Cardiac electrophysiologist and arrhythmia specialist Paul C. Zei, MD, PhD, joined the Heart Rhythm Disorders Program at Brigham and Women’s Hospital (BWH) as director of the Comprehensive Atrial Fibrillation Program (CAFP) with the goal of establishing it as one of the leading programs in the world for managing patients with atrial fibrillation (AF).
Beyond Catheter Ablation
“We will still perform catheter ablations at the Comprehensive Atrial Fibrillation Program, but we will take a more comprehensive approach to treating atrial fibrillation. As such, ablations will be a part of a bigger picture treatment strategy,” says Dr. Zei.
For instance, many AF patients have multiple risk factors that both contribute to the development of atrial fibrillation and may cause recurrence, if not addressed. Such risk factors include: obesity, diabetes, hypertension, sleep apnea, genetics, and other cardiac diseases.
“The infrastructure we have built targets many of these risks factors and treats the whole patient. We work closely with endocrinology, weight loss, and sleep experts at BWH to address these risk factors,” says Dr. Zei.
Clinical Research on Atrial Fibrillation
The Comprehensive Atrial Fibrillation Program (CAFP) is also collaborating with research groups within the Heart and Vascular Center to involve patients in ongoing clinical trials in order to better understand the pathophysiology of atrial fibrillation.
“There’s preliminary data which suggests that intervening on some of these risk factors can make a difference for AF patients. We are tracking patients who receive treatment from their specialists to see which interventions are most impactful,” says Dr. Zei.
The arrhythmia specialists in the CAFP also collaborate with the Brigham Digital Innovation Hub, using algorithms to track patients and help determine the most appropriate medications for patients. The CAFP team also established a remote monitoring center for offsite tracking of patients.
Innovations in Catheter Ablation
Dr. Zei is engaged in multiple research projects that involve new approaches to using catheter ablation for atrial fibrillation. He and his colleague have developed a unique stereotactic radio ablation protocol to treat arrhythmias.
“We also now perform catheter ablations without x-ray fluoroscopy. The complete elimination of fluoroscopy in our ablations means patients and treating physicians will not be exposed to radiation,” says Dr. Zei. “Our current treatments for atrial fibrillation are reasonably effective, but there’s a room for improvement. The Comprehensive Atrial Fibrillation Program will allow us to develop a better understanding of this condition and develop better treatment options for patients.”
This comprehensive program includes left atrial appendage management options and innovative surgical techniques for addressing atrial fibrillation surgically when concomitant valve surgery is being considered or if minimally invasive techniques prove less successful.
Cardiac surgeons at BWH are considered leading experts in performing surgical solutions for atrial fibrillation using a range of tools and techniques, including minimally invasive laser technology. This experience, and their collaboration with specialists in the Comprehensive Atrial Fibrillation Program enables the team to manage the most complicated heart rhythm cases.