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New Heart Arrhythmia Treatment Reduces Risks

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The Gazette


COLORADO SPRINGS, Colo. - For the past few years, Andrea Fielitz has suffered from arrhythmia, her heart at times beating "really, really fast" - up to 240 beats per minute.

"When it beats that fast, you can't really do anything," the Grand Junction, Colo., 18-year-old said. "It just makes you so tired."

On July 23, Fielitz underwent cardiac cryoablation, a new treatment for certain kinds of arrhythmia, at Memorial Hospital in Colorado Springs. Memorial is one of 19 centers in the United States that have acquired the Freezor CryoAblation System since its approval in April by the Food and Drug Administration.

Arrhythmia, a disturbance in the heart's regular rhythm, involves an erratic heartbeat or one that is too fast or too slow. A normal resting heart rate is about 60 to 100 beats a minute. One cause of arrhythmia is malfunctions in the electrical impulses that cause the heart to beat.

Arrhythmias are common, and an occasional skipped beat isn't usually cause for alarm. But millions have recurrent arrhythmias that, if untreated, could lead to serious health problems. Arrhythmia can even be life-threatening, resulting in congestive heart failure or cardiac arrest.

Dr. T. Duncan Sellers, a Colorado Springs electrophysiologist, hails cryoablation as an improvement over the more-established radiofrequency ablation.

Radiofrequency ablation, a common treatment for arryhthmias involving abnormally fast heart rates, uses heat to destroy malfunctioning heart cells.

The procedure has a high success rate, Sellers said. In up to 2 percent of cases, though, it leads to heart block, which means the heart's electrical signal can't pass from the upper to lower chambers. In those cases, implanting a pacemaker becomes necessary.

Cryoablation freezes the tissue instead of heating it. Because it allows for more control and destroys fewer cells, it promises to reduce the risks, Sellers said.

"This, to me, is going to be a real night and day difference."

In cardiac cryoablation, doctors insert a catheter through a small incision in the groin and guide it through a vein into the heart. The catheter's tip then is cooled to about minus-20 degrees, allowing doctors to test whether a certain area of the heart is causing the arrhythmia.

If it isn't, doctors can re-warm the area without harm. Once an area of tissue is confirmed as the culprit, the catheter tip's temperature is reduced to about minus-70 to kill the defective cells.

Patients are sedated during the procedure, which lasts several hours and may require an overnight stay in the hospital, Sellers said. Normal activities generally can be resumed in a few days.

Fielitz remembers little of her cryoablation other than her legs being numbed before the incision was made for the catheter and a time when her heart was beating really fast.

"I'm not sure how different I feel yet," she said. So far, though, she has had no episodes of arrhythmia.

Some types of abnormal heart rhythms can be treated with radiofrequency ablation but not the cryoablation, such as atrial fibrillation, Sellers notes.

He said he expects that to change, though, as the new technology is further refined.


(c) 2003, The Gazette (Colorado Springs, Colo.). Distributed by Knight Ridder/Tribune News Service.

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