Surgeons at The Heart Hospital in London have operated on the first UK patient using the CardioFocus Endoscopic Ablation System, which involves inflating a balloon inside the heart. Inside the balloon is a camera that films the organ, allowing greater accuracy during surgery and improved success rates compared to previous techniques.
TV cameras filmed the ground-breaking first procedure, which was carried out on 34-year-old Scott Rosser from Croydon by a team led by consultant cardiologist, Dr Oliver Segal.
The heart condition atrial fibrillation currently affects more than 200,000 people a year in the UK and occurs when the normal pattern of electrical conduction in the top chambers of the heart becomes chaotic, resulting in a rapid, irregular heart beat and causing palpitations, breathlessness and tiredness. People suffering from the condition are up to nine times more likely to have a stroke and twice as likely to die prematurely compared to those with a normal heart rhythm. Until now treatment 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. If a barrier can be created to prevent electricity spreading from the pulmonary veins, the vast majority of patients are cured.
The laser balloon is an incredibly exciting new technology for treating patients with paroxysmal, or intermittent, atrial fibrillation
However, the heart often repairs the damage, which limits the success of this technique to about 50% of patients after one attempt. The new laser 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 the camera incorporated inside the centre of the balloon.
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. Dr Segal said of the procedure: "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 US, 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 are much less likely to develop complications from ablation, which can include stroke, cardiac perforation, emergency surgery and, on very rare occasions, death. We are absolutely delighted that The Heart Hospital has become the first centre in the UK to offer this treatment."
Mr Rosser, a keen scuba diver, was treated under a general anaesthetic and kept in hospital overnight as a precaution. Prior to the operation, his heart rate used to reach heights of 202 beats per minute even when on medication. Following the procedure his heart rhythm was normal. He said: "This 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 been encouraging compared to other techniques, with a sub-study of more than 50 patients demonstrating an 86% success rate after a single procedure.
The Heart Hospital, part of University College London Hospitals NHS Foundation Trust, performs around 380 atrial fibrillation ablation procedures every year and estimates that the laser balloon could potentially be used to treat approximately half of those patients.