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Heart Procedure Reduces Need for Defibrillator Shocks
Date:12/26/2007

While study results are promising, they don't address benefits of drug therapy

WEDNESDAY, Dec. 26 (HealthDay News) -- A treatment that wipes out abnormal heart tissue reduces the number of shocks delivered to people who have defibrillators implanted after heart attacks, a new trial showed.

While those shocks do keep the heart going when it slips into abnormal rhythms, they are desirable to avoid not only because they are unpleasant to experience but carry hazards of their own, said study senior author Dr. Mark E. Josephson, chief of the cardiovascular division at Beth Israel Deaconess Medical Center in Boston.

"People with these devices have a lower quality of life because of the shocks and the fear of getting shocks," Josephson said. "With ablation, there was a marked reduction in any kind of therapy, and shocks specifically."

Ablation is a technique of identifying and eliminating cardiac tissue that can generate the kind of abnormal rhythm that sets the heart beating irregularly, so that a defibrillator shock is needed to restore normal heart rhythm.

The study led by Josephson included 128 people who had defibrillators implanted after heart attacks. Half of them underwent ablation, half did not. In an average follow-up period of 22.5 months, just eight of those who had ablation experienced defibrillator shocks, compared to 21 -- a full third -- of the group that did not have ablation.

And there was a marked reduction in deaths among those in the ablation group, Josephson said. Eleven of those who did not have ablation died, while there were just six deaths in the ablation group, he said. The numbers were too small to reach statistical significance, but Josephson described it as "a remarkable finding."

The study results are published in the Dec. 27 issue of the New England Journal of Medicine.

But the study did not address the issue of drug treatment to keep abnormal
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