How "Zapping" Hearts Alleviates Atrial Fibrillation
Catheter ablation is a new surgical procedure used to treat atrial fibrillation
Catheter ablation helps in about 85 percent of the cases
The procedure carries some risks, so it’s important that patients be screened carefully
For patients who are sidelined by atrial fibrillation—a rapid, irregular heartbeat—and have not found relief through medication, a new, minimally invasive surgical procedure called catheter ablation may prove helpful.
Catheter ablation uses a long tube (catheter) to deliver short bursts of energy to the heart. The tube is inserted into a vein in the patient’s arm or leg until it reaches the heart. The energy waves delivered through the tube cause an interruption in the electrical impulses that are causing the irregular heartbeat.
According to Steven Rothman, MD, chief of cardiology at the Main Line Health Heart Center at Lankenau Medical Center, the perfect candidate for this procedure is someone who:
Has been on at least one medication for the treatment of atrial fibrillation
But still has significant symptoms that are affecting the quality of his or her life
Atrial fibrillation, the most common serious heart rhythm disturbance, is a rapid heartbeat that starts in the atria, the heart’s upper chambers. While not life-threatening, atrial fibrillation is a serious malfunction of the heart that can lead to a stroke, if not treated.
According to Dr. Rothman, even if a patient remains stroke-free, atrial fibrillation can cause a number of symptoms that can affect quality of life, including
Shortness of breath
Fainting or feeling light-headed
Congestive heart failure
The first step in treatment is usually medicine. But patients need to be monitored consistently to make sure the drugs continue to do their job. If blood thinners are used, a patient should be checked regularly to ensure their use of them remains safe.
“Most medications used for atrial fibrillation don’t seem to work indefinitely,” explained Dr. Rothman. “It can be a changing ailment, and treatment may have to be modified. In other cases, patients just can’t tolerate the adverse effects of the drugs.” When this happens, catheter ablation might be a solution.
Dr. Rothman said the procedure originally began as a treatment that was administered during open heart surgery but has been adapted for atrial fibrillation. Because catheter ablation is a relatively new procedure that carries some risk, patients must be screened and selected carefully.
“Catheter ablation has only been used for atrial fibrillation for the last five to eight years,” Dr. Rothman said. “It is an invasive procedure with a one to two percent chance of serious risks, including stroke. Evaluating a patient correctly for this procedure is very important.”
Individuals who experience only occasional symptoms of atrial fibrillation are the best candidates. Their success rate is close to 85 percent, said Dr. Rothman.
For patients with persistent atrial fibrillation, changes in the heart make the procedure less effective.
Because there are no long-term results for catheter ablation, it’s not yet known how long patients’ hearts will remain in normal rhythm or if they may need repeat procedures or medication down the road.
“Those questions will be answered as more data is collected,” he said.
Patients who are considering catheter ablation to treat their atrial fibrillation should consult with their physician and discuss three important factors:
The severity of their symptoms
Their potential risks
The likelihood of success
Dr. Rothman said that for his patients who have benefited from catheter ablation, the improvement in their quality of life has been dramatic. “They are so pleased by the outcome. They feel just wonderful.”
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