduled in Memphis for the coming weeks.

Atrial fibrillation, a condition associated with an abnormal heart rhythm coming from the upper chambers of the heart, affects anywhere from 3 million to 5 million Americans and occurs most commonly in seniors.

Dr. Guy Reed, University of Tennessee Health Science Center Diggs professor of medicine and chair of the Department of Medicine, said it is most commonly caused by high blood pressure and diseases of the arteries of the heart. If left untreated, it can increase the risk of stroke.

“It’s a major cause of death in the Memphis area. It’s a very significant problem here,” he said, adding that atrial fibrillation often prevents people from performing routine activities.

“And the ablation technique is very useful because it can allow them to regain their ability to exercise and do other things and get rid of that constant feeling of palpitations.”

Johnson said pulmonary vein isolation has been the standard procedure to treat atrial fibrillation.

“Traditionally we’ve been using radio-frequency energy that creates a burn in the heart tissue,” he said. “We’ve had to go point by point by point burning veins in a circular fashion. It’s very time consuming, and there’s actually significant risk associated with it.”

The standard procedure took about four to six hours, whereas the cryoballoon technique, which freezes the tissue rather than burning it, is completed in roughly half the time.

“Pharmacologic therapy has never been shown to reduce the risk of stroke or make people live longer, so we’re trying to come up with non-pharmacologic therapies to treat atrial fibrillation,” said Johnson.

He said that, in terms of innovative technology, Baptist also offers a magnetic navigation system, a way to conduct remote navigation inside the heart, allowing for more precise movement than the standard manual method.

“We’re very fortunate to be on the cutting edge of all this technology,” Johnson said.

Reed also said another innovation in cardiology is a small surgical procedure for bypass that reduces surgical recovery time and causes less pain than traditional open chest surgery.

And, he said, trials are being conducted to change the way in which heart valves are replaced.

“This can be done using a catheter, putting it through the vein in the artery of the leg, and moving it up into the heart and replacing the valve that way instead of opening the chest,” Reed said.

The professor said Memphis has a track record of staying on the cutting edge of new medical technologies.

“Memphis has a tradition of early adoption of innovations in cardiovascular care that have led to improved outcomes and reduced hospitalization,” he said. “I think it’s very exciting. The trend is to be able to treat conditions that haven’t been treatable before.”

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