SEK 9 M / 3 YEARS
TOWARDS A BETTER QUALITY OF LIFE FOR HEART PATIENTS Nearly 400,000 Swedes live with the cardiovascular condition atrial fibrillation, but current drugs do not fully relieve the symptoms. In a large study Carina BlomströmLundqvist wants to investigate whether a procedure in the heart produces better results – in terms of both the recurrence of fibrillation and the patients’ quality of life. 20–30 percent of patients after a year’s medication, which is not good enough,” she says. But there is another way to control the heart rhythm. In the 1990s French doctors developed a method known as pulmonary vein isolation using ablation. It involves using heat or cold to create tissue damage just where the cells in the atrium send the irregular signals. This creates scarring that forms a barrier to the electrical pulses. Since there is a small risk of complications, however, this method is only recommended as a secondary treatment after treatment with drugs has been tried without success. In the project ‘CryoStopPersAF – First-line cryoablation for early treatment of persistent Atrial Fibrillation – a randomized study comparing early trigger isolation using the Cryoballoon versus anti arrhythmic medication’ – Carina B lomströmLundqvist and her colleagues now want to compare the two methods. “We want to give half of those taking part in the study ablation straight away, without first taking the drug treatment route. Registry studies have shown that the sooner ablation is used, the better its effect. It reduces the risk of the fibrillation worsening, as well as the risk of the musculature in the atria changing such that the patient suffers chronic fibrillation.” A total of 220 patients will be randomly a ssigned ablation or drug treatment. The study will be carried out at various Swedish hospitals and at some hospitals in other countries. One aim is to include a higher proportion of women than would normally be the case. Carina Blomström-Lundqvist says that generally only a fifth of the patients in cardiac studies are women, even though the proportion of women
Atrial fibrillation is common and between 350,000 and 400,000 Swedes are living with the diagnosis. Fibrillation means that the heart beats irregularly and often quickly. It is caused by incorrect electrical signals from areas in the heart’s left atrium, often at the opening for the pulmonary veins. The result is a chaotic heart rhythm in the atria at speeds of up to 300 beats a minute, compared with the normal 50–80 beats. The atria cannot contract at that rate and the heart’s ability to pump out oxygen-saturated blood reduces by up to 15 percent. Carina Blomström-Lundqvist, a professor in the Department of Medical Sciences at the universities of Uppsala and Örebro and senior consultant in cardio logy at Uppsala University Hospital and Örebro University Hospital, meets these patients daily. “Atrial fibrillation also produces complications in the form of an increased risk of stroke, and people also experience a clear reduction in quality of life because they don’t have the energy to do what they want to,” she says. Increasing age is a risk factor for being affected, as are high blood pressure, diabetes, heart failure, obesity and high alcohol consumption. “But atrial fibrillation can also affect those who train extra hard, such as elite athletes,” she says. Of the cardiac conditions that result in arrhythmia, atrial fibrillation is the most common cause of hospital admissions. One big problem is that the drugs used to stabilise the heart rhythm are not sufficiently effective. “You might expect that 80–90 percent of patients would be free of fibrillation after a year, but it’s not like that. The drug only eliminates fibrillation in
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