Breaking News
August 19, 2018 - Bifidobacteria supplement colonizes gut of breastfed infants
August 19, 2018 - Why patients with Alzheimer’s markers never develop the condition
August 19, 2018 - ACA’s Medicaid expansion associated with increase in prescriptions for opioid use disorder treatment
August 19, 2018 - Important factor may be missing in models used to predict spread of epidemics from climate change
August 19, 2018 - Indian-Americans have fewer sudden infant deaths, study finds
August 19, 2018 - Experts advise against universal genomic screening of newborns
August 19, 2018 - New trial to investigate whether weight loss before conception can make mom and baby healthier
August 19, 2018 - Sun Pharma Announces FDA Approval of Cequa (cyclosporine) Ophthalmic Solution to Treat Dry Eye Disease
August 19, 2018 - Researchers examining Parkinson’s resilience
August 19, 2018 - Researchers find mechanism that prepares brain to replicate repeated actions
August 19, 2018 - Those who are emotionally stable when young may remain the most stable as they age
August 19, 2018 - URI professor develops simpler and quicker method for detecting impurity in heparin
August 19, 2018 - Mayo Medical Laboratories and NDSC collaborate to develop new patient blood-management solution
August 19, 2018 - Insight into endocrine cancers and treatment options
August 19, 2018 - HPV Legislation Doesn’t Impact Teen Sexual Behaviors
August 19, 2018 - Exenatide treatment alleviated symptoms of depression in patients
August 19, 2018 - Tufts researchers win grant to study integration of genomic sequencing into neonatal care
August 19, 2018 - Novel finger-prick test can help prevent toxoplasmosis
August 19, 2018 - Cosmetic Procedures Boost Well-Being, Poll Shows
August 19, 2018 - Responsive parenting intervention results in lower BMIs through age three
August 19, 2018 - Anticancer drugs can help plants to battle infection
August 19, 2018 - Sunscreen from bathers releases significant quantities of polluting titanium dioxide into the sea
August 19, 2018 - Case Western Reserve gets three-year grant to enhance food systems in Cleveland neighborhoods
August 19, 2018 - Teenagers can thank their parents’ positive attitude for avoiding obesity
August 19, 2018 - Body mass index positively linked with blood pressure
August 19, 2018 - New tool fills gap in Small Molecules market
August 19, 2018 - Study compares survival outcomes in rural and urban cancer patients enrolled in clinical trials
August 19, 2018 - Researchers develop molecular matrix that delivers healing stem cells to injured elderly muscles
August 19, 2018 - Teva and Regeneron Announce Positive Topline Phase 3 Fasinumab Results in Patients with Chronic Pain from Osteoarthritis of the Knee or Hip
August 19, 2018 - New study pinpoints ways to improve quality of food and nutrition research
August 19, 2018 - Ology Bioservices wins $8.4 million worth agreement to manufacture anti-Ebola monoclonal antibody
August 19, 2018 - New CRISPR technology may help eliminate mutated gene sequence
August 19, 2018 - “Zombie gene” protects elephants from cancer finds study
August 19, 2018 - Study explores how many American cities protect the rights of employed breastfeeding mothers
August 19, 2018 - FDA Approves Lenvima (lenvatinib) for First-line Treatment of Unresectable Hepatocellular Carcinoma (HCC)
August 19, 2018 - Pain: Considering Complementary Approaches (eBook)
August 19, 2018 - Autoimmune response drives vision loss in glaucoma
August 19, 2018 - Tandem Diabetes Care introduces t:slim X2 Insulin Pump with Basal-IQ Technology in the US
August 19, 2018 - Innovative platform developed to destroy cancer cells
August 19, 2018 - Lowering pH inside tumor cells can slow down spread of cancer
August 19, 2018 - Biomarker predicts kidney cancer risk years before diagnosis
