Arrhythmias usually caused by heart disease

The symptoms are the same as far as chest discomfort and shortness of breath, but there's also the sense one is barely hanging on and could pass out. "It's a life-threatening arrythmia and you need to seek treatment very fast."

Treatment is an implantable defibrillator.

The shock it delivers saves lives, but it's not pleasant. That's why patients with ventricular tachycardia are increasingly opting for ablation to reduce the chance they'll need to be shocked by the device. That's one of the riskier ablation procedures, Weiss said.

With ablation, the doctor determines where the electrical problem is and cauterizes it. Ablation is also used with several types of atrial (upper heart chambers) arrhythmias.

There's also a rare condition where people develop what is called idiopathic ventricular tachycardia, which can occur in patients with otherwise-normal hearts. Most of the time, that's not life-threatening.

Patients who experience ab- normal heart rhythms need to let their physician know. It can be easily diagnosed. Weiss and Day recommend that patients over 65 make it a point to check their pulse at least a couple of times a year to see if it's irregular. If it is, it's important to see a doctor. Atrial fibrillation, for instance, is a major trigger of strokes.

Younger patients with a funny, fast or irregular pulse should find out why. And anyone with heart disease needs to know his ejection fraction.

Implantable defibrillators are not all that's exciting in pacing the heart. Cardiac resynchronization therapy, also called biventricular pacing, involves a type of device only recently available. Instead of pacing just the right ventricle, this can pace both the right and left side at the same time. It is proving a valuable treatment for heart failure, because the two sides stop working well together and this improves the heart's efficiency. It clearly boosts quality of life and probably longevity, Weiss said.

The "Cadillac device" is the biventricular defibrillator, which combines the best of both the defibrillator and the biventricular pacemaker, he said.

Another exciting development is cryoblation, which involves freezing rather than burning. Ablation uses radio frequency energy to burn tissue — and once it's burned, it's burned. Cryoblation allows for a test run. Tissue can be frozen partway and if the results look good, it can be frozen completely to kill the tissue. If not, it can thaw and return to its previous state.

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E-mail: lois@desnews.com