Ultrasound and 3D Mapping Reduce Radiation Exposure and Increase Patient Outcomes

At least 2.5 million Americans suffer from atrial fibrillation, or Afib. More than 5 million are expected to have it by 2050. Afib causes an abnormal heart rhythm and is the leading cause of stroke in the United States. In fact, Afib sufferers may be up to five times more likely to have a stroke.

Some people have severe atrial fibrillation symptoms, while others live for years without knowing they have this potentially dangerous condition. Because Afib is so prevalent, particularly in those 60 and older, it is important to make every effort to prevent this condition. This includes living a healthy lifestyle, maintaining normal body weight, as well as identifying and controlling conditions that put patients at risk for Afib such as sleep apnea, high blood pressure, thyroid disease, coronary artery disease, congestive heart failure and valvular heart diseases. Nevertheless, we see some patients who develop atrial fibrillation despite leading a very healthy lifestyle.

Treatment options have grown dramatically over the last decade for those diagnosed with Afib. For example, we can frequently identify exactly which pacemaker cells in the left atria (the upper left chamber of the heart) are misfiring, so we can destroy those cells to restore normal heart rhythms. Through a minimally invasive technique, we use an ablation catheter to encircle the pulmonary vein. Once those abnormal cells are deactivated, the normal heartbeat is restored.

To guide our way during this procedure, we create highly accurate 3D maps of the heart based on ultrasound images. Then we monitor where the catheters are and make sure blood clots aren’t developing. We can identify potential problems early to make sure the procedure is safe. Using ultrasound has an added advantage. We are far less dependent on the traditional use of X-rays to see inside the heart, meaning radiation exposure is dramatically reduced.

My colleague, Dr. Saumil Oza, and I are constantly working to improve our procedures along with the patient's comfort and overall experience as they undergo ablation procedures. For example, it is a common and acceptable practice to use the neck in addition to both groins as an entry point for the catheters. We use just one vein in a single groin site for nearly all of our patients. This tremendously cuts the rate of problems at the entry site and it makes for an easier and faster recovery for the patient. 

-- Anthony Magnano, MD, is a cardiac electrophysiologist (EP) with Diagnostic Cardiology Associates who practices at St Vincent’s Medical Center in Jacksonville, FL.