Life-changing heart procedure

Posted on 27 March 2014

Cardiologist Dr Razeen Gopal at Mediclinic Panorama performed a revolutionary heart procedure for patients who suffer from early-stage atrial fibrillation.

What is atrial fibrillation (AF)?
It’s a very common heart condition, which is often referred to as a chaotic or irregular heartbeat. It causes the heart to reach 150 to 200 beats per minute – normally, your heart beats at 60 to 90. This condition increases with age and many South Africans over the age of 65 suffer from it. Without treatment, the risk for strokes increases 500 fold. An irregular heartbeat can also lead to blood pooling in the left atrium, which increases the risk for clotting. If these clots detach and move to the brain, they can cause an obstruction of blood flow and a stroke.

And how can AF be corrected? What is this new procedure all about?
The cryoballoon ablation procedure, performed by Dr Gopal who is one of a few specialists in South Africa qualified as an interventional electrophysiologist with international accreditation, is a non-invasive technique.

An extremely low temperature (or ‘freezing’) is used to eliminate the effect of malfunctioning cells that spark additional electrical signals, which regulate the heart’s rhythm and pace. Basically, this means the doctor inserts two catheters through the groin and into the femoral veins, which are then pushed up into the right atrium of the heart. They are positioned in the left atrium through two small holes made in the septum between the two chambers. A cryoballoon 2,8cm in diameter is then placed at the base of one of the four pulmonary veins, inflated and cooled. The cold from the balloon creates a perfect band of damaged heart tissue, which effectively blocks all faulty signals. The process is repeated on the other three veins.

How will it help AF sufferers?
Hein Pietersen, a 35-year-old man from Malmesbury, was the first AF sufferer to have this procedure, which he describes as life changing. ‘Playing golf became a struggle because of my chaotic heartbeat. Every time my heart started racing, I was aware that I am at high risk of a stroke or even death,’ he says. ‘Since my procedure about a year ago, my heartbeat has been regular, even during high-intensity activity.’

How successful is this groundbreaking procedure?
‘There’s little doubt that, compared to heat energy released by radiofrequency ablation, the low temperatures used in a cryoballoon ablation cause less tissue damage and thus less new-rhythm defects as a result,’ explains Dr Gopal.

About 75% of patients with paroxysmal (intermittent) atrial fibrillation don’t need to take any anti-arrhythmia medication within a year of having the procedure, while 60% of patients with persistent AF recover after a series of ablations. These success rates achieved at Dr Gopal’s unit compare well with the very best internationally.


The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.

Published in Cardiology

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