University Medical Center's first atrial fibrillation unit opens in Germany

Oct 30 2014

Diagnostic and therapy unit for the care of patients with atrial fibrillation

Nearly 1.8 million people in Germany suffer from atrial fibrillation. This is the most common and clinically significant form of heart rhythm disorder. Shortness of breath, a sudden sense of dizziness, a feeling of pressure in the chest, and palpitations or thumping of the heart so extreme it can be felt beating rapidly and irregularly - this is how many patients describe their first episode of atrial fibrillation. If left untreated, it can result in secondary complications such as stroke or organ infarction. Greater emphasis is now being placed on the early detection of atrial fibrillation so that appropriate therapy can be initiated. It was with this in view that the University Medical Center of Johannes Gutenberg University Mainz (JGU) opened the first atrial fibrillation unit in Germany.

"In our aging society, the number of people affected by atrial fibrillation is rising every year. As a state-of-the-art hospital dedicated to providing the best possible level of care, we plan to ensure that our Atrial Fibrillation Unit becomes a diagnostic and treatment facility specialized in early detection, thus helping minimize the risk of development of subsequent serious complications," explained the Chairperson and Chief Medical Officer of the Mainz University Medical Center, Professor Babette Simon.

There are forecasts that the number of patients suffering from atrial fibrillation will triple in the next 20 years. This is mainly because the risk of developing atrial fibrillation also increases exponentially with age. While up to 4 percent of the population over 60 years old have the disorder, it is some 10 to 15 percent of persons older than 80 years old who suffer from atrial fibrillation. In addition to age as the predominant predisposing factor, people with high blood pressure, diabetes, or an overactive thyroid are most at risk. Cardiac arrhythmias are also often accompanied by other major heart disorders, such as cardiac insufficiency or heart valve defects.

Half of those affected are not even aware that they have developed atrial fibrillation because their arrhythmia remains asymptomatic. The other half, however, experience the typical signs, such as a completely irregular pulse, extrasystoles, shortness of breath, and feelings of anxiety. Cardiac arrhythmia is a condition that is not immediately life threatening, but it can lead to serious complications such as a stroke because in the presence of atrial fibrillation there is the risk that blood clots may form in the heart. If these become detached, the arterial blood circulation can transport them into the brain. Here they can block a blood vessel, disrupting the supply of blood to the brain and thus triggering a stroke.

At least 15 percent of all strokes are caused by atrial fibrillation, the most common form of cardiac arrhythmia. That is equivalent to nearly 40,000 cases of stroke annually in Germany alone. The risk of a stroke can be significantly reduced by the use of anticoagulant medications. If patients have existing heart diseases, atrial fibrillation can put even more stress on an already damaged heart and exacerbate the impaired pumping action of the organ. It is thus apparent that early diagnosis of atrial fibrillation is an important strategy that makes it possible to initiate appropriate preventive measures.

The new Atrial Fibrillation Unit at the Mainz University Medical Center will provide acute and emergency care of atrial fibrillation patients with medical conditions requiring particularly complex intervention. The unit has four beds supervised by a cardiologist, specially trained staff, and special monitoring equipment to enable the team to deal rapidly with critical cases. In emergencies, the unit can immediately respond by performing transesophageal echocardigraphy (TEE) to rule out the presence of blood clots in the left atrium and by initiating cardioversion, a procedure used to restore stable sinus rhythm of the heart. Depending on progress, the patient will then be discharged after appropriate monitoring or will be admitted for further hospitalized treatment, such as interventional therapy in the form of catheter ablation. Medical personnel will be on 24-hour stand-by to provide monitoring and treatment in the Atrial Fibrillation Unit. The new unit is currently located in the Rhythmology ward; it is thus integrated in the ward where patients with atrial fibrillation are already being treated and is also in the immediate vicinity of the Chest Pain Unit (CPU), the emergency department for patients with suspected cardiac infarction. This also means that resources of the Chest Pain Unit will be freed up in future as the new emergency unit will be able to deal directly with patients with disorders associated with atrial fibrillation.

"The Atrial Fibrillation Unit will, as our experience with our Chest Pain Unit has shown, help us to quickly and efficiently treat patients with this common and complex form of heart rhythm disorder," explained the Director of the Department of Internal Medicine of the Mainz University Medical Center, Professor Thomas Münzel. The new Atrial Fibrillation Unit will be headed by Professor Thomas Rostock, Director of the Department of Electrophysiology. One of the main focuses of this department is the treatment of all aspects of atrial fibrillation. The new unit thus represents the logical further development of this objective and it will be able to provide earlier and more optimized treatment to patients with atrial fibrillation to prevent them suffering later complications, such as stroke.

"I jumped at the chance to come to here to Mainz for the opening of the first Atrial Fibrillation Unit in the country. The German Heart Foundation is providing support to this pilot trial and will be closely monitoring progress," explained Professor Thomas Meinertz, Chairman of the German Heart Foundation. "This unit will ensure that the procedure for treating atrial fibrillation is more standardized and this will mean that any accompanying disorders patients have will be more readily diagnosed. Patients will thus be more rapidly discharged and returned to their normal everyday lives."