At the Heart of Treatment: Therapeutic Approaches

An estimated 2.7 million Americans have the heart rhythm disorder atrial fibrillation (AF), and that number is expected to rise as the population ages. Cardiologist Dr. Srijoy Mahapatra, vice president of clinical, medical and scientific affairs at St. Jude Medical, talks about emerging strategies to manage the condition.

In the U.S., the incidence of atrial fibrillation (AF) and associated conditions is expected to grow as the population ages.² Treatment of AF contributes to the ever-growing costs of health care, particularly costs associated with hospitalizations.^3,4 Compounding the challenge, the condition has been associated with increased risk for stroke, heart failure and death, all of which increase in frequency and severity as patients grow older.

Treatment for AF and associated conditions begins at diagnosis, with a treatment plan, lifestyle modifications, and often, medication. Medication also plays an important role in disease management through heart rate and rhythm control; however, currently available medications treat AF symptoms and not the root cause of the condition. St. Jude Medical has developed a comprehensive portfolio of therapeutic approaches to provide physicians multiple treatment options for patients.

Ablation can be an effective treatment option that targets the underlying causes of heart rhythm disorders. Performed via a minimally invasive procedure, ablation alters tissue inside the heart where the irregular beats are triggered. Recent clinical trial data show that ablation using St. Jude Medical catheter contact force technology is safe and effective for patients with AF.⁵ St. Jude Medical has also developed cardiac mapping technology to support complex ablation procedures while reducing procedure times.

At St. Jude Medical, we've designed solutions not just for AF, but for the condition's comorbidities, including heart failure. For people suffering from the earliest stages of heart failure, St. Jude Medical can offer a complete line of arrhythmia management, cardiac resynchronization therapy (CRT), and mechanical circulatory support in addition to solutions for AF.

This includes:

The St. Jude Medical TactiCathTM Quartz Contact Force Ablation Catheter provides physicians with an innovative solution designed to improve outcomes, efficiency and productivity during electrophysiology procedures worldwide. Catheter provides physicians with an innovative solution designed to improve outcomes, efficiency and productivity during electrophysiology procedures worldwide.⁶

Our EnSite™ Cardiac Mapping System supports physicians during both contact force and non-contact force ablation procedures by creating three-dimensional models that are based on the anatomy of the patient's own cardiac chamber.

In addition to our complete line of comprehensive arrhythmia management and cardiac resynchronization therapy (CRT) devices, the CardioMEMS™ HF System is the first and only FDA-approved heart failure monitoring device that, when managed by a physician, has been proven to significantly reduce hospital admissions and improve quality of life in NYHA class III HF patients who have been hospitalized in the previous 12 months. The CardioMEMS HF System and St. Jude Medical's left ventricular assist technology is transforming patient outcomes and altering patient and physician experiences with heart failure.

ST. JUDE MEDICAL is a market leader in the research, design and development of electrophysiology and interventional cardiology solutions for pediatric patients worldwide. As a global medical device manufacturer, we are dedicated to transforming the treatment of some of the world's most expensive epidemic diseases by developing cost-effective medical technologies that save and improve lives. For more information, please visit SJM.com or follow us on Twitter @StJudeMedical.

It's important to note that surgical procedures involve risk. Potential adverse events associated with ablation procedures include, but are not limited to, cardiovascular related complications, such as hematoma, effusion and infection. More serious complications or death are possible, though rare. Potential adverse events associated with the implantation of the CardioMEMS HF System include, but are not limited to, infection, arrhythmias, bleeding, hematoma, thrombus, myocardial infarction, transient ischemic attack, stroke, death and device embolization. Patients are advised to talk to their physician to understand all indications and contraindications for any St. Jude Medical device.

The TactiCath™ Quartz Contact Force Ablation Catheter is indicated for use in cardiac electrophysiological mapping and for the treatment of drug refractory recurrent symptomatic paroxysmal atrial fibrillation, when used in conjunction with a compatible RF generator and three-dimensional mapping system. The system is contraindicated for patients who have had certain recent heart surgery; prosthetic valves; active systemic infection; use in coronary vasculature; myxoma or intracardiac thrombus, or an interatrial baffle or patch; retrograde trans-aortic approach in patients with aortic valve replacement.

The CardioMEMS HF System is indicated for wirelessly measuring and monitoring pulmonary artery pressure and heart rate in New York Heart Association (NYHA) Class III heart failure patients who have been hospitalized for heart failure in the previous year. The system is contraindicated for patients with an inability to take dual antiplatelet or anticoagulants for one month post implant.

Source / Reference

1. CDC Atrial Fibrillation Fact Sheet available at: http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atrial_fibrillation.htm

2. CDC Atrial Fibrillation Fact Sheet available at: http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atrial_fibrillation.htm

3. and 4. Coyne KS, Paramore C, Grandy S, Mercader M, Reynolds M, Zimetbaum P. Assessing the direct costs of treating nonvalvular atrial fibrillation in the United States. Value Health. 2006;9(5):348-356.

Kim MH, Klingman D, Lin J, Pathak P, Battleman DS. Cost of hospital admission for antiarrhythmic drug initiation in atrial fibrillation. Ann Pharmacother. 2009;43(5):840-848.

5. http://media.sjm.com/newsroom/news-releases/news-releases-details/2014/St-Jude-Medical-Announces-TOCCASTAR/default.aspx

6. Albenque et al. - Interest Of Real-time Contact Force Sensing For Pulmonary Vein Isolation - Mid-term outcome After Paroxysmal Atrial Fibrillation Catheter Ablation. P532, Heart Rhythm Society 2013

Berkowitsch et al. - Clinical success of conventional vs. contact force-controlled radiofrequency catheter ablation of atrial fibrillation: outcome after 12 months. , 5845 ESC Amsterdam 2013