Atrial fibrillation (AF) can lead to stroke, significant morbidity, and increased risk of premature death due to heart failure. Exploring effective treatment methods for AF through electrophysiology presents an opportune means for avoiding these severe complications.

David N. Kenigsberg, M.D., a clinical cardiac electrophysiologist who recently joined the staff at Westside Regional, states that “there are many options now available to cure atrial fibrillation, including catheter-based ablative approaches and advances in surgery.”

“Curing AF is defined as absence of the condition, as verified by long-term monitoring as an outpatient,” says Dr. Kenigsberg. “Several procedures offer the possibility of curing AF, from open-chest surgeries to less-invasive catheter-based procedures. The type of procedure should be recommended based upon the underlying cause of the AF, the presence of other medical conditions, age of the patient, and presenting symptoms.”

“The cure rates for catheter-based treatment of the supraventricular arrhythmias are greater than 95 percent with a single procedure,” says Dr. Kenigsberg. “Since the discovery of pulmonary vein potentials by Dr. Haissaguerre in 1998, an improvement in the understanding of the pathophysiology of AF has transpired. Because of this discovery, there has been an increase in catheter ablations to treat and potentially cure AF, especially in patients with paroxysmal atrial fibrillation.”

With continuous improvements in the tools and technology that are used to treat this arrhythmia, much progress has also been made toward equivalent cure rates for people with chronic AF. “In the past, it was more common for doctors to give up on converting patients with chronic AF to normal sinus rhythm,” says Dr. Kenigsberg. “However, today we can offer these patients a potential cure via a catheter-based approach. Furthermore, even patients who are not ‘cured’ typically experience improved health and fewer episodes of AF following ablation.”

One improvement in the catheter-based approach to treating AF is the use of an alternative energy source.

Unlike radiofrequency ablation, which burns the cardiac tissue to destroy it, cryoablation freezes the tissue. Cryoablation enables curative measures to be taken for AF sufferers with reduced risk. “This technique has proven to be safer when working in areas of the heart where the tissue to be ablated is juxtaposed with tissue that should not be affected,” says Dr. Kenigsberg, a local expert in cryoablation. “Cryoablation allows the electrophysiologist to go deeper into the pulmonary vein in order to isolate it without worrying about pulmonary vein stenosis as a complication. The same is true when working inside the coronary sinus in a patient with chronic AF and when working near the esophagus.”

David N. Kenigsberg, M.D.

David N. Kenigsberg, M.D., is a clinical cardiac electrophysiologist in private practice in Plantation, Florida. He is currently on staff at Westside Regional Medical Center, Plantation General Hospital and Broward General Hospital. He completed two years of advanced electrophysiology training at the Virginia Commonwealth University Medical Center in Richmond, Virginia. Previously he was the Chief Cardiology Fellow at Henry Ford Hospital where he was awarded the Division of Cardiology Frances Fernandez Fellowship Award. He did his residency training in internal medicine at Jackson Memorial Hospital in Miami, Florida. At the University of Miami, he was in the Honors Program in Medical Education, a six-year combined Bachelor of Science and M.D. program. He was a semifinalist in the 51st Annual Westinghouse Science Talent Search. He serves as the district representative for the Florida Chapter of the American College of Cardiology and on the Advocacy Committee of the American College of Cardiology. He holds U.S. and international patents, has published a number of papers in peer-reviewed journals in his field, has presented his research at national and international scientific meetings and has been a co-investigator in multi-center clinical trials.