Laser balloon used in breakthrough heart operation 

19/08/2011 00:00 

A new ‘laser balloon’ which is allowing surgeons to see inside the beating heart for the very first time is giving hope to patients who suffer from the most common heart rhythm disorder in the world.

Scott Rosser recovering following his pioneering treatment

Patient Scott Rosser with senior staff nurse Dennis Lalusis and staff nurse Ellen Quinney


The procedure which inflates a balloon inside the heart is the latest development of a technique known as ‘atrial fibrillation ablation’ and is being pioneered in the UK at The Heart Hospital. The first patient in the country, Scott Rosser, 34 from Croydon, was treated with procedure this week. His surgery was featured on Sky News, click here to view.

The balloon has a camera within it which films inside the heart allowing greater accuracy during surgery and improved success rates compared to previous techniques.

Atrial fibrillation affects more than 200,000 a year in the UK. It occurs when the normal pattern of electrical conduction in the top chambers of the heart (or atria) becomes totally chaotic resulting in a rapid, irregular heart beat causing palpitations, breathlessness and tiredness.

People with the condition are up to nine times more likely to have a stroke and twice as likely not to live as long as someone with a normal heart rhythm.

Until now, the procedure has involved inserting fine tubes from the top of the leg into the heart to deliver radiofrequency energy to destroy tissue surrounding the pulmonary veins (known as PV isolation). If a barrier can be created to prevent electricity spreading from the pulmonary veins, the vast majority of patients are cured.

However, the heart often repairs the damage which limits the success of this technique to about 50 per cent of patients after one attempt.

The new laser balloon procedure is also 'keyhole' and involves inserting catheters via the top of the leg. The end of the catheter has a balloon which is inflated and put into the pulmonary vein. A laser is then used to perform PV isolation guided by a camera which is incorporated inside the centre of the balloon.

The laser ballooon in action

The laser ballooon in action


The balloon creates a ‘blood free zone’ and the camera allows doctors to see inside the heart making it possible for specific areas to be targeted.

The laser is directed by a camera within the beating heart allowing greater accuracy than the previous procedure which uses a 3D computer map generated by dragging a catheter around the inside of the heart.

Dr Oliver Segal, consultant cardiologist at The Heart Hospital, said: “The laser balloon is an incredibly exciting new technology for treating patients with paroxysmal (or intermittent) atrial fibrillation. From the cases performed so far in Europe and the United States, it appears to be significantly better than existing technology in achieving pulmonary vein isolation after just one attempt.

“This means patients will be much less likely to need two ablation procedures and therefore much less likely to develop a complication from ablation, which can include stroke, cardiac perforation, emergency surgery and on very rare occasions, death.

“We are absolutely delighted that The Heart Hospital will be the first centre in the UK to offer this treatment to patients with atrial fibrillation.”

Dr Oliver Segal, consultant cardiologist at The Heart Hospital

Dr Oliver Segal, consultant cardiologist at The Heart Hospital


Mr Rosser, a keen scuba diver, was treated under a general anaesthetic and kept in hospital overnight as a precaution.

His heart rate used to go up as high as 202 beats per minute despite medication. But his heart rhythm following the procedure was normal. He said: "This procedure has a greater degree of accuracy so you don't have to come in for a second procedure, which is good. The fewer surgical interventions you have the better."

Results from the first 400 cases worldwide have shown very encouraging results in comparison to other techniques.  A sub-study of more than 50 patients demonstrated a much higher rate of permanent PV isolation of 86% after only a single procedure.

The Heart Hospital, part of University College London Hospitals Foundation Trust performs around 380 atrial fibrillation ablation procedures every year and the laser balloon could potentially be used to treat approximately half of these patients.

If you are a patient and think you might be suitable for this procedure, please call 020 3456 4506.

 

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