Friday, 9 Dec 2022

What patients with atrial fibrillation helps


Often the disease is manifested by a very unpleasant feeling of pressure on the breast, rapid heartbeat or palpitations, associated with dyspnea and dizziness. The so-called atrial fibrillation lowers the quality of life of Patients. And it increases your risk of developing a weak heart or suffer a stroke.

The heart rhythm disorder occurs relatively often in Germany is estimated to have affected two million people. Most of them are older than 50 years.

The heart through the atrial fibrillation device more frequently from the clock or stop such an attack longer than a day or two, then those Affected should seek medical advice.

Electrical shock can bring the heart back into the clock

To a physician clotting inhibitor can prescribe, and so the risk of stroke reduce. On the other, you can liberate with a short electrical shock, called cardioversion, heart rhythm disorder, so that it beats regularly again. This can also antiarrhythmic drugs by the administration of specific drugs to happen, so-called.

The Flicker returns, however, there are two possibilities:

  • the permanent Taking anti-arrhythmic drugs,
  • the so-called catheter Ablation, where a catheter through the blood vessels to the heart were introduced and the area of the heart is obliterated, from which the Arrhythmia originates.

The current guidelines recommend both options, Doctors and Sufferers must consider. A team of Doctors has been compared to medication and surgery in a large study.

2204 patients included in North America, Europe and Asia in the investigation part, let the random decide which method of therapy came. The participants were on average 68 years old and suffered for well over a year, atrial fibrillation, almost two-thirds were men.

Participants in the medication group were not able to decide, later, for an Ablation if your symptoms are abated by the drugs. So did 27 percent of those Affected. At the same time was not carried out for approximately nine percent of the patients in the Ablation group, the intervention but, what the analysis of the study data.

The Team led by Douglas Packer (Mayo Clinic, Rochester, USA), and Daniel Mark (Duke Clinical Research Institute, USA) accompanied the patient in an average of four years and determined:

  • how many a stroke, cardiac arrest, or severe bleeding suffered or died
  • and how the patients perceived their quality of life one year after the Ablation, respectively, after the start of administration of antiarrhythmic drugs.

Difference in the quality of life

The result, the researchers report in the journal “Jama”: Ablation, and medications to protect approximately equal to the potential consequences of atrial fibrillation such as stroke. In the group that the catheter procedure was carried out, hit the eight per cent, one of the dreaded complications of Fibrillation. In the group that took drugs, it was 9.2 percent. Statistically, the difference of a percent has no meaning here.


Who paid for it?

The study was financed in part by a US national Institute (NHLBI), of the Mayo Clinic, as well as three medical devices manufacturers (Biosense Webster, Medtronic, Boston Scientific Corporation).


Both of these methods can have unpleasant side effects: about one percent of the patients had post-Ablation fluid accumulation in the pericardium or a bruise on a vein, a so-called pseudo aneurysm. In the medication group, around one and a half percent of the patients developed a thyroid disorder.

But regardless of whether catheter Ablation or antiarrhythmic drugs: In both groups, the patients reported after one year of a higher quality of life. However, it increased after Ablation stronger. The patients had after the procedure a higher Chance that the Flicker appeared again, and were, accordingly, less likely to go to the hospital. They complained less likely to have shortness of breath or fatigue.

However, more than half of the patients in whom Ablation was performed in the following four years, a further intervention is needed because the Arrhythmia had returned.

Collectively, the study confirmed the currently recommended procedure: the Affected parties can decide together with the doctor after a thorough consultation, whether you are taking rather anti-arrhythmic drugs or Ablation prefer. Both therapies are designed to improve the quality of life and reduce at a similar rate, the risk of serious complications of atrial fibrillation. Detailed information from the current, large study, about possible side effects of treatments, can help patients and Doctors to make a decision.