Procedure May Beat Drug in Patients With Heart Failure, Irregular Heartbeat

new article illustration

MONDAY, March 16, 2015 (HealthDay News) -- Patients with heart failure can sometimes also develop the dangerous irregular heartbeat known as atrial fibrillation, which can raise their odds for stroke.

Now, a study to be presented Monday in San Diego at the annual meeting of the American College of Cardiology (ACC) examines the best way to treat these patients. It suggests that patients have better outcomes if they undergo a procedure called catheter ablation to ease the atrial fibrillation, compared to using a standard medication called Amiodarone.

"Even when it is effective, Amiodarone often needs to be discontinued after a while due to serious long-term side effects," said lead author Dr. Luigi Di Biase in an ACC news release. He is a cardiologist and electrophysiologist, and director of arrhythmia services at the Albert Einstein College of Medicine at Montefiore Hospital in New York City.

"Our study suggests that in patients with heart failure and atrial fibrillation, catheter ablation is an effective alternative treatment that can help patients avoid or discontinue this drug to reduce the risk of these long-term side effects," said Di Biase, who is also a senior researcher at St. David's Medical Center in Austin, Texas.

In catheter ablation, small wires are placed inside the heart to deliver energy or heat that destroys areas of the heart that cause abnormal heart rhythm.

One expert agreed that for many patients, catheter ablation may be the preferred option.

"Patients with heart failure are already on an average of eight medications," noted Dr. Justine Lachmann, director of the Congestive Heart Failure Program at Winthrop-University Hospital in Mineola, N.Y.

"The option to have a procedure performed that would obliterate the need for another medication is a great option for patients," she said.

According to the ACC, about 5 million Americans have heart failure, and an estimated 5.6 million have atrial fibrillation. People with both conditions have a high risk of serious complications and death.

In the study, Di Biase's team tracked outcomes for 200 American and European patients who had heart failure plus atrial fibrillation. The patients were treated with either catheter ablation or Amiodarone.

After two years of follow-up, 71 percent of patients who had catheter ablation were free of the arrhythmia, compared with 34 percent of those who took the drug. Patients who had catheter ablation were also less likely to be hospitalized or to die, the study found.

Dr. David Friedman is chief of heart failure services at North Shore-LIJ's Franklin Hospital in Valley Stream, N.Y. He said the problem of treating heart failure and atrial fibrillation together is a "vexing" one.

The new findings highlight "a promising alternative" to Amiodarone therapy, Friedman said, since often this drug therapy is "difficult to handle."

Di Biase agreed. "It is very important to control persistent atrial fibrillation in patients with heart failure," he said. "These patients need every bit of blood that the heart can pump, so it becomes particularly dangerous when an arrhythmia happens. People with both of these conditions frequently wind up in the hospital."

Experts note that findings presented at medical meetings are often considered preliminary until published in a peer-reviewed journal.

More information

The U.S. National Library of Medicine has more about cardiac ablation.