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.
The potential for serious complications from the ablation is 1 percent or less, Weiss says. Patients are able to leave the hospital the next day, with just two or three Band-aids.
Intermountain Medical Center doctors are hoping next spring to begin updating the ablation technology with a more flexible catheter, to make the procedure even more accurate.
Anything that puts stress on the heart high blood pressure, sleep apnea, obesity can cause atrial fibrillation, Weiss says. But genetic predisposition is also a factor, as is the normal aging process of the heart.
The heart, in essence, runs on electricity: electrical impulses stimulate the atrial (upper) and ventricular (lower) chambers of the heart to rhythmically contract and relax with each heartbeat. Arrhythmias can be caused by a short circuit, or many short circuits, or by an extra pathway where there shouldn't be one.
Other arrhythmias include supraventricular tachycardia (SVT) and potentially lethal ventricular fibrillation.
People who are concerned that they have any type of arrhythmia can contact Intermountain Healthcare's CARE (Cardiac Arrhythmia Evaluation) program at 507-3513. Patients can be assessed with electrocardiograms and echocardiograms, a stress test (ECG while exercising), and use of monitoring devices such as an "event" monitor.Some patients who have atrial fibrillation write the condition off as "anxiety," Weiss says. And others may become anxious because of their heart palpitations, thus causing more fibrillation. "It's a vicious cycle," he says.
Call hotline Saturday
Heart arrhythmias are the topic of Saturday's Deseret Morning News/Intermountain Healthcare Hotline.
Dr. John R. Doty and Dr. Peter Weiss, cardiologists at Intermountain Medical Center, will take phoned-in questions from 10 a.m. to noon. All calls are confidential.
From the Salt Lake area, call 236-6061. Elsewhere, the toll-free number is 800-925-8177, but the numbers are only operational during the hotline hours.