Features July 2013 Issue

Recent Studies Shed New Light On Atrial Fibrillation Treatment

Research looks at managing atrial fibrillation and its associated risks with medications and as part of other cardiac interventions.

Two recent studies provide greater insight into the treatment of patients who have atrial fibrillation (AF), an increasingly common condition involving an unhealthy beating of the heart’s upper chambers.

 In one study, led by Cleveland Clinic electrophysiologist Mohamed Bassiouny, MD, researchers found that the oral anticoagulant dabigitran need only be withheld for one dose prior to radiofrequency ablation, and may be restarted immediately after the procedure is completed. Radiofrequency ablation involves the use of a special catheter that contains a tip that can be electrified to deliver a tiny charge that burns or ablates the tissue causing the irregular heart rhythm. Because patients with AF are at a higher risk of blood clot formation (due to blood pooling in the heart because of the abnormal rhythm), they usually take an anticoagulant such as dabigatran or warfarin to reduce clot risk. The study, published in the journal Circulation: Arrythmia and Electrophysiology, found that this use of dabigatran before and after radiofrequency ablation was just as safe as uninterruped warfarin management.

In a separate study, presented at the recent American Association for Thoracic Surgery 2013 annual meeting, researchers found that treating paroxysmal AF (PAF) during cardiac surgery shows benefits ranging from reduced surgical complications to lower mortality rates compared with untreated PAF.

PAF is a condition in which episodes of abnormal atrial rhythms can last for minutes or days, as opposed to  other types of AF that are permanent. Cleveland Clinic cardiac surgeon Marc Gillinov says PAF is a common clinical problem and shouldn’t be ignored by surgeons, and that treating PAF during surgery can improve survival.

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