Dr. Chauncey W. Crandall, author of Dr. Crandall’s Heart Health Report newsletter, is chief of the Cardiac Transplant Program at the world-renowned Palm Beach Cardiovascular Clinic in Palm Beach Gardens, Fla. He practices interventional, vascular, and transplant cardiology. Dr. Crandall received his post-graduate training at Yale University School of Medicine, where he also completed three years of research in the Cardiovascular Surgery Division. Dr. Crandall regularly lectures nationally and internationally on preventive cardiology, cardiology healthcare of the elderly, healing, interventional cardiology, and heart transplants. Known as the “Christian physician,” Dr. Crandall has been heralded for his values and message of hope to all his heart patients.

Tags: atrial fibrillation | irregular heartbeat | internal atrial defibrillator | catheter ablation | treating atrial fibrillation | Dr. Chauncey Crandall

Healing Atrial Fibrillation

Wednesday, 12 September 2012 09:12 AM

Atrial fibrillation (AF) occurs when the heart beats fast and uncontrollably, generating 300 to 600 beats per minutes. Fibrillation is much more chaotic than a flutter, and not all the beats reach the ventricle. As a result, the heart is often unable to perform its main function, which is providing a fresh supply of oxygen-rich blood to the body.

If you have mild atrial fibrillation, treating it may simply involve identifying and eliminating the cause. For instance, Jane, who is in her 30s and consumes energy drinks every day, suddenly found her heart racing. Replacing that beverage with water solved her problem.

However, at 79, my patient Ben was another story. His first episode of atrial fibrillation occurred on a sizzling South Florida day when he collapsed while playing golf. Ben needed to be hospitalized and be given drugs to regulate and cool his body down to a normal temperature.

When serious atrial fibrillation occurs for the first time, as with Ben, hospitalization and intravenous drugs are generally necessary. These drugs re-establish the normal heart rhythm about 95 percent of the time.

The most common drugs for AF treatment include beta-blockers, calcium antagonists, and digitalis. All of these medications slow the transmission of electrical signals from the atria to the ventricles, thereby reducing the heartbeat. People who have atrial fibrillation may need a pacemaker if they have “tachy-brady” syndrome, a condition in which the heart goes through a combination of very fast and very slow heart rates. Medications can treat the fast heart rate but only a pacemaker can treat the slower rates or pauses.

A similar device, called a low-energy internal atrial defibrillator (atrial ICD) can be implanted under the skin to deliver a controlled electric shock and restore the heart’s normal rhythm.

When medications are not effective to control AF, a new cutting-edge procedure called catheter ablation can be used.

Catheter ablation (CA) employs bursts of radiofrequency energy to destroy small areas of the heart muscle that are giving rise to the abnormal electrical signals and causing fibrillation. A different type of CA may be used to permanently cut the electrical connection between the atria and ventricles (AV node ablation). But destroying the AV node means the patient will need a pacemaker.

The popularity of this technique has been growing in part because it is a lucrative specialty. The drawback is that the success of the procedure is highly dependent on selecting the right patients and also on it being performed properly, which requires both time and skill.

You can increase your chance of success by having a CA performed at a recognized medical center or one that is connected with a major medical school. The success rate is higher at these larger academic centers because they perform a larger number of procedures.

You must get an echocardiogram screening before considering a CA. People with good heart function and smaller left atrial size have a better chance of success with the procedure.

Ablation often eliminates the need for blood thinners when a normal heartbeat is restored. Unfortunately, it is not a permanent cure for all patients.

© HealthDay

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If you have mild atrial fibrillation, treating it may simply involve identifying and eliminating the cause, while more serious cases may require medication or surgical procedures.
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Wednesday, 12 September 2012 09:12 AM
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