The condition called atrial fibrillation—having an erratic heartbeat—can
lead to serious health problems, including stroke. But an effective, minimally
invasive catheter treatment can provide a cure.
As Americans live longer, many will develop a condition that causes their
hearts to beat chaotically. “Atrial fibrillation is the most common
heart rhythm disorder worldwide,” says
Aseem D. Desai, MD, FACC, FHRS, co-director of the Heart Rhythm Center at
Mission Heritage Medical Group. It can lead to stroke and even heart failure.
But if atrial fibrillation—or a-fib as this disorder is commonly
called—is diagnosed early and treated properly, patients can go
on to lead active, healthy lives. One treatment involves threading catheters,
or small tubes, into the heart to destroy cells that cause the arrhythmia.
It is a minimally invasive and highly effective procedure that allows
the heart to pump normally again.
Luckily for Orange County residents, several hospitals are equipped and
staffed to perform this procedure, including Mission Hospital, St. Joseph,
St. Jude, Hoag, and Saddleback.
The dangers of atrial fibrillation
With a-fib, the heart’s top chambers (atria) beat in an uncoordinated
and rapid manner, allowing blood to pool and a clot to form, causing a
stroke. In fact, people with a-fib are five times more likely to have
a stroke than people who don’t have that condition, according to
the Heart Rhythm Society.
Because the atria beat out of sync with the heart’s bottom chambers
(ventricles), the heart’s pumping efficiency is reduced and can
contribute to congestive heart failure. It can also cause fainting—a
danger if a person is driving, for instance.
The problem is that atrial fibrillation can be easy to miss. It doesn’t
always happen all the time, so many people suffer with the condition long
before it’s identified.
Recognizing the symptoms
The hallmark symptom of atrial fibrillation is intense fatigue. Others
include palpitations (a pounding sensation related to the rapid heart
beat or a flip-flop sensation related to the irregular heart beat), shortness
of breath, lightheadedness, and, if congestive heart failure is present,
leg swelling and weight gain. “Sometimes people do not feel the
typical a-fib symptoms, but they feel really tired,” says Dr. Desai.
John Dillon, a young Orange County resident who became a patient of Dr.
Desai in his 40s, complained that he was becoming more and more tired,
out of breath and dizzy. As a result, he began doing less of the activities
he most enjoyed. This affected his quality of life and time with his wife
When a patient complains of symptoms like these, a doctor might suggest
wearing a heart rhythm monitor that can correlate a patient's symptoms
with the heart rhythm at that moment. Some monitors can detect atrial
fibrillation even when a patient does not experience symptoms (known as
silent a-fib)—which can be a major cause of stroke, says Dr. Desai.
Destroying culprit cells
The cause originates in the pulmonary veins that lead from the lungs to
the left side of the heart. Abnormal circuits can develop in these veins
for several reasons, including aging, diabetes, sleep apnea, high blood
pressure, obesity, and coronary artery disease.
Medications used to treat a-fib can be problematic—they are often
ineffective or cause significant side effects and in some cases life-threatening
toxicities, says Dr. Desai. Catheter ablation (destruction) of atrial
fibrillation is a preferred approach, he says, because it is designed
to cure the condition rather than temporarily suppress it.
In this procedure, catheters are fed through a patient’s femoral
vein, located in the groin region, and into the heart. It is performed
by a cardiac electrophysiologist (a cardiologist with special expertise
in diagnosing and treating heart rhythm disorders) who uses a 3-D mapping
system to identify areas of tissue causing the problem.
“They’re like castles of abnormal circuits,” says Dr.
Desai. “The catheters hone in and create a wall around the castle
to prevent the erratic impulses from getting out of the pulmonary veins
and into the heart."
Two energy sources can be used: radio frequency energy, which heats the
tissue, and cryoablation energy, which freezes the tissue. Both are highly
effective, says Dr. Desai.
Success rate is high
Atrial fibrillation is a progressive disease, which is why cardiac electrophysiologists
try to catch it as early as possible. “For paroxysmal atrial fibrillation—early
stages of a-fib—ablation can have up to an 80 to 90 percent success
rate for cure,” says Dr. Desai. When a-fib is cured, patients often
return to an active lifestyle that they had feared was gone forever.
John Dillon’s life changed dramatically after his catheter ablation
procedure, which was done by Dr. Desai using the cryoballoon technology.
In thanking Dr. Desai, he wrote, “I can’t remember the last
time I felt this good. I was afraid a-fib was going to consume my future
and now I believe I am free.”
Learn more about
Dr. Desai. Learn more about
Mission Heritage Medical Group.
(This article originally appeared in
OC Catholic, December 2015)