Originally created 01/19/99

Heart-burning operation proves safe and effective



DALLAS -- An increasingly common operation in which doctors burn away heart tissue to try to eliminate heart rhythm disturbances almost always succeeds and carries low risks, according to the biggest study ever done of the procedure.

Researchers said the results should encourage doctors to consider radiofrequency catheter ablation over drugs when treating patients with certain irregular heart rhythms, including a rapid beat.

"This procedure has clearly moved into a front-line therapy of choice," said Dr. Eric Prystowsky of the Indiana Heart Institute in Indianapolis, one of the researchers.

The findings were published in Tuesday's issue of Circulation, a journal of the American Heart Association.

Catheter ablation was introduced about 10 years ago and has grown rapidly, with thousands now performed every year. The irregular heart rhythms treated by catheter ablation are usually not life-threatening but cause palpitations that can frighten patients.

Catheters are threaded through blood vessels from the groin or an arm or leg into the heart and used to burn away tissue containing nerve pathways that cause the heart to misfire.

Researchers looked at 1,050 patients at 18 hospitals who underwent a catheter ablation.

The irregular rhythm, or arrythmia, disappeared in about 95 percent of the patients. A few patients needed repeated treatment, and 3 percent developed major complications, including three who died within a month of the surgery.

The researchers said there was a 1 percent risk that patients would eventually require a pacemaker.

The patients who fare poorly after surgery "generally have the most heart disease. Some of them are going to die, period," Prystowsky said.

Surgery generally costs $10,000 to $12,000 and up, and it's usually covered by insurance, although insurers frequently require that drugs be tried first.

Earlier studies of catheter ablation tended to focus on individual, elite hospitals.

"These are numbers we can hang our hats on and will help us when we discuss options using this procedure rather than drug therapy," said the study's lead author, Dr. Hugh Calkins of Johns Hopkins Hospital in Baltimore.

Dr. Kenneth Ellenbogen, director of cardiac electrophysiology at the Medical College of VirginiaVirginia Commonwealth University, commented: "I think the findings actually are consistent with what most people in this field believe, that this is a technique that's been around seven or eight years now and is a relatively safe technique and it's a very effective alternative to lifelong drug therapy."