August 19, 2018 - Consequences of healthcare-associated infections go beyond patients’ physical health
August 19, 2018 - New drug- free, nanotechnology-based method detects and treats oral plaque
August 19, 2018 - Integration of Opioid, Infectious Disease Treatment Needed
August 19, 2018 - How eye disorders may have influenced the work of famous painters
August 18, 2018 - Blood biomarker could help predict kidney cancer up to five years prior to diagnosis
August 18, 2018 - Dartmouth scientists create more sustainable feed for aquaculture
August 18, 2018 - Immigrants Not a Burden on U.S. Health Care: Study
August 18, 2018 - Women who eat fast food take longer to become pregnant
August 18, 2018 - Most YouTube videos on plastic surgery are misleading marketing campaigns
August 18, 2018 - The essential guide to make your laboratory more sustainable
August 18, 2018 - Loyola Medicine offers scalp cooling treatment to reduce risk of chemotherapy hair loss
August 18, 2018 - Researchers describe promising strategy to remove melanoma’s most powerful defenses
August 18, 2018 - Women with polycystic ovary syndrome dissatisfied with medical care
August 18, 2018 - Research discoveries reveal insights behind neurological degeneration
August 18, 2018 - Researchers win multi-million Euro award to conduct research into liver disease
August 18, 2018 - Survey highlights variations in practice of airway management in pediatric intensive care units
August 18, 2018 - UK students win sponsorship from Promega Corporation
August 18, 2018 - Janssen Reports Positive Topline Results for ATLAS Phase III Study of a Novel, Long Acting Injectable Two-Drug Regimen for the treatment of HIV-1
August 18, 2018 - PSD as a molecular platform for understanding synapse formation and plasticity
August 18, 2018 - Improved visual communication could help patients to make informed health-care decisions
August 18, 2018 - New algorithm helps identify and manage diabetic patients at increased fracture risk
August 18, 2018 - Microscopic insect odour detecting mechanisms discovered
August 18, 2018 - Researchers develop new approach to study how tuberculosis infects people
August 18, 2018 - FDA Approves Kalydeco (ivacaftor) for Cystic Fibrosis in Children Ages 12 to
August 18, 2018 - An ion channel differentiates newborn and mature neurons in the adult brain
August 18, 2018 - Conditions of first sexual encounter can be indicators of future HIV risk and gender-based violence
August 18, 2018 - Socio-economic position associated with pregnant women’s exposure to environmental hazards
August 18, 2018 - Study evaluates how students change their breakfast consumption when given extra time
August 18, 2018 - Chronic perinatal hypoxia linked to locomotor miscoordination, long-term cerebellar learning deficits
August 18, 2018 - Voters to settle dispute over ambulance employee break times
August 18, 2018 - AGA urges policymakers and stakeholders to improve affordability of drugs
August 18, 2018 - Increasing dietary protein may lower risk of diabetes in people with NAFLD
August 18, 2018 - New HIV therapy suppresses viral replication and increases immune cells in drug-resistant patients
August 18, 2018 - Broad Genetic Testing for NSCLC May Not Improve Survival
August 18, 2018 - Discovery opens door for synthetic opioids with less addictive qualities
August 18, 2018 - Transgenic rice plant extracts could help stop the spread of HIV
August 18, 2018 - Hologic’s Cynosure division partners with Porter Instrument to distribute nitrous oxide and oxygen system
August 18, 2018 - Two thyroid medications recalled by FDA
August 18, 2018 - Forecast Sees Abnormal Heat Worldwide Through 2022
New biomarker may indicate success of popular treatment for atrial fibrillation

