Video Interview with Dr. David Wilber at Heart Rhythm 2009
July 7, 2009 6:20 AM CT
In this video, Dr. David Wilber, George M. Eisenberg Professor of Medicine and Director, Cardiovascular Institute and Division of Cardiology at Loyola University Medical Center, talks about atrial fibrillation findings reported on at the Heart Rhythm Society’s 2009 annual meeting in Boston. He talks about the results of a large multicenter catheter ablation trial as well as the window of opportunity for treating afib for those with paroxysmal atrial fibrillation.
View the video: Dr. Wilber on Heart Rhythm 2009
Mellanie: This is Mellanie True Hills for StopAfib.org. I am at the Heart Rhythm Society 2009 annual meeting and with me today is Dr. David Wilber. He is the director of cardiology and clinical electrophysiology at Loyola University Medical Center. He is going to share with us some of the things that have been happening here at the Heart Rhythm Society meeting.
Dr. Wilber: Thanks, Mellanie. I think there are actually several exciting things that have been discussed about atrial fibrillation at these meetings and it’s information that I think patients need to know.
There were the results of a large multicenter trial comparing catheter ablation of atrial fibrillation to drug therapy in patients that have paroxysmal atrial fibrillation and have failed at an initial attempt at drug therapy. The broad results of the study suggest that whatever way you look at the problem, either by quality of life or by the number of episodes of atrial fibrillation experienced by patients in the study, that treatment by catheter ablation was significantly more effective than treatment with an additional anti-arrhythmic drug after the first one failed.
Patients that were treated by ablation had much improved quality of life, fewer symptoms, and were less likely to have any episode of atrial fibrillation. In fact, after a year of follow up, of patients that were randomized to ablation only, 60-to-70 per cent of patients had no further afib, not even a single episode, during follow up, compared to only 20 per cent of patients who were taking anti-arrhythmic drug therapy.
So that’s pretty compelling evidence that once you have tried to treat your atrial fibrillation with a drug and it didn’t work, you should give strong thought to having catheter ablation as opposed to additional drug treatments.
There are many other concerns. Patients have other kinds of atrial fibrillation. You may have atrial fibrillation and have never had any treatment at all, and you might ask the question, “Well is ablation right for me?” It is possible that it may be, but there is little evidence right now. There is an ongoing trial that is actually addressing just that issue and hopefully we will have more information in the future about which therapy is best for people who have never had previous treatment.
One of the thoughts about afib that’s paroxysmal is that many patients (up to 50% over ten years) may ultimately develop more persistent forms of atrial fibrillation. There is a window of opportunity to treat and suppress atrial fibrillation that may be missed if you keep putting off decisions about what you want to do until your atrial fibrillation becomes more established. So it is important to talk to your physician about where you are in the course of atrial fibrillation, and not only what will control your day-to-day symptoms, but what may help prevent long-term progression of this intermittent form of atrial fibrillation to something more persistent.
Mellanie: Great. Dr. Wilber, thank you so much for sharing with us the results that were reported on here at the Heart Rhythm Society and for joining us today. For StopAfib.org, this is Mellanie True Hills.
Dr. Wilber: It was a pleasure.