Researchers work to find atrial fibrillation treatment

Editor's Note: This is part of a series of stories on cardiovascular health that the Your Health edition is publishing as part of National Heart Month.

The statistics and projections on the percentage of people in the United States with the most common abnormal heart rhythm, atrial fibrillation, are startling.

According to the American Heart Association, atrial fibrillation is a disorder found in about 2.2 million Americans, and up to 5 percent of people 65 and older have the disorder. The disorder is responsible for about 15 percent of strokes.

During atrial fibrillation, the heart's two small upper chambers, or the atria, quiver instead of beat effectively. Blood isn't pumped completely out of them, so it may pool and clot. And if part of a blood clot in the atria leaves the heart and becomes lodged in an artery in the brain, a stroke results.

As the population ages, the medical research community, including researchers at the Medical University of South Carolina, is looking at ways to better treat atrial fibrillation, which can range from simple, inexpensive electric shock to expensive and exotic medications and a complex catheter procedure.

At MUSC, researchers have discovered a simple blood test, which measures a "protein signature" unique to patients with atrial fibrillation, that can better guide them in the array of treatment options. "So far, it's been a trial-and-error approach to treating each patient," says Dr. Michael Gold, chief of cardiology.

Gold and Dr. Rupak Mukherjee have been focused on what happens in the heart of a patient with atrial fibrillation.

"We wanted to investigate whether there were markers in the blood so we could be more direct in treating," Gold says.

In November, they presented their findings to the annual meeting of the American Heart Association in Chicago.

With the blood test, which has yet to be made commercially available, MUSC is taking steps to further efforts to personalize medical care.

Gold adds that he does not know when the test will be available because it will have to be approved by the Food and Drug Administration.

For patients such as Vito Pascullis, who is a patient of Gold's, advances in atrial fibrillation and other coronary care have extended his life and quality of life.

Pascullis, 73, a retired architect and partner with the LS3P firm, has had heart problems most of his adult life, starting with a heart attack at age 30 and subsequent triple bypass surgeries at 38 and 58.

He chalks up his heart problems to work stress and family history. His brother died of a heart attack. He's been treated at MUSC's heart center for 43 years.

Today, Pascullis lives with both atrial and ventral fibrillation every day.

"Living with rapid heart rhythms is a normal to me," says Pascullis,

When he has a heart-rhythm episode, implanted defibrillators shoot a volt into his heart that he describes as being both "a kick in the chest and a kick between the ears."

In fact, the shocks are so memorable he keeps count: "48 shocks in 27 events in 14 years."

"It's a humbling kind of event, but I always come out of it," says Pascullis. "I have a love-hate relationship with my defibrillator, but it's always love after the event is over."

Ultimately, advances in modern medicine have allowed him to live a relatively normal life and retirement. He and his wife of 50 years, Judy Pascullis, celebrated their anniversary in Avignon, France, and frequently travel to England to see their grandchildren. He even likes to bike while staying in Europe.

"I have really benefited by all the science and technology and great care," says Pascullis.

Reach David Quick at 937-5516.