Cardiac arrhythmia: Why standard treatments fail so often

Cardiac arrhythmia: Why standard treatments fail so often

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Gaining deeper understanding of electrical signals from the heart

An English research team recently showed that certain patterns of chaotic electrical impulses, which often occur in the context of irregular heartbeats, lead to failure of standard treatments for cardiac arrhythmias. A deeper understanding could improve therapy.

In a recent study, researchers from Imperial College London gained a deeper understanding of how electrical signals move inside and outside the heart via the muscle. Among other things, this led to the knowledge of why some corrective operations are not useful. The study will appear in the journal "Physical Review E".

Too often catheter ablation has no effect

Atrial fibrillation is the most common cardiac arrhythmia and the main cause of strokes. Despite the frequency, treatment options are limited. The most common treatment currently used is surgery to clear areas of the heart from the inside, because it is believed that this eliminates the irregularities. However, so-called catheter ablation is only effective in around 50 percent of those affected.

Electrical signals in the heart have different patterns

The research team now recognized the reason why the chances of success of such a treatment are relatively slim. They developed a model that recognizes different patterns of electrical signals. According to the researchers, the model can be used to identify patients who benefit from catheter ablation and who do not.

Prevent unnecessary operations

"We hope that the model could help us to further develop who is affected by surgery and who would benefit from surgery if the right regions of the heart were targeted," said study author Dr. Max Falkenberg together. Surgery could thus be improved by avoiding unnecessary operations and making necessary ones more efficient.

The location of the impulses is crucial

The developed model shows, for example, that obliterations inside the heart fail if the irregular impulses arise on the outside of the heart. For this type of cardiac arrhythmia, the surgical procedure would have to be optimized to increase the chances of success and reduce the symptoms.

Better differentiation of various rhythm disorders

According to the new model, catheter ablation also proves to be ineffective if there are multiple sources of the chaotic electrical impulses at different depths in the heart. An operation could even cause unnecessary damage here, the researchers warn. In addition, there is also a form in which the heart muscle is already so damaged that new rhythm disorders occur again and again, no matter how often a source is destroyed.

Personalized treatment of atrial fibrillation

"We are very excited about the future clinical applications of our results for the personalized treatment of atrial fibrillation," emphasizes Professor Kim Christensen from the study team. Atrial fibrillation is a fascinating example of how complex phenomena can also have relatively simple origins. The findings were only possible because researchers from the departments of physics and cardiology worked closely and across disciplines. "In this way, persistent barriers were overcome and we are now reaping the fruits of this effort," summarizes the professor. (vb)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Graduate editor (FH) Volker Blasek


  • Imerial College London: Deeper understanding of irregular heartbeat may lead to more effective treatment (access: 09.12.2019),
  • Max Falkenberg, Andrew J. Ford, Kim Christensen, u.a .: Unified Mechanism of Local Drivers in a Percolation Model of Atrial Fibrillation; Physical Review E, 2019

Video: New Option for Hard-to Treat Arrhythmias (August 2022).