Featured Research

from universities, journals, and other organizations

Catheter ablation a first-line treatment for atrial flutter

Date:
July 1, 2014
Source:
University of California, San Francisco (UCSF)
Summary:
Use of catheter ablation is not only beneficial for treating atrial flutter but also can significantly reduce hospital visits – both inpatient and emergency – and lower the risk for atrial fibrillation, according to research. Atrial flutter (AFL) is a common abnormal heart rhythm similar to atrial fibrillation (AF).

Use of catheter ablation is not only beneficial for treating atrial flutter but also can significantly reduce hospital visits -- both inpatient and emergency -- and lower the risk for atrial fibrillation, according to research by UC San Francisco.

The study is in the July issue of PLOS ONE and available online.

"We've seen firsthand in our clinical experience that atrial flutter is difficult to control with drugs, even more than atrial fibrillation," said senior author Gregory Marcus, MD, director of clinical research in the UCSF Division of Cardiology. "Based on our study findings, physicians and patients need to be educated that atrial flutter can be readily cured through catheter ablation, and the procedure may reduce the risk for atrial fibrillation."

Atrial flutter (AFL) is a common abnormal heart rhythm similar to atrial fibrillation (AF). In AF, electrical impulses are triggered from many areas in and around the upper chambers (atria) of the heart instead of just one area. This activity is chaotic, and the atrial walls quiver rather than contract normally in moving blood to the lower chambers (ventricles). In AFL, the electrical activity is more coordinated into one rapid circuit, but the atria contract very rapidly.

"The use of catheter ablation for AFL is very effective and can significantly reduce hospital visits and demand on health care services," Marcus said. "It's a safe procedure we frequently perform, even on people in their 90s."

AFL can be treated through catheter ablation, especially if medications or electrical cardioversion (shocking the heart back to a normal rhythm) are unsuccessful. In the minimally invasive procedure, thin, flexible wires called catheters are inserted into a vein and threaded into the heart. The tip of the catheter either delivers heat or extreme cold to destroy tissue responsible for the initiation and/or perpetuation of the abnormal heart rhythm.

Ablation has a high rate of success and symptom improvement, but little has been known if the procedure also results in reduced use of hospital services and lower risk for atrial fibrillation or stroke in a large, real-world population. Small studies have been limited to single academic centers or carefully selected randomized trial participants, and results have not been replicated through subsequent studies.

Using the California Healthcare Cost and Utilization Project database of community and academic hospitals across California, Marcus and his colleagues identified patients undergoing AFL ablation from 2005-2009. Of the 33,004 patients with an AFL diagnosis (in the absence of an AF diagnosis) and who were observed an average of 2.1 years, 2,733 (8.2 percent) received a catheter ablation.

Performing a multivariate analysis adjusting for patient demographics and comorbidities, the UCSF researchers determined AFL catheter ablation reduced the risk for overall hospital-based health care by 6 percent, inpatient hospitalization by 12 percent and emergency department visits by 40 percent.

"We think our most convincing finding was that health care utilization significantly dropped after vs. before the AFL ablation within the same patients," said study first author Thomas Dewland, MD, cardiac electrophysiology fellow at UCSF.

Ablation also led to an 11 percent reduction in risk for health care for AF but only a negligible drop in risk for acute stroke.

Patient demographics included age, gender, race, insurance and income. Comorbidities included hypertension, diabetes, coronary artery disease, heart failure, remote history of cardiothoracic surgery, valvular heart disease, pulmonary disease, chronic kidney disease, neurologic disease and AF.

According to American College of Cardiology/American Heart Association guidelines issued in 2003, catheter ablation to treat a first episode of AFL currently is only a Class IIa recommendation, Class I after arrhythmia recurrence. In Class IIa, the weight of evidence or opinion favors the procedure or treatment. In Class I, there is evidence for and/or general agreement that the procedure or treatment is useful and effective.

"However, we believe our study findings, in combination with the previous literature and our clinical experience, are sufficient to support catheter ablation as first-line treatment for AFL," Marcus said.


Story Source:

The above story is based on materials provided by University of California, San Francisco (UCSF). The original article was written by Scott Maier. Note: Materials may be edited for content and length.


Journal Reference:

  1. Thomas A. Dewland, David V. Glidden, Gregory M. Marcus. Healthcare Utilization and Clinical Outcomes after Catheter Ablation of Atrial Flutter. PLoS ONE, 2014; 9 (7): e100509 DOI: 10.1371/journal.pone.0100509

Cite This Page:

University of California, San Francisco (UCSF). "Catheter ablation a first-line treatment for atrial flutter." ScienceDaily. ScienceDaily, 1 July 2014. <www.sciencedaily.com/releases/2014/07/140701145523.htm>.
University of California, San Francisco (UCSF). (2014, July 1). Catheter ablation a first-line treatment for atrial flutter. ScienceDaily. Retrieved July 30, 2014 from www.sciencedaily.com/releases/2014/07/140701145523.htm
University of California, San Francisco (UCSF). "Catheter ablation a first-line treatment for atrial flutter." ScienceDaily. www.sciencedaily.com/releases/2014/07/140701145523.htm (accessed July 30, 2014).

Share This




More Health & Medicine News

Wednesday, July 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Generics Eat Into Pfizer's Sales

Generics Eat Into Pfizer's Sales

Reuters - Business Video Online (July 29, 2014) Pfizer, the world's largest drug maker, cut full-year revenue forecasts because generics could cut into sales of its anti-arthritis drug, Celebrex. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins