John Gregory: One of the first patients to benefit.PATIENTS at Monash Medical Centre are the first in Australia to benefit from a new technique in which cardiologists use a camera to see directly inside the beating heart during surgery to correct a rhythm disorder.
The technique promises to improve outcomes for patients with atrial fibrillation – which occurs when the normal pattern of electrical conduction in the top chambers of the heart become chaotic, resulting in a rapid and irregular heartbeat.
To eliminate the disturbance, surgeons insert catheters from the top of the leg into the heart to deliver laser energy to destroy tissue in the mouth of the pulmonary veins where they drain into the left atrium.
Cardiologists have previously relied on imaging to pinpoint the exact location to direct the laser energy to create scars that stop the erratic electricity spreading, but the surgery is not always successful.
The new technique involves putting a ”laser balloon” containing a camera on the end of a catheter, allowing surgeons to see inside the heart for the first time and target specific areas.
MonashHeart director Ian Meredith said the technique was a significant advance that should improve the surgery’s success rate and reduce the risk of the condition recurring.
”This technique allows you to directly see where the veins drain into this chamber. You can go right up on the mouth of the vein and deploy the laser balloon there. It provides brilliant targeting,” he said.
”It is like being in an underwater chasm with murky water and trying to find your way into a cave. This gives you a headlamp that allows you to see where you are going.”
John Gregory, 58, was one of the first Australian patients to benefit from the new technique last week in surgery led by MonashHeart cardiologist Emily Kotschet.
Mr Gregory was diagnosed with atrial fibrillation after finding he was unable to complete his regular beachside run.
Drugs to control his heart rhythm made him feel ”a bit hungover, with no energy”, and every six weeks Mr Gregory’s heart would go back into an arrhythmic state requiring a trip to hospital to be ”zapped”.
A shock to the chest helped to temporarily reset his heart’s electrical system, but surgery presented the best chance of a permanent fix.
Mr Gregory said he hoped to be able to stop taking medication and improve his quality of life.
More than 240,000 Australians have been diagnosed with atrial fibrillation. They are up to seven times more likely to have a stroke and three times more likely to suffer heart failure than the general population.
The new technique will feature in an episode of Heart Starters, a series about MonashHeart, tonight at 7.30pm on Channel 31.
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