Wilford W. Spradlin Professor Senior Associate Dean for Education
Volume 4, 2011
UVA Researchers Treat Common Heart Disorder Without X-ray Exposure Decoding the Riddle of Disease
New Catheter Ablation Technique Corrects Patients’ Irregular Heart Rhythm Using Ultrasound and Computer Mapping in Place of Conventional X-ray
UVA Study Offers Key Insights About How Industry Funding Compromises Integrity in Academic Research
The novel technique also uses a computer mapping system, which displays in 3D the image of the heart and the catheter’s location and allows physicians to record precise location points along the catheter’s path.
A growing body of research continues to warn of the potential long-term effects of radiation exposure for patients and medical providers during such imaging procedures as x-rays and computed tomography (CT) scans.
Now researchers at the University of Virginia Health System have developed a promising x-ray free technique to treat atrial fibrillation – a breakthrough that could all but eliminate radiation exposure to patients and their medical providers.
“One of the most exciting things about our research is the direct impact on patient care and safety,” says John D. Ferguson, MD, associate professor of cardiology in the UVA School of Medicine. The study, led by Ferguson, appeared in the December 2009 issue of Circulation. “Cardiac interventions continue to evolve toward lower risk procedures, and this study is another huge step in that direction.”
More than two million Americans suffer from atrial fibrillation, a condition characterized by an irregular heart rate that can lead to weakness, blood clotting and even stroke. Current conventional treatment involves the use of x-ray fluoroscopy to guide a catheter to the affected area of the heart. The procedure typically lasts three to four hours, leaving patients and medical providers exposed to significant radiation.
Ferguson’s research team has developed and successfully tested a new technique to perform catheter ablation of AF using an ultrasound catheter (intracardiac echocardiography) and electroanatomic mapping without the use of x-ray fluoroscopy for the entire procedure.
Using an ultrasound catheter within the heart, physicians can obtain high resolution images of the heart and other key anatomic structures. This provides complete visualization at all times of the catheter’s location, allowing physicians to steer the tube to affected target areas while avoiding injury to key cardiac structures.
And to further eliminate radiation exposure in AF patients, the new technique uses cardiac MRI instead of CT scans for all required imaging prior to the procedure. Researchers performed the novel technique in a pilot study on 21 consecutive patients referred to the UVA Atrial Fibrillation Center.
In addition to improving patient safety, this new technique gives healthcare providers relief from significant exposure to radiation and a welcome reprieve from the need to wear extremely heavy aprons that help minimize x-ray exposure during the three-to- four-hour procedures. Over time these aprons can cause healthcare providers to suffer from chronic back and neck pain.
“Larger studies are needed to confirm the safety of the procedure, but the concept that you can perform complex electrophysiology procedures without any use of x-ray is outstanding,” says Brian Annex, MD, chief of the UVA Division of Cardiology.
“This research is a ground-breaking step in our efforts to minimize radiation exposure to all patients. This is a major goal that is especially critical to those most vulnerable – patients who would otherwise require excessive radiation due to weight, women of child bearing age, and of course children and younger adults,” Annex says.
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