Mediclinic Midstream is at the forefront of new cardiac ablation technology

Together with a handful of centres in Japan and the UK 

Mediclinic Midstream is one of the first hospitals worldwide to use new technology for ablation procedures effective in the treatment of various heart rhythm abnormalities.

Cardiac ablation is a treatment to correct abnormal heart rhythms (arrhythmia) by blocking irregular electrical signals that harm your heart, and a specialist team at Mediclinic Midstream is now among the first worldwide to use the latest ablation technology from leading American multinational medical devices and healthcare company, Abbott.

Dr Ruan Louw, a cardiologist and electrophysiologist (heart rhythm specialist) at Mediclinic Midstream and his team are now conducting ablation procedures using Abbott’s Tactiflexablation catheter and EnSite X mapping system. Abbott selected Mediclinic Midstream as one of the first centres to use this new technology, and in so doing, optimise patientoutcomes. “It’s a feather in the cap for Mediclinic and South Africa that a large international company rates us highly enough to allow us to be one of the first use this new technology,” says Dr Louw. “They’re entrusting us with their latest technology prior to it being available for widespread commercial use – something they only do with select, trusted centres.”

Dr Louw and his team recently hosted an atrial fibrillation workshop showcasing the latest ablation techniques and other treatment strategies. Electrophysiologists from various North African and Middle Eastern countries attended, including Egypt, Saudi Arabia, Iraq, Morocco, Tunisia and Algeria. “Being invited to host these kinds of international workshops again confirms that our treatment strategies are state of the art,” he says.

Understanding atrial fibrillation

Atrial fibrillation is the most common heart rhythm disorder affecting patients today. “A normal heart beats in an organised, regular fashion,” explains Dr Louw. “During atrial fibrillation, the heart beats rapidly and irregularly.”

“Tiny muscle fibres in the upper chambers (atria) create abnormal electrical impulses, which result in the atria quivering (‘fibrillating’). The quivering then results in a fast, irregular heart rhythm and a reduction in the amount of blood being pumped through the body.” This impairs patients’ quality of life because they tend to feel weak or tired, out of breath, and experience heart palpitations.

Left untreated, the condition places patients at risk for stroke or heart failure. “Atrial fibrillation may lead to blood clots forming in the heart that may circulate to other organs and lead to stroke,” Dr Louw explains. For this reason, patients are often started on blood–thinning medication. They’re generally also given medication to help suppress atrial fibrillation.

An alternative, more effective treatment option for some patients is cardiac ablation. In addition, since atrial fibrillation is in many cases a result of lifestyle factors that lead to obesity, focus is also placed on weight loss and exercise.

How ablation works

Ablation addresses the site of the abnormal electrical impulses, treating the root cause of the rhythm problem, says Dr Louw. “During a catheter ablation procedure, a therapeutic catheter – a flexible little wire or rod that we use inside the heart to make little burns or freezes – is inserted through a small incision in the groin and weaved up through a blood vessel in the leg.”

“Via two small punctures in the groin, catheters are advanced through the veins to reach the right and left upper heart chambers, or atria. Once the catheter has reached the left upper chamber of the heart, advanced 3D imaging assists us in applying controlled levels of radiofrequency energy around the openings of the pulmonary (lung) veins. In this way, we encircle the areas from which these abnormal impulses originate.”

Abbott’s Tactiflex ablation catheter and EnSite X mapping system, which provides advanced3D imaging, further streamlines this process.

By creating tiny 4mm burns, doctors create two circles around specific areas in the heart. “These little burns are sequentially performed, and they coalesce with one another, creating two continuous little circles which eventually become thin circles of scar tissue,” Dr Louwcontinues. “Scar tissue doesn’t conduct electricity well, so by encircling the problem areas we’re isolating it electrically from the rest of the heart. In that way if these impulses are generated, they can’t spread beyond their little circles.” Patients are generally mobile and fit to be discharged the next day and can resume normal activities within a week.

“With any technology, upgrades generally are made because they tend to work better than the previous generation of tools,” explains Dr Louw. “They’re likely to improve the efficacy of the therapy and reduce the risk of complications.”

By pioneering the use of Abbott upgrades, Mediclinic and Dr Louw’s team have reinforced the reputation of private health care in South Africa as being at the forefront of technology and therapies for heart rhythm problems. “Internationally, we’re second to none as far as our tools, technology and expertise are concerned,” he says.