electrophysiology research

[Abeybaby]

Hello and tks for taking some questions. I too suffer from PVC's but for a change let's not beat a dead horse but rather perhaps we can discuss the furure and what advances are being made?
1. what might the future hold for electropysiology advances and hence better prognosis for all arrythmia patients?
2. Is there drug therapy that spifically targets ventricular arrythmias being tested that are not anti-arrythmics?
3. Are there less invasive techniques being looked at for electrophysiology in dealing with arrythmias?
4. What is the single biggest advancement to be made over the next 10 yrs in cardiology?

Tks- I find cardiology and medicine very interesting and rewarding. Perhaps in my next life I will switch from I-banking to medicine! Thanks for all the questions and your patience. Its an incredibly successful web site. Well done!

[CCF-M.D.-MJM]

Hello,

I don't think I will be able to do these questions justice -- you could probably read journal articles written about these topics.


1. what might the future hold for electropysiology advances and hence better prognosis for all arrythmia patients?

It is tough to improve the prognosis of most arrhythmia patients because most arrhythmias are not life threatening.  I think there is a long way to go with atrial fibrillation ablations and new catheters, techniques and technologies are coming out everyday.  It is hard to tell which ones will have the biggest impact.  The bigger bang for the buck is controlling the hypertension, smoking, diets, lack of exercise that is causing the dangerous ones in the case of heart attacks.


2. Is there drug therapy that spifically targets ventricular arrythmias being tested that are not anti-arrythmics?

There are not any non anti-arrhythmic medications that I know of.  Serendipity can help the process every now and then, but for the most part the medications used for arrhythmias are planned and require years of testing before FDA approval.  I do not know of any big new drugs coming to the market soon.

3. Are there less invasive techniques being looked at for electrophysiology in dealing with arrythmias?

There are devices and techniques working to decrease the times of procedures, but it will difficult to make them less invasive.  Ten years ago treating someone with WPW meant open heart surgery, now we are doing it with three catheters in the femoral vein.  There is always room for improvement, but as far as I know there is nothing less invasive coming down the pipeline yet.

4. What is the single biggest advancement to be made over the next 10 yrs in cardiology?

If I know that I would be buying the stock as we speak.  My guess is the biggest advancement will come in the area of genetics and proteinomics, but what this advance will be is difficult to say.  We have come a long way in the last decade and have a long way to go.  It is always important to keep in perspective the best things we could do for the US and the world will not be new discovers but properly using technology and knowledge that is currently available -- smoking and diet being the biggest offenders in the US, worldwide we could save millions of lives with antibiotics and vaccines.

Sorry my response is late but I was without internet for a few days.  Thanks for posting.

[dande4]

Great question. I suffer from sinus tachy and svt. I have not had the need to undergo ep studies but I always worried about having it done.

I hope to hear that less invasive means are on the way..One can be hopeful:)

[rhythmAKL]

Great Post!  Thanks, I will look for the answer you receive.

[CollegeGirl143]

i loved this question.. mainly for the fact that its a different spin on the same questions about pvc's that gets asked every day...And for u guys out there who are scared about an ep study or ablation... Its cake... i promise.. and it immediatly changes your life.. its already minimally invasive, so im not sure how much less invasive it can get, but if you can set your fear aside it will be the best thing you do for yourself

[Curmudgeon76]

Hey,

I was re posting cuz you asked me to give you an update once I'd been to see the cardiologist.  I haven't gone yet, but if you like I can give you my e-mail address as it may be easier to converse that way, as opposed to taking up valuable forum space that other visitors to this site could be using.

I was curious about ablation: not everyone can benefit from it correct? In other words, it's not advanced enough yet that it can be used to correct ALL types of arrythmias?  I was also under the impression that in order to "fix" a pathway, or whatever is causing the arrythmia, the doctor must be able to cause the heart to experience the arrythmia in question while the catheterization is being done?  Any truth to this?

I had a "bad one" as I call it - a run of three beats I think, followed by a short pause before heart resumed normal function, last month, and the last time it happened that bad was about a year ago.  It'd be very difficult to catch these happening regularly in my case :( which in a way, I guess is a good thing (Provided they're not very dangerous! lol)

[Curmudgeon76]

Hi,

Some interesting news: I was reading that atrial fibrilation is very difficult to treat with current ablation techiniques, as the arrythmia is apparently produced from many different signals in the heart (I'm not an expert, that's just my understanding: feel free to correct me if I'm wrong)  I was also reading however in the same article, that much research is being done and they were saying that it seems in 2-3 years that ablatation to cure atrial fibrilation will not only be feasible, but will probably be practiced widely and succesfully.  I'd love to hear from my cardiologist that they'd be able to cure what's wrong with me. lol. :)

[arthur]

Ablation techniques currently in use cure paroxysmal AF at about an 80% success rate (counting a second procedure if necessary).  The cure rate for persistent AF is significantly lower, but not zero (more like 40-50%).  Better techniques have been developed recently, eg, ablation of the PV antrum region (not the ostia as done previously and currently).  The antrum is the conical connection between heart and PV (pulmonary vein) which is not well defined but is thought to contain most focally active tissue, so specialized tactics are used to image the region (this is perhaps not a widely practiced technique because of the instrumentation needed).  All such ablation techniques still carry some risk, however, the antrum bit is especially lower in risk, since the burns target away from the usual PV ostia and appear to avoid PV stenosis.
-Arthur

[CollegeGirl143]

Yes its very true that not all arrhythmia's can be helped  by ablation.. the success rates differ depending on what type of problem you have.. i had SVT (a certain kind called AVNRT) and my ep told me it is 98% curable.. And yes it is true the physcian must be able to induce the arrhythmia, otherwise they wont know where they have to ablate. They also try and induce the arrhythmia after ablation to make sure the pathway is infact treated. (btw, i would love your email address) The way i look at is, the risks of ablation are very low ( im most cases less than 1 percent) even if you only have a 50% chance of a cure, isnt the possible benifit worth the risk? the only case of this that i DONT agree with is sinus node ablation, which can result in a pacemaker.