Earlier the better? Intervening to halt the Progression of Atrial Fibrillation

“I am always looking for ways to help patients with atrial fibrillation lead full lives,” says Dr. Jason Andrade, University of British Columbia Cardiology Professor.
He is currently leading a CANet-funded project, ‘Early Invasive vs. Delayed Intervention for Atrial Fibrillation’ which explores the first line of treatment for atrial fibrillation (AF).
AF, a heart rhythm disorder, results in rapid, irregular heartbeats. Patients are at a greater risk for stroke and death.
“We have pretty good information on how to manage atrial fibrillation at its later stages,” Andrade says, “but can we intervene sooner to improve outcomes?”
Andrade’s quest for an improved, more rapid treatment for AF might just come down to a matter of when to intervene.
He has teamed up with CANet’s industry partners Baylis and Medtronic CryoCath.
Medtronic has developed a revolutionary new technology to advance AF treatment, Medtronic’s Cryoablation Catheter freezes and destroys the faulty cardiac tissues.
“This is a major advance in the interventional treatment of AF, and a significant Canadian accomplishment,” Andrade says.
Importantly, it reduces the patient’s dependence on antiarrhythmic drugs (AADs), which are often ineffective, and can have severe side-effects such as organ toxicity.
CANet’s industry partnerships, such as with Medtronic, demonstrate the network’s commitment to commercialize technologies that improve the efficiency, effectiveness, and accessibility of arrhythmia care delivery in Canada and the world.
Andrade’s CANet-funded project is currently evaluating the use of the therapy early in the course of the disease before progressing to an advanced condition with the consequence of further complications, such as heart failure and stroke.
“I hope to determine which approach to the early management of atrial fibrillation will result in optimal improvement patient outcomes and reduce the burden of AF in Canada,” Andrade says.
The research study will ask patients who have undergone the cryoablation procedure to undergo implantation of a cardiac monitoring device that will continuously track the heart rhythm, and determine the amount of AF patients are experiencing per day.
“The combination of implantable rhythm monitors and home monitoring devices will permit us a fairly intense, yet minimally intrusive follow-up. In addition, this combination of monitoring will enable us to definitively determine the best possible treatment for early AF,” Andrade says.
His work is aligned with CANet’s Strategic Goal of achieving a 20 per cent drop in atrial fibrillation hospitalization and emergency department visits.
In fact, a significant portion of AF-related healthcare costs come from hospitalization and acute care.
Andrade is working with healthcare economists to look at the budgetary and cost-savings impact of this treatment strategy.
“More effective treatment also means less healthcare costs, and increased economic productivity because fewer people are missing out on work due to illness,” Andrade says.
The CANet project is also training Highly Qualified Personnel (HQP) like Dr. Christopher Cheung, reflecting its goal to cultivate the next generation of researchers in patient engagement and partnership.
“Research is a great way to learn about gaps in our knowledge, and how we can improve it moving forward,” Cheung says.
Andrade and CANet are also working with the Heart and Stroke Foundation – a non-profit organization – to develop a patient decision support tool.
“As someone who is clinically trained, it is a privilege to work with these patients and hear their stories,” Cheung says.
The decision support tool is an online platform of educational materials, interactive information, and social media. It will empower patients to be more involved in their own healthcare decisions, and improve their quality of life.
“Our patient partners, who have been involved with the project since the very beginning, have been critical in designing the project questionnaires and making sure that the study has a meaningful impact on their healthcare,” Andrade says.
The questionnaires – open to patients and medical professionals (general practitioners, internal medicine specialists, and cardiologists) – will help Andrade and his team capture patient experiences associated with AF and its treatment.
“Eventually, we want to be able to deliver an optimal, tailored treatment strategy for each patient,” he says.