|
|||
   |
|||
Atrial Fibrillation Innovative Techniques Help Reduce Risks
Suggested Links:
Atrial Fibrillation (AF) is the most common heart rhythm disorder encountered in clinical practice, currently afflicting more than three million people in the U.S. There are over 200,000 new cases of atrial fibrillation each year.
What is atrial fibrillation?
While a normal resting heart rate is between 60 and 80 beats per minute, AF is characterized by very fast, irregular beating of the upper heart chambers (atria). This usually results in a fast and irregular pulse. AF leads to an impairment of the heart pumping function, and this can cause small blood clots to form within the heart's upper chambers, increasing the risk for stroke. The American Heart Association estimates that in the United States, AF is responsible for more than 70,000 strokes each year. In other patients, AF can also impair overall heart muscle strength, increasing the risk of heart failure.
What factors contribute to AF?
Atrial fibrillation usually occurs in older adults, and with each passing decade of life, the incidence of AF increases. There are a variety of clinical factors that contribute to the development of AF, including high blood pressure, diabetes, thyroid disorders, valvular and coronary heart disease, and chronic lung disease. Excessive alcohol consumption and certain medications also can promote AF episodes. For otherwise healthy young adults, AF can arise in the absence of other clinical factors, a situation referred to as "lone" atrial fibrillation.
What are the symptoms of AF?
The symptoms of AF include irregular palpitations, shortness of breath, exercise intolerance, chest discomfort, and dizziness. Many patients also experience feelings of weakness caused by the heart's diminished pumping ability. The awareness of a rapid and/or irregular heartbeat also may cause some patients to feel anxious, although some patients have few symptoms, according to Shaun Cho, M.D., cardiac electrophysiologist on staff at John Muir Health. "Our primary goals in managing atrial fibrillation are to relieve symptoms and prevent strokes," Dr. Cho said.
Prompt treatment is essential
Prompt recognition and treatment of AF are essential. The diagnosis is usually established by a standard EKG, although intermittent episodes can be difficult to capture. Treatment of AF should be initiated as soon as possible, since untreated AF can actually cause arrhythmia episodes to last longer, resulting in lower chances of reversing the disorder. Lifestyle adjustments, such as controlling high blood pressure, limiting alcohol consumption, and eliminating smoking can help prevent reoccurrences of AF. Often, medications are required to control the arrhythmia. In all patients, blood-thinning medications such as aspirin or warfarin must be considered, although in some cases, Dr. Cho finds their use to be limited by their inconvenience, side effects, and increased risks for bleeding.
Catheter ablation brings results
For selected patients who are unsuccessful in controlling AF with lifestyle changes or medications, catheter ablation is effective. According to Susan Eisenberg, M.D., cardiac electrophysiologist on staff at John Muir Health, she and her colleagues at both hospitals will collectively perform approximately 50 AF ablation procedures this year. During catheter ablation, thin catheters are inserted into the heart and record electrical activity in the regions of the heart that are responsible for initiating AF events. These catheters are first introduced into blood vessels in the groin, and they are then carefully positioned in the heart chambers. Electrical information from the catheters allows physicians to locate the appropriate sites targeted for ablation. The specialized radiofrequency current is then delivered to the involved tissue, creating small lesions that prevent future electrical disturbances.
Currently, only a few heart centers in the U.S. are performing ablation procedures for AF. "Our Atrial Fibrillation program at the Cardiac Rhythm Center will allow those of us who specialize in cardiac electrophysiology to develop the latest treatment techniques," said Dr. Eisenberg, "and to give patients in the community a local resource to obtain this important therapy." She emphasizes that catheter ablation therapy is not presently suited to all who suffer from AF, and all potential candidates are carefully screened prior to scheduling the procedure.
Surgical Solutions
For other AF patients who have other serious heart conditions for which open heart surgery is needed, they have the option of having a surgical procedure to eliminate atrial fibrillation recurrences. The procedure, known as the "Maze" operation, is performed by a cardiac surgeon. Like the catheter ablation procedure, the surgical "maze" uses radiofrequency current to eliminate abnormal electrical impulses that are responsible for AF. The cardiologists, cardiac electrophysiologists, and cardiac surgeons at John Muir Health work together to determine which treatment is best suited for those suffering from atrial fibrillation.
This article is part of a series of informational advertisements focusing on health brought to you by John Muir Health and the John Muir Physician Network.