Innovation

Southlake uses breakthrough to arrhythmia

NEWMARKET, Ont. – A Toronto-area hospital is the first in North America to perform a new procedure using breakthrough technology that is proving to be a more effective way to treat patients with a severe arrhythmia, or irregular heartbeat, than current treatment methods.

Newmarket-based Southlake Regional Health Centre has already treated six Toronto-area patients using the method – a new generation radiofrequency (RF) technology for the treatment of atrial fibrillation (AF), the most common heart rhythm disturbance.

The first-of-its-kind technology uses a new ablation (tissue destruction) method to effectively target and eliminate areas in the heart that cause heart rhythm problems, while significantly reducing procedure times and exposure to x-rays, said Dr. Yaariv Khaykin, who conducted the first five procedures.

“Atrial fibrillation is a serious concern, not only for the patients who suffer from the chronic condition but also for Canada as a whole,” said Dr. Khaykin, an electrophysiologist at Southlake, explaining that the high cost of treatment and care required to combat AF puts a significant strain on the healthcare system.

Affecting millions of people worldwide, including 200,000 Canadians, AF is a condition in which the upper chambers of the heart beat rapidly and erratically, disturbing the heart’s ability to adequately pump blood to its lower chambers and the rest of the body. The condition is responsible for 15 to 20 percent of all strokes, is a contributor to heart failure and is a leading cause of hospitalizations, causing debilitating symptoms and poor quality of life.

Medications to control the condition are often ineffective, so ablation – or burning inside the heart to destroy the tissue – is often used. The traditional ablation method includes burning the tissue surrounding the pulmonary veins (an area that has shown to transmit electrical signals that trigger AF) to create a scar that blocks abnormal signals to the heart.

While traditional ablation methods have to date yielded adequate results, they are not optimal and are associated with relatively high rates of complications and long procedure times, said Dr. Khaykin, adding that currently, hospitals such as Southlake have about 300 AF patients on their waiting list at any given time, resulting in average wait times of more than a year.

Southlake’s new technology, called the Medtronic Ablation Frontiers Cardiac Ablation System – developed by Minneapolis, Minn.-based medical technology leader Medtronic, Inc. – speeds up treatment by allowing heart specialists to better identify and selectively ablate a broader area of the heart tissue. A significant advancement from current RF ablation tools, which use a single point catheter and complex mapping and navigation equipment to target trouble spots, the new process uses minimally invasive three-dimensional, multi-electrode catheters to allow physicians to customize RF energy and eliminate abnormal electrical impulses from the upper left chamber of the heart that initiate or sustain AF.

“The technology simplifies and shortens ablation procedures without depending on elaborate mapping and imaging tools or costly equipment,” said Dr. Khaykin, explaining that, as a result of the new process, procedure times are reduced by more than 75 percent.

The initial cases at Southlake were completed in less than two hours, whereas current AF ablation procedures require a 3 hour and 20 minute time frame. “This means we can potentially do three or four cases a day, compared to the one to two cases we’re currently doing,” he explained, adding that doubling the case volume could virtually eliminate wait times for AF procedures.

Another major benefit is that the new technology requires only 20 to30 minutes of x-ray exposure, compared to 60 to 80 minutes of radiation required with traditional ablation procedures.

What’s more, studies conducted by Medtronic revealed that the new procedure reduces the risk of complications. They also demonstrated that more than 80 percent of the 500 patients participating in the studies had no evidence of AF nine months after their treatment, compared to about 70 percent who undergo treatment through traditional methods.

“I feel lucky and privileged to have been one of the first to have this procedure,” said James Kerr, 74, a resident of Town of the Blue Mountains, Ont., who received treatment at Southlake early last month. Kerr, whose regular episodes of AF would previously last anywhere between 27 and 63 hours, used to perform physical activities and travel with hesitation in fear of a trigger. Since the procedure more than a month ago, however, he hasn’t experienced a single occurrence of AF.

“I have no more fluttering or pain in the chest, so I’m feeling much more confident to do things,” said Kerr after returning from playing a round of golf. He added that while he still feels tired after exercise, the medical team advised that his full energy will return within three months of the procedure. “Overall, I feel really good and very happy.”

Expected to be approved for widespread use in Canada in the next three to six months, the new technology is currently under investigation in the U.S. and has been implemented in Europe for the last couple of years, with positive results.

“We anticipate that this new procedure will ultimately become the standard of practice for most AF procedures in Canada,” said Dr. Khaykin.

About Southlake Regional Health Centre (www.southlakeregional.org)
Based in Newmarket, Southlake Regional Health Centre is a full-service hospital with a provincial mandate to deliver advanced diagnostic and treatment services in cancer care, cardiac care, pediatric and perinatal care, child and adolescent eating disorders, and child and adolescent mental health care. It also specializes in arthritis care and thoracic and cataract surgery. Serving more than one million residents of York Region and South Simcoe, Southlake is in the process of transforming to a teaching and research centre.

Posted July 15, 2010