Cardiac Rhythm Specialists for the University of Pennsylvania Health System have documented the effectiveness of a new technique to cure atrial fibrillation (A-Fib). The technique targets and isolates the triggers, or "hot spots," on pulmonary veins leading to the heart, preserving the heart's natural electrical circuitry and eliminating the need for a pacemaker or medication.

Francis E. Marchlinski, MD, director of Cardiac Electrophysiology for the University of Pennsylvania Health System, discusses the findings at a session of the American College of Cardiologists meeting in Atlanta.

"This procedure can eliminate atrial fibrillation completely and patients can resume their lives without relying on mechanical devices or any form of medication, including blood-thinners," Marchlinski says.

Atrial fibrillation is a serious condition, often associated with aging, which results when electrical discharges in one of the atria (upper chambers of the heart) disrupts the normal, organized electrical activity, or "sinus rhythm," generated by the heart's sinus node.

Patients with this arrhythmia often suffer a rapid heartbeat, palpitations, weakness, shortness of breath and fatigue, although sometimes the condition manifests no symptoms. The arrhythmia may begin with occasional or regular bouts of an irregular heart beat, but it generally worsens over the years.

Traditional ablation procedures for this arrhythmia deliver an electrical charge that permanently blocks the electrical connection that transmits the impulse from the atria to the heart's lower ventricles. A pacemaker is then required to maintain an adequate heart rate. The older procedure does not cure afibrillation but merely prevents the fast heart rate that frequently accompanies atrial fibrillation, and patients still require blood-thinning medication.

The Penn procedure is more specific in targeting the triggers for atrial fibrillation, rather than blocking the main electrical road to the heart. During the ablation process, Penn electrophysiologists infuse drugs that promote the firing of so-called "hot spots" in the pulmonary veins. Once those triggers are identified with the use of sophisticated electrical recording techniques, a catheter-based ablation procedure isolates the abnormal fibers that cause them.

The Penn team has developed what it believes are the optimal recording strategies and pacing techniques for identifying the affected veins rapidly and confirming the effectiveness of the isolation procedure. "We've been working on this problem for the last five years, and we're excited by the effectiveness and low complication rates associated with our current technique," Marchlinski says.

Others who assisted Marchlinski include David. J. Callans, MD; Erica S. Zado; Andrea J. Russo, MD; Edward P. Gerstenfeld, MD; Sanjay Dixit, MD; Robert W. Rho, MD; Vickas Patel, MD; John Beshai, MD; Joseph W. Poku, MD, and David Lin, MD, all of the Penn heath system.


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The University of Pennsylvania Health System and School of Medicine are distinguished not only by their historical significance -- first hospital (1751), first medical school (1765), first university teaching hospital (1874), first fully integrated academic health system (1993) -- but by their leadership in the practice of medicine in the 21st Century. Among all American medical schools, Penn ranks second in funding from the National Institutes of Health, perhaps the single most important barometer of research strength.

 

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $5.3 billion enterprise.

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 18 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $373 million awarded in the 2015 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2015, Penn Medicine provided $253.3 million to benefit our community.

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