Health Rounds: New atrial fibrillation treatment seen as 'transformative'

Reuters07-24

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By Nancy Lapid

July 23 (Reuters) - Hello Health Rounds Readers! Improvements in treatments and diagnostics are always welcome and today we have news of one of each - a potentially game changing treatment for atrial fibrillation and a new method for diagnosing prostate cancer. We also report on a study that found an alarming link between endometriosis and ovarian cancer.

New Afib treatment called 'transformative'

A new procedure using electrical pulses for treating the common heart rhythm disorder atrial fibrillation causes fewer complications than the standard-of-care technique, according to a large study.

Doctors have long known that by destroying tiny sections of heart tissue in patients with this arrhythmia, they can block faulty heart signals and restore a normal heartbeat. Traditionally, they destroy that tissue using heat.

The new, nonthermal technique, called pulsed field ablation (PFA), uses short, high-voltage electrical current pulses to damage cell membranes and induce cell death. Other studies have shown that PFA more accurately targets heart cells, avoiding injuries to nearby tissues such as the esophagus, the pulmonary vein and local nerves, all common side effects of older approaches.

Researchers analyzed 17,642 patients with either intermittent or constant atrial fibrillation who underwent PFA procedures in 2021 with a then-experimental Boston Scientific device. They found no esophageal damage, no dangerous effects on the pulmonary vein, and no persistent injuries to nerves controlling the muscles used for breathing, according to a report published in Nature Medicine.

Rates of stroke and death were 0.12% and 0.03%, respectively.

PFA “has the potential to be transformative for the management of patients with atrial fibrillation,” the researchers said.

Boston Scientific’s device won U.S. approval in January a month after the Food and Drug Administration approved PFA devices from Medtronic and Biosense Webster.

The website Medical Device Network says 1.7 million ablation procedures will occur this year, with 20% involving PFA. By 2030, that proportion is forecast to reach 75% to 80%.

Uterine disorder linked with ovarian cancer

Women with the common uterus disorder endometriosis are at significantly higher risk for ovarian cancer, new research shows.

In these women, the tissue that lines the uterus grows elsewhere in the pelvic cavity, creating lesions on the ovaries, fallopian tubes, or behind the uterus and causing pain and fertility problems.

Researchers in Utah compared 78,893 women with endometriosis to five times as many women without the disease. Overall, the risk of developing ovarian cancer was four times higher with endometriosis, and it was nearly 10 times higher in women whose endometriosis had invaded the bowel or bladder or other nearby organs, according to a report in JAMA.

In women with severe endometriosis, “we found a 19-fold increased risk (of type 1 ovarian cancer), which compares to the connection between smoking and lung cancer,” study coauthor Karen Schliep of University of Utah Health said in a statement.

An editorial published with the study advises that in women with endometriosis who have completed childbearing or have alternative fertility options, hysterectomy or removal of the ovaries, “should be discussed and considered.”

In the U.S. alone, more than 6.5 million women have endometriosis, according to the Department of Health and Human Services.

New prostate cancer blood test effective regardless of race

A new blood test for prostate cancer screening is better than the standard prostate-specific antigen test at identifying patients who need further testing, regardless of race, researchers found.

The Stockholm3 test, marketed in the U.S. by A3P Biomedical AB and BioAgilytix, runs a combination of protein and genetic markers from a blood sample through an algorithm to find the probability that a patient has clinically significant cancer.

“Compared with PSA, Stockholm3 could reduce (unnecessary) biopsies by 45% overall and between 42% and 52% across racial and ethnic subgroups,” the researchers said.

It was developed in Sweden, where it was tested primarily in white men. For a new study, published on Monday in the Journal of Clinical Oncology, Stockholm3 was tested in an ethnically diverse group of more than 2,000 men in which 16% were Asian, 24% Black, 14% Hispanic and 46% white.

Overall, Stockholm3 was noninferior to PSA for identifying men with prostate cancer and nearly three times more accurate at identifying men without prostate cancer.

Results were consistent across racial and ethnic subgroups, the researchers said.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

((nancy.lapid@thomsonreuters.com))

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