Doctor Pioneers Heart Procedure

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A Pinehurst doctor has developed a procedure that could drastically improve treatments of a heart disorder called atrial fibrillation.

Dr. Andy Kiser, 41, of Pinehurst Surgical has spent the past year researching the procedure, which potentially could save the lives of the millions of people who have atrial fibrillation, or AF.

"Five million people have AF," Kiser said. "And about half of those people don't have a good treatment. The number of patients is astronomical and the need is astronomical."

Kiser's work has been based primarily in the new BioSkills Learning Laboratory at Pine-hurst Surgical. The lab, which opened Aug. 1, is the only one of its kind in the country operating in a private practice setting. It's designed to facilitate surgical research and education.

"Once we get this started," Pinehurst Surgical CEO Bill Edsel said, "(Kiser) will be using the BioSkills lab to teach doctors from all over world. He will then be a certified teacher because he invented the procedure."

During AF, the heart's upper chambers (the atria) don't beat effectively, possibly leading to a blood clot, which could cause a stroke. To treat the disorder, doctors have been using a variation of what Kiser calls the "gold standard" maze procedure -- essentially cutting up part of the heart and then sewing it back together, with the "maze" of lesions repairing the electrical pathways within the heart that cause irregular heart rhythms.

"The problem was that the heart has to be stopped," Kiser said, "and you'd have to cut it."

But now, using this ablation (literally, "removal") device and his new "ex-maze" procedure, Kiser can burn lesions onto the heart without actually stopping it or cutting it. The "ex-maze" takes about 20 minutes -- other procedures take about an hour. And, because the heart keeps beating during the whole process, Kiser said it's a lot easier to see if the operation is working.

"What's been important about this whole process," he said, "is that so far no one has been able to do entire procedure on a beating heart. But (with this procedure), we can see (the heart) change from the wrong rhythm to right when it's beating. Now you can tell if it works. You see the heart convert into a normal rhythm."

Although he hasn't yet performed the procedure on patients in the United States, Kiser already has operated on about 30 European patients.

"It was definitely a success," Kiser said of the European operations.

Kiser began performing the procedure in January on patients at Pinehurst Surgical, which already sees more than 300 heart cases a year.

He also will be traveling to make presentations in California. Kiser has been working with a world-renowned German surgeon in Pinehurst to move the procedure from an open chest operation to something less invasive.

"We really do think that this is going to make a big impact," Edsel said.

Katherine Evans can be reached at 693-2480 or by e-mail at kevans@thepilot.com.

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