Written by David M. Benson, MD, FHRS
We focus on maintaining our patients' quality of life, which often involves diagnosis, prevention, and treatment of various conditions.
Arrhythmias
The heart is an electrical organ, and it is divided into the upper (atria) and lower chambers (ventricles). Arrhythmias can originate from any part of the heart. Even in the absence of obvious symptoms, they can lead to stroke, injury, congestive heart failure, or death. This is why it is so important to regularly follow up and communicate with your healthcare provider if you have any symptoms such as palpitations, dizziness, chest pain/pressure, or changes in your ability to perform your regular activities. The diagnosis of a stroke or TIA may also be a warning that you may have cardiac arrhythmia.
One of the most common arrhythmias is atrial fibrillation. It becomes more common as people get older and is associated with other common medical conditions. For some, it is symptoms of fatigue or palpitations; for others, it may go unrecognized for years. Depending on your medical history, anticoagulation (blood thinners) is often recommended to reduce the risk of stroke. Fortunately, some treatments may reduce your risk of future hospitalizations or stroke, such as ablation. Atrial fibrillation ablation has been around for many years. The effectiveness of this treatment is often linked to the timeliness of a referral to an electrophysiologist. The success rates increase with early intervention.
Often, people require devices such as pacemakers, loop recorders, and defibrillators to keep them safe from dangerously low or fast heart rates or abnormal rhythms. Patients who have these devices are then followed by our compassionate and knowledgeable staff in our device clinic to monitor their devices and answer questions.
What is an ablation?
Depending on your type of arrhythmia, mechanism, and location in the heart- of your arrhythmia, your doctor will usually request imaging and blood testing before the procedure. For atrial fibrillation, the procedure may take, on average, about 3 hours. It involves general anesthesia and is performed in the hospital in a specialized lab dedicated to this purpose. Catheters are advanced into the heart from veins in the legs/groin. Mapping of the inside of the heart is performed to increase the procedure's safety and reduce procedure time and radiation exposure. The application of energy (ablation) to the tissue is applied via specialized catheters, often around the pulmonary veins and, at times, other areas. The creation of a scar around these areas effectively isolates them electrically from the rest of the heart to separate the abnormal signals that may put the heart into atrial fibrillation. At the end of the procedure, all the catheters are removed, and the venous access sites are often closed with small plugs to speed healing. This is an outpatient procedure, and after a few hours of rest in the recovery area, people generally go home the same day. Other types of arrhythmias, such as supraventricular tachycardia, are very common and often curable with ablation. These types of procedures are outpatient procedures, often done with sedation. They can be life-changing for people who suffer from these recurrent and often difficult-to-manage arrhythmias. In most instances, people can come off medications prescribed to manage these types of problems after ablation.
Anticoagulation Medication (Blood Thinners)
The electrophysiology department also can aid in managing the often-difficult issues associated with anticoagulation use. If and when people reach a point where the risk of being on blood thinners for atrial fibrillation becomes prohibitive, we can discuss and recommend closure of the left atrial appendage to safely allow discontinuation of anticoagulation and keep the risk of stroke associated with atrial fibrillation to a similar degree as to when the patient was taking their blood thinner.
To schedule an appointment with North Suffolk Cardiology, call (631) 941-2000.