Atrial Fibrillation Patients Could See Substantial Declines In Stroke Risk When Treated With Catheter Ablation
People suffering from irregular heartbeats could see substantial declines in stroke risk, thanks to a heart procedure called catheter ablation.
While not a new procedure, catheter ablation has experienced little exposure as a viable treatment option. This is due in large part to the procedure's high cost of $80,000, which many medical facilities cannot cover, leaving individuals to often opt for blood-thinning medication to reduce the chance of stroke-causing clots. A recent three-year study of nearly 38,000 people has shown that individuals with atrial fibrillation (AF) who underwent the ablation treatment had better outcomes than people on medication alone.
Cardiac arrhythmia is currently the leading cause of stroke in the United States.
During the study period, ablation patients had similar stroke rates to individuals without AF, pointing to the treatment's success regardless of initial risk.
"The risk going in doesn't seem to matter on the outcome," Dr. Douglas Packer at the Mayo Clinic in Rochester, Minn., told Reuters. "Those at the highest risk (of stroke) still appear to have received substantial benefit from the ablation."
What is a-fib?
Atrial fibrillation is the most common form of cardiac arrhythmia, defined by the Mayo Clinic as a rapid and irregular heartbeat. When the atria fibrillate, the upper two chambers beat out of sync with the lower two, causing impeded blood flow and possible clots. If left unabated, these clots can escape to the brain, resulting in a stroke.
The study doesn't prove catheter ablation's lone success in treating atrial fibrillation. External factors may have contributed to the patients' greater success rates, such as post-treatment care or differences in medication, as the researchers did not have access to such information.
In total, the study included 37,908 patients with atrial fibrillation, with 4,200 undergoing the ablation treatment, 17,000 taking only medication, and another 17,000 who matched the stroke risk profile of the first two groups but without AF. At the end of the study, Dr. Thomas Bunch, heart rhythm specialist at Intermountain Medical Center in Murray, Utah, and his colleagues found that 900 participants had strokes after one year.
Among those with AF who didn't receive ablation treatment, 3.5 percent had a stroke, while 1.4 percent of ablation patients had a stroke. In the control group, the stroke rate was also 1.4 percent.
What is catheter ablation?
Catheter ablation involves inserting a thin metal wire through the vessels of the heart, where it can then use an electrical signal to burn the arrhythmia-causing tissue. However, despite its success rate in Bunch's study, the procedure takes a backseat to blood-thinning medication that doesn't treat the arrhythmia directly. Medication that directly restores the heart's normal rhythms often comes with unsatisfying results and painful side effects.
According to the American Heart Association, AF affects 2.66 million people in the United States, with 15 to 20 percent of all strokes being the result of AF.
The most common group of people to experience AF is the elderly, and the problem is expected to grow as the population ages. The Centers for Disease Control and Prevention expects 12 million people to have atrial fibrillation by 2050. The age range in Bunch's study was 60 years old to the late 80s.
"This is a condition that is increasing rapidly by reasons beyond old age," Bunch told Reuters. "One in eight of us will develop AF, if we live long enough."