New biomarker may indicate success of popular treatment for atrial fibrillation

image_pdfDownload PDFimage_print

Johns Hopkins researchers report successful use of heart imaging to predict the benefit or futility of catheter ablation, an increasingly popular way to treat atrial fibrillation, a common heart rhythm disorder.

The researchers caution that a more randomized and controlled clinical trial is needed before doctors can reliably use their cardiac imaging analysis routinely with patients, but if confirmed, they say the method should reduce ablation procedures unlikely to work, along with the procedures’ substantial costs and complication risks.

The investigators described their findings Jan. 17 in the Journal of the American College of Cardiology: Cardiovascular Imaging.

Atrial fibrillation, diagnosed in 3.4 million Americans and the most common heart rhythm condition in the United States, is marked by irregular and sometimes extremely rapid heart rates that cause fatigue and shortness of breath, and significantly increase the risk of heart failure and stroke. Treatments include drugs to regulate the electrical pulses in the upper chambers of the heart and ¾ increasingly ¾ catheter ablation. The procedure involves general anesthesia and imaging guided use of a wire catheter threaded through a vein to the heart to make scores of tiny burns of tissue in which the irregular heartbeats arise.

However, an estimated 20 to 30 percent of the ablation procedures performed each year fail to prevent irregular heart rhythms, and cardiologists have long sought various biological or anatomical factors to help them determine in advance which patients are the best candidates for ablation.

“In our study, we found that the best indicator of success is how in sync the left atrium chamber of the heart is when it relaxes,” says Luisa Ciuffo, M.D., a postdoctoral fellow in the Division of Cardiology at the Johns Hopkins University School of Medicine. “Diseased, damaged hearts with a lot of scar tissue don’t contract and relax at the same time throughout the atrium because it is more difficult to rhythmically contract the thicker, tougher damaged tissue.”

For the study, designed to identify the best predictors, the researchers used data from 208 atrial fibrillation or “Afib” patients admitted to The Johns Hopkins Hospital to undergo ablation between June 2010 and December 2015.

Some 29 percent of the patients were women and the average age of all patients was 59. Prior to the ablation, each subject underwent computed tomography scans or MRIs of their hearts and were followed for an average of 20 months to assess recurrence of Afib, including a faster than normal heartbeat or an irregular heartbeat lasting longer than 30 seconds. Atrial fibrillation recurred in 101 patients.

The researchers then analyzed various characteristics of the imaging scans from 208 people in a subgroup: 107 of the people with successful ablations compared to 101 of those with failed ablations. The researchers investigated factors such as smallest and largest sizes of the left atria, the percentage of blood pushed out of the left atrium when the heart contracted and the amount of strain on the left atrium during heart contraction.

The analysis to determine the level of dys-synchrony in the left atrium took about nine minutes per case. Using the cardiac images, the atrium was divided up into 12 segments, and the researchers calculated the relaxation time in each of the segments and then compared them to each other. Those hearts that had the most differences between the segments of the atrium ¾ a higher deviation ¾ were considered the most dys-synchronous.

Overall, the Johns Hopkins researchers found that patients with recurrent atrial fibrillation had on average more preoperative dys-synchrony throughout the left atrium than those who had successful ablations (3.9 percent versus 2.2 percent), with the higher value indicating more diseased atrium.

In a second part of the research, the investigators took the scans from a group of 103 patients, both with successful and unsuccessful ablations, analyzed the percentage of atrial dys-synchrony in the left atrium and assigned them to one of two groups: one less than or another greater than 2.86 percent.

They expected those people with values lower than 2.86 percent to be better candidates for ablation because atrial fibrillation would be less likely to recur than in those people with more than the 2.86 percent cutoff. They then compared these groupings to their actual outcomes after ablation. They found that their model had a 76 percent sensitivity ¾ the ability to correctly identify those who were unlikely to have successful ablations ¾ and 81 percent specificity ¾ the ability to correctly identify those who would most likely have successful ablations.

“We believe we are developing a tool that can help with personalized decision-making to help refine patient selection and thus reduce the failure rate by saving candidates with low potential benefit from futile procedures and complications,” says senior author Hiroshi Ashikaga, M.D., Ph.D., assistant professor of medicine at the Johns Hopkins University School of Medicine.

An ablation procedure isn’t cheap, says Ciuffo, sometimes costing as much as a new car. The cost of cardiac imaging typically performed before the ablation procedure is a fraction of the cost of the procedure.

Although the risk of complication is small, about 6 percent with ablation, there is still the chance of puncturing the heart or forming a fistula.

Source:

https://www.hopkinsmedicine.org/news/media/releases/biomarker_predicts_success_of_afib_treatment

Tagged with:

About author

Related Articles