Aleisha Orr
New surgical approach to treat atrial fibrillation a first in WA
A novel dual-energy focal ablation catheter was used to perform a keyhole cardiac operation to treat rhythmic disturbance of the heart in a WA hospital in August.
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Aleisha Orr
The procedure, which was undertaken at Sir Charles Gairdner Hospital (SCGH), marked the first time that this specific type of catheter was used for this procedure in WA.
Cardiologist doctor Sohail Popal, who is trained in electrophysiology, said being able to carry out such a procedure to treat atrial fibrillation allowed a more tailored approach to addressing the specific rhythm issues of patients.
“The operation is performed by intentionally making small areas of scar in the heart muscle to treat certain rhythm disturbances," he said.
Dr Popal said just three to four years ago the energy used to perform this operation this was cold energy (cryo), or heat energy (RF).
However, in recent years the options had expanded to include pulse field energy, which along with the specific catheter use in this operation, allowed for this WA first to take place.
“A newer energy modality, or a newer way of causing of scars using high voltage energy, has come about which has distinct advantages,” Dr Popal said.
“This specific tool, or the catheter that we use, allows us to be able to use two energy sources through the same catheter. That is, the heat energy as well as high voltage - otherwise known as pulse field energy.”
He said this was particularly useful when a patient had more than one rhythm disturbance.
“Traditionally we would be limited by the catheter that we're using and the energy of that catheter, so we would only be able to use cold energy, heat energy, or the high voltage (PFA) energy.
“This catheter, which allows us to toggle between energies, allows us to be able to treat different parts of the heart muscle with different energies. There's certain areas of the heart that benefits from one type of energy, and certain areas where we might choose to use the other type of energy.”
Atrial fibrillation is the most common heart rhythm disorder in Australia, affecting around2-4% of the population. It is caused by chaotic electrical signals in the heart's upper chambers, causing them to quiver instead of pumping blood normally.
Catheter ablation is frequently used to treat atrial fibrillation.
Dr Popal said while there have been other catheters that have allowed surgeons to toggle between energies, they were likely limited to ablating a larger footprint - meaning surgeons were potentially causing more scarring in areas where it may be required.
Whereas the catheter used in this WA-first allowed doctors to perform very discrete areas of ablation as well as using two types of energies.
“The benefit is having both energy sources enabled to deliver that through a single catheter in very discrete defined spots,” he said.
Dr Popal said he understood some of his SCGH colleagues had since carried out the procedure using this method and he expected it to be utilised more often in WA.