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Site FeedbackA New Option in Arrhythmia Treatments
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More than 2.5 million Americans live with heart rhythm disorders known as arrhythmias. These electrical malfunctions can range from harmless skipped beats or palpitations to more serious disorders. Some arrhythmias are serious enough to be life-threatening, or to increase risk for heart attack or stroke. Because the condition can reduce the heart's efficiency, treatment can dramatically improve a patient's quality of life. A treatment now offered at the John Muir Cardiac Rhythm Center, using "cryo," or freezing technology, is helping some patients overcome rhythm disorders in a new way.
What Is An Arrhythmia?
Arrhythmias are variations from the normal rhythm of the heartbeat. They come in different categories: a racing heartbeat (tachycardia), a slow heartbeat (bradycardia) and "extra" heartbeats, called ectopic beats. They can occur when abnormal or irregular electrical impulses within the upper heart chambers (the atria) replace the heart's normal electrical signals, or when the heart's chamber size or function changes, for instance, due to congestive heart failure or coronary artery disease. Congenital issues can also cause arrhythmias.
Treatment Options
Treatment options for arrhythmias include use of medication, pacemakers, and implantable defibrillators. Radio-frequency (heat) ablation is also commonly used, especially for those with disorders in the upper heart chambers. In this non-surgical procedure, extremely small catheters (tiny, flexible wires) are threaded into the heart's chambers to cauterize minute portions of heart tissue that may be throwing off the heart's electrical rhythm.
A New Treatment Tool
Now, a new technology, cryoablation, is also available at John Muir Health. This treatment method uses catheters similar to those used in radio-frequency ablation, but they deliver extreme cold, rather than heat, to treat abnormal tissue. According to Shaun Cho, M.D., a cardiac electrophysiologist on staff at John Muir Medical Centers in Walnut Creek and Concord, "This is an important tool in our armamentarium, especially for certain high-risk procedures. It's the first time freezing technology has been applied to this specific field, and not many centers have it yet. Now, we can offer our patients everything that's available in electrophysiology, right here in our own community."
Suiting The Treatment To The Case
The symptoms of palpitations, fluttering, or other rhythm abnormalities that bring a patient to the physician's office can give important clues about which treatment to use, as different types of arrhythmias have their own "signatures." Results of tests such as EKGs help to pinpoint the type and cause of the problem. After careful evaluation, the best treatment plan is determined.
Cardiac ablation is the treatment most often chosen to treat rapid heartbeats that begin in the upper chambers, or atria, of the heart. As a group, these arrhythmias are known as supraventricular tachycardias. Types include atrial fibrillation, atrial flutter, atrial tachycardia, and others.
How Ablation Works
Ablation is a procedure that involves inserting very small catheters into a blood vessel, and sending the tiny wires up into the heart. The journey is navigated by images created by a fluoroscope, an X-ray-like machine that provides "live" images of the catheter and tissue.
Once the catheter reaches the heart's chambers, electrodes at its tip gather data and perform a variety of electrical measurements. The data pinpoints the location of the faulty electrical site.
When that site is confirmed, energy is used to destroy a small amount of tissue, ending the disturbance of the electrical flow through the heart and restoring a normal rhythm.
According to Susan Eisenberg, M.D., also an electrophysiologist on staff at both John Muir Medical Centers, "Cryoablation allows us a safer way to do certain procedures that have been considered high-risk. For instance, in the case of a very small heart, or small spaces near critical structures such as the heart's main electrical system, we can go in more safely. The difference with cryoablation is that as you begin to cool the cells, there is a halfway point, and you can see the physiologic effect you are creating. So, if we start to see a problem, we can simply reverse the procedure."
Dr. Cho adds, "While radiofrequency ablation has proven to be very safe, in certain instances it does have limitations. This new procedure allows us to treat some patients who previously could not have been helped safely."
Like radiofrequency ablation, doctors can perform cryoablation on an outpatient basis, using light sedation.The doctors agree that the procedure is very well tolerated. Afterwards, patients can usually return home the same day and resume normal activities within a week. Cryoablation is considered safe for pediatric, adult and geriatric patients.
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