Treatment is urged for heart fibrillation

Irregular heartbeats prompted a steady stream of calls at Saturday's Deseret Morning News/Intermountain Healthcare Health Hotline, whose focus this month was arrhythmia.

The majority of callers were concerned about the fluttery electrical malfunction known as atrial fibrillation, which is one of the most common forms of cardiac arrhythmias, affecting about one in every 100 people in their 60s and one in 15 people over age 80.

Callers who were unable to get through to the hotline because of the large volume of nonstop calls are encouraged to contact the Utah Heart Clinic at Intermountain Medical Center at 507-3513.

"Unfortunately, there are lots of primary care physicians who think atrial fibrillation is not a big deal," said Dr. John Doty, cardiovascular surgeon with Intermountain Medical Center. Doty joined cardiologist Dr. Peter Weiss to field the morning's calls.

"They put patients on a blood thinner, which reduces the risk of stroke but doesn't eliminate" the arrhythmia, Doty said.

Left untreated, atrial fibrillation — a misfiring in the upper chambers of the heart — can increase in frequency and duration, and can lead to strokes and heart disease, Doty and Weiss told the callers. The doctors recommend a procedure known as cardiac ablation, either via catheter or via surgery.

With ablation, the doctor identifies the areas of the atria that are short-circuiting, then cauterizes those areas with radio frequency energy. This burning technique is more effective than ultrasound or lasers, which don't destroy the flawed tissue as successfully, Doty and Weiss said.

Ablation is effective in 85 percent of "a-fib" cases, and more than 95 percent in cases of SVT (supraventricular tachycardia — a sudden racing but regular heartbeat), they said.

The most dangerous atrial fibrillations are those that last hours or days, because these can cause the blood to pool and clot and thus can lead to stroke. They may also be a sign of underlying heart disease.

The causes of "a-fib" include aging, high blood pressure, sleep apnea, heart disease and hyperthyroidism.

Once atrial fibrillation becomes chronic, persisting most of the time, it is more difficult to treat, the doctors said.

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E-mail: jarvik@desnews.com