Atrial fibrillation affects some 300,000 people in the Netherlands and is the most common form of arrhythmia, whereby the heart's electrical impulses no longer function properly. Patients may experience an irregular heartbeat, excessive sweating and dizziness. In healthy people, the heart sends an electrical impulse from a specific area to trigger the cardiac cycle. Various factors, such as age, lifestyle and other conditions, can cause the heart to send these impulses from other areas as well, thereby creating an arrhythmia.

Making scars

Cardiologists can use ablation to remove unnecessary stimulation. Cold or heat are applied to create a scar in the area where the unwanted stimulation occurs. For complex arrhythmias, it can be difficult to locate the source and to determine whether the scar tissue treatment has worked. As a result, patients have to come back for another procedure. The insights derived from this new technique are expected to significantly reduce the number of repeat procedures.
 

150,000 measurements per second

The procedure uses a so-called 'mapping' catheter, which can carry out roughly 150,000 measurements per second. These measurement points allow doctors to visualize the heart chamber from the inside using ultrasonic sound waves. It can also map the heart's electrical impulses in minute detail. 'This allows us to see the cause of the disorder in real-time,' says cardiologist Laurent Pison, who is applying this technique in practice. 'You can identify disorders that previously went undetected and you can immediately see the effects of an ablation procedure. This makes it far less likely that the patient will experience new symptoms from an undiagnosed disorder.'

Visualisation

This new technique is expected to make CT scans and the accompanying radiation unnecessary for patients. Normally, these scans would be used to map the heart before the procedure is carried out. This is no longer necessary using the new technique, as it visualises the heart in real-time. To be on the safe side, however, the CT scan will still be used for the time being.

The Maastricht Hart+Vaat Centrum now uses various innovative techniques to treat complex cardiac arrhythmias, including hybrid ablation, the Sensei robot and the mapping catheter technique. The latter was developed by Acutus Medical and is currently being carried out as part of a research project.