News : 2016 : December

New Precision Therapies for Atrial Fibrillation

Though it is one of the most common heart rhythm disorders, atrial fibrillation (A-fib) can eventually lead to heart failure or stroke if not properly diagnosed and treated. Jeffrey Goldberger, M.D., M.B.A., head of cardiology at UHealth – the University of Miami Health System, is working on the development of new precision therapies that could dramatically improve the health outcomes of patients with A-fib.

“We are developing potentially groundbreaking technologies. If we show that they are effective, it will change the way we practice,” said Goldberger.

Goldberger spoke about the new treatments as the featured speaker at the 24th Annual Miriam Lemberg Visiting Professorship Lecture in Cardiovascular Disease, at the Rosenstiel Medical Sciences Building on the Miller School of Medicine campus.

Since joining the faculty in November 2015, the nationally renowned cardiologist has continued his research on innovative diagnostic and treatment approaches for patients with arrhythmias, particularly atrial fibrillation and prevention of sudden cardiac death. During the lecture, Goldberger spoke about some of the newer paradigms and methods in treating A-fib, including new stroke prevention tools, and an innovative heart mapping technology called Morphology Recurrence Plot (MRP) mapping. The technology is the first and only device of its kind in the nation that identifies the exact source of A-fib based on the morphology of the electrical signals. It could allow ablation using radiofrequency energy to be targeted to the areas contributing to A-fib. For MRP mapping, a catheter is inserted via the veins, and by recording electric impulses in the heart, a plot is created showing where the abnormal areas are located. With this tool, Goldberger believes physicians will be able to identify precisely the location of the A-fib source, which to this point has not been possible.

“Initially, this procedure will be used on patients who have already had an ablation procedure, but still suffer from A-fib. With this new diagnostic tool, we hope to confidently eliminate those heart muscle cells contributing to the disorder. This could be beneficial to patients who have suffered from A-fib for years,” Goldberger said.

Goldberger’s team is also developing another revolutionary technique, called 4D Flow MRI, which measures cardiac blood flow to better identify which A-fib patients are at risk for stroke. While precision medicine allows physicians more flexibility in pinpointing the underlying causes of disease and a more precise approach for targeted treatment, there is a need to continually assess the kinds of technologies that advance personalized medicine. Due to a gap in traditional funding, Goldberger says the bulk of the clinical research funding in the past decade has come from industry, meaning most of the research has been technology- or product-based.

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