Heart patients at UHNM to benefit from new minimally invasive procedure

UHNM's Cardiothoracic Surgical and Cardiology Teams. Mr Lognathen Balacumaraswami, (third left), Joanne Hill, (third right) and Dr Thanh Phan (second right)

A groundbreaking new procedure at University Hospitals of North Midlands NHS Trust is giving hope to patients with a long-term heart condition.

Patients suffering from an irregular heart rhythm, also known as atrial fibrillation (AF), would previously be dependent predominantly on medications to help manage their condition.  

But cardiothoracic surgical and cardiology teams at the Royal Stoke University Hospital are now able to offer those suitable, the new convergent minimally invasive surgical AF ablation procedure. 

Mr Lognathen Balacumaraswami, Consultant Cardiothoracic Surgeon at University Hospitals of North Midlands NHS Trust (UHNM) said: “AF is a big problem as it increases the risk of stroke by around five times and can also lead to heart failure if left in the long-term.

“Research also shows that around 13 per cent of patients who have long-term AF also risk developing dementia.

“A significant proportion of these patients are troubled by episodes of worsening symptoms which need further management. This in turn puts pressure on primary care and neurology services to treat the consequences of long-term AF.

“Until now, patients who have more serious symptoms would be treated only through a catheter ablation, a keyhole procedure where cardiologists get inside the heart with a catheter and create a small burn to cause scarring to help break up the electrical signals that cause irregular heartbeats. This procedure has modest results in long-term AF, and if this is unsuccessful, patients would have to rely only on medications.

“This new procedure can access the back of the heart to reach the area where substrate for AF is present, through an endoscope that is inserted under the breastbone.

“The 90-minute procedure is 80 to 90 per-cent effective, with patients left with just an inch-long cut from which they recover from amazingly well and are discharged from hospital typically within three days.”   

Following the operation, patients would continue to be monitored by cardiologists in what’s known as a convergent hybrid procedure.

One of the first patients to undergo the procedure was retired nurse Karen Clamp from Burton-upon-Trent. The 66-year-old was referred to Mr Balacumaraswami following three failed ablations.

Karen said: “I suffered with AF for a number of years which was interfering with both my work and home life. Medication failed to control this, so I was moved onto ablations. Over a five-year period I had three but none of these worked long-term.

“I was referred to Mr Balacumaraswami who wanted to carry out this new procedure on me as by this point I was suffering quite badly.

“Since I’ve had the procedure I’ve had no abnormal heart rhythms. Mr Balacumaraswami and the doctors at UHNM were excellent and I was treated with great respect and dignity. They were very responsive to any problems and everything was dealt with in a timely manner. I’m very grateful to have been given the opportunity to undergo this new procedure.”   

Mr Balacumaraswami added: “It’s extremely exciting for everybody involved. Furthermore, it is gratifying to see that our patients derive the benefits from what we do. We’re driven by our aim to achieve a reduction in stroke, heart failure and accelerated dementia, and further improve the quality of life for those with long-term AF by restoring regular sinus rhythm and getting them off medications.”

Dr Thanh Phan, Consultant Cardiologist at UHNM said: “I am delighted that the convergent hybrid ablation is now available at UHNM. Convergent hybrid ablation combines endoscopic surgical AF ablation with conventional catheter AF ablations in symptomatic patients with persistent AF. The surgical approach offers an extra dimension and strategy to the treatment of symptomatic patients with persistent AF that are difficult to control with conventional catheter AF ablations alone.”

Joanne Hill, Directorate Manager for UHNM’s Heart Centre added: “This new procedure is a real positive for the directorate, for the surgeons and theatre team but most importantly our patient population as UHNM has become the first NHS Trust in the North West of England to offer this.

“There are wider benefits for UHNM too as this is a more effective procedure, has a quicker recovery time and this reduction in hospital stays, frees up beds for other patients.”