Sunday, October 18, 2009

Catheter ablation & Heart Surgery

http://www.revolutionhealth.com/articles/catheter-ablation-for-atrial-fibrillation/hw159948
http://www.texasheartinstitute.org/hic/topics/proced/
http://www.texasheartinstitute.org/hic/topics/proced/mazes.cfm

Basically this is an extension on the previous topic. Related but is a different thing altogether. It's about atrial fibrillation. Basically these procedures are done when conventional medical treatment fails to treat the condition.

Catheter Ablation
Indication: Refractory atrial fibrillation (not responding to medication)
Method: Thin, flexible wires are inserted into a vein in the groin and threaded up through the vein and into the heart. There is an electrode at the tip of the wires. The electrode sends out radio waves that create heat. This heat destroys the heart tissue that causes atrial fibrillation or the heart tissue that keeps it happening.

1) Focal ablation
2) Circumferential ablation
3) Pulmonary vein ablation
4) Nodal ablation (attempt to control symptoms)

http://www.revolutionhealth.com/articles/av-node-ablation/zm6205

Of note of this procedure is that a permanent pacemaker would be inserted (note that this procedure actually destroys an AVN. So definitely you need to reimburse something right?)

Maze Surgery
Indication: Chronic Atrial Fibrillation
Method: Refer to Day of Surgery

Check out this website

http://www.hrsonline.org/Education/SelfStudy/

Okay, so I come across this website. I was looking on a trial--AFFIRM trial just to take a look on the efficacy of antiarrhythmic drugs. For further information about the trial, http://www.hrsonline.org/Education/SelfStudy/ClinicalTrials/AF/AFFIRM.cfm, check out the website I put out.

One word about the AFFIRM study. It's basically comparing the efficacy of using rate-limiting method and rhythm-limiting method to control atrial fibrillation. Result is that no statistical difference observed in both treatment. Rhythm-limiting method is referred usage of sodium channel blockers whilst rate-limiting method is referred to usage of beta-blockers, ccb etc. methods to control atrial fib.

Currently I can't think of any good subject to write on. But what I can do is just look out for good websites where they can provide a certain good information that we could appreciate as a medical student who hungers for nothing but knowledge.