UCLA uses brain aneurysm treatment to stop irregular heart rhythms

For the first time, a UCLA team has used a technique normally employed in treating brain aneurysms to treat severe, life-threatening irregular heart rhythms in two patients.

This unique use of the method helped stop ventricular arrhythmias - which cause "electrical storms" - that originated in the septum, the thick muscle that separates the heart's two ventricles. This area is virtually impossible to reach with conventional treatment.

The research is published in the February issue of Heart Rhythm, the official journal of the Heart Rhythm Society, and is highlighted on the cover.

Many people suffer from ventricular arrhythmias, which are one of the leading causes of death in the U.S., claiming 400,000 lives annually. These arrhythmias can usually be controlled by medications, by implanting a cardioverter defibrillator device that automatically shocks the heart back into normal rhythm, or by a procedure called catheter ablation, which involves a targeted burn or the application of extreme cold to the tiny area of the heart causing the irregular heart beat.

None of these traditional treatments worked for the two patients featured in this report, who suffered from a severe form of arrhythmia called ventricular tachycardia, which causes a dangerous rapid heartbeat.

Instead, the UCLA team of cardiologists and interventional neuro-radiologists used coil embolization, a minimally invasive method originally developed at UCLA and now commonly used around the world to treat brain aneurysms.

"We have to think outside the box to help patients with severe arrhythmias located in hard-to-reach areas of the heart," said senior author Dr. Kalyanam Shivkumar, director of the UCLA Cardiac Arrhythmia Center and a professor of medicine and radiological sciences at the

David Geffen School of Medicine at UCLA. "We hope that this treatment will offer new hope for these heart patients, who previously had few options."

As is common with other arrhythmia procedures, the team first took colorful images of the electrical system of each patient's heart using wires within the arteries of the heart muscle, which helped pinpoint the exact origin of the arrhythmia and served as a roadmap for the medical team.

During the coil embolization procedure, the team inserted a tiny catheter through a small incision in the groin, then guided it up to the heart and into the small arteries known as septal perforators, which supply blood to the area of the septum wall in which the arrhythmia originated.

Once positioned, the team carefully guided tiny, soft-metal coils - just slightly larger than the width of a human hair - through the catheter and into the arteries. The doctors filled each targeted artery with coils, thereby cutting off the blood supply to the region where the arrhythmia originated and stopping it.