When the Heart Loses its Rhythm: Treatment for Atrial Fibrillation
When we think about the heart, we tend to think of the pipes and pumping involved in circulating blood. But the heart also has a sophisticated electrical system to control the speed and rhythm of the heartbeat. For every heartbeat, an electrical signal travels from the top of the heart to the bottom, causing the heart to contract and pump blood. Sometimes, the heart’s electrical system can malfunction and cause arrhythmias, problems with the heartbeat’s speed or rhythm. About 2.7 million Americans have atrial fibrillation, which becomes more common with age.
“Atrial fibrillation is the most common arrhythmia,” says Anil Bhandari MD, director of the Electrophysiology Laboratory at PIH Health Good Samaritan Hospital. “In atrial fibrillation, the heart’s two upper chambers -- called the atria -- contract very quickly and irregularly as a result of rapid, disorganized electrical signals,” notes Dr. Bhandari, who is board-certified in internal medicine, cardiovascular medicine and clinical cardiac electrophysiology. “As a result, blood does not get pumped completely out of the atria and can pool and clot. When this happens, the heart’s upper and lower chambers don’t work together as they should. Also, a piece of the blood clot can loosen and travel to an artery in the brain, where it can cause a stroke.”
Physicians like Dr. Bhandari use a variety of methods for treating atrial fibrillation. Medications may slow the rapid heart rate or restore the heart’s normal rhythm. Atrial pacemakers, which regulate the heart rhythm, can sometimes be implanted beneath the skin.
In other cases, radiofrequency ablation may be an effective treatment. This non-surgical procedure is performed in the electrophysiology and catheterization laboratories at PIH Health Good Samaritan Hospital. It involves inserting thin and flexible tubes through blood vessels in the groin area and guiding them to the exact spot where the faulty electrical signals originate. Radiofrequency energy is used to block or destroy the pathway that triggers the abnormal electrical signals. The procedure takes 3 to 4 hours and done under general anesthesia.
“Radiofrequency ablation is the preferred treatment for many atrial fibrillation cases,” says Dr. Bhandari. “It has a success rate of between 80 and 90 percent, although 20 to 25 percent of patients may require a second procedure. Complications may occur in 0.5 to 1 percent of patients but most patients go home the same day and can resume normal activities within a seven to ten days of undergoing the procedure. The procedure may also eliminate the need for any medications used to treat AFib.”