28 March 2013
Patients with heart failure and the most common type of irregular heartbeat have new hope for a better quality of life following a successful trial of a new treatment led by the Trust.
Over 50 patients took part in the trial led by a team of cardiologists at Royal Brompton and Harefield hospitals, which examined the role of catheter ablation, a minimally invasive treatment using radiofrequency energy to destroy the area causing the abnormal heart rhythm.
The ARC-HF study, which took place between 2009 and 2012, included 52 patients with heart failure and persistent atrial fibrillation (AF), randomised to either catheter ablation or the more usual treatment of beta-blockers and/or digoxin.
The results were positive – after 12 months patients who had the ablation saw improvement in exercise performance and quality of life compared with the patients who did not have the treatment – and have been described as “very favourable” by Cardiosource-American College of Cardiology.
The study – published in the Journal of the American College of Cardiology (JACC) – was led by Dr David Jones, locum consultant cardiologist at the Trust, who presented the results at a special session at the American Heart Association (AHA) Annual Scientific Sessions in Los Angeles.
Dr Jones said: ”AF and heart failure can cause a vicious cycle of deterioration, but to date the best strategy for managing this challenging combination of conditions has been unclear. This study has shown, for the first time, a clear benefit of ablation therapy over the contemporary standard of care, namely tablet-based ’rate-control’.”
Dr Tom Wong, consultant cardiologist at Royal Brompton & Harefield NHS Foundation Trust and the senior investigator for the trial added: "Clearly the results need to be confirmed by larger multi-centre randomised trials. However, even in this small study, we have shown a significant improvement in these patients in maximum oxygen consumption, which is a very strong predictor of mortality in patients with heart failure.
“The procedures are typically long, with lots of ablation, and a very sick patient population where you need expertise to be sure you get a good clinical outcome and minimise the complication rate. If you can achieve that, then I think the patient will benefit."
The team included co-investigators Dr Shouvik Haldar, Dr Rakesh Sharma, Dr Shelley Rahman Haley, Dr Wala Mattar, Professor Richard Underwood, Dr Wajid Hussain, and Dr Vias Markides.
The Trust has a large and expanding electrophysiology service and its clinical teams have specific expertise in treating heart failure and arrhythmia.