All types of heart arrhythmias treatable

Although atrial fibrillation may not feel like much — a brief fluttery feeling in the chest, an erratic heartbeat that quickly returns to normal — it's not just a benign problem, says Dr. Peter Weiss.

In fact the condition may eventually cause a stroke or increase the risk of congestive heart failure. But heart arrhythmias of all types can be treated, say Weiss, a cardiologist, and Dr. John Doty, a cardiovascular surgeon, both at Intermountain Medical Center. Both doctors will be answering calls about arrhythmias during Saturday's Deseret Morning News/Intermountain Healthcare Health Hotline, from 10 a.m. to noon.

Atrial fibrillation — which doctors usually shorten to a-fib — becomes more common with age, affecting about one in every 100 people in their 60s, and one in 15 by the time people reach their 80s. In some cases it's so subtle that it shows up as a feeling of fatigue, says Weiss. For others it may feel disconcertingly like the heart's electrical system has gone haywire.

Often the condition begins as brief, occasional episodes, but left untreated may eventually become a nonstop short-circuiting that is difficult to treat. The misfiring and resulting chaos in the heart's upper chambers can cause blood to swirl and pool, sometimes causing blood clots to form, which can then travel to the brain and cause a stroke.

A-fib can also lead to valve damage and other heart problems. About 25 percent of all strokes are believed caused by atrial fibrillation, and the mortality rate for people with a-fib is 2.5 times higher than for the overall population.

The best treatment, Weiss says, is a "very minimally" invasive but complex procedure known as cardiac catheter ablation. Any patient with recurring atrial fibrillation should consider having the procedure done, says Doty.

Drugs for treating a-fib "are less than satisfactory," Weiss says. "Even the strongest are successful in keeping people in rhythm 60 percent of the time." After treating close to 1,200 patients with cardiac catheter ablation, he says, Intermountain Medical Center's Utah Heart Clinic has an overall success rate — no more fibrillation, no need for anti-arrhythmia drugs — of 85 percent.

During the ablation procedure, the cardiologist inserts a catheter in a vein in the leg, then uses that catheter to explore the heart's electrical pathways via magnetic resonance imaging (MRI) and a 3-D electro-anatomic mapping system. Short-circuits are then shut off permanently by cauterizing them using radio frequency energy.