Cardiac Ablation: Low Risk, Non-Surgical Treatment for Heart Rhythm Problems

Author: Sujoya Dey

Image of Sujoya DeyBy Sujoya Dey, MD, cardiologist and Medical Director of electrophysiology at Marin General Hospital

GREENBRAE, CA — Atrial fibrillation, a common form of heart rhythm abnormality in which irregular heartbeats or heart palpitations are some of the major symptoms, affects 3 to 6 million Americans — that’s almost one in 10 over age 65. 

A number of treatment approaches are available including lifestyle changes and medications. Patients whose cases of atrial fibrillation (AFib) have not responded to other treatments now have the option of effective new procedural techniques such as cardiac ablation and occlusion of the left atrial appendage, both of which are performed at Marin General Hospital.

In AFib, an electrical disturbance in the upper chambers of the heart disrupts the heart’s normal rhythm. This causes the heart to beat too slow or too fast and in an irregular way, causing a slowdown of blood flowing into the lower chambers. Clots can form from this pooled blood and when pumped out of the heart, can go to the brain, block an artery and cause a stroke. AFib is associated with a 5 times greater risk for stroke. 

AFib can occur in brief episodes, frequently, or become a permanent condition. About one-third of people affected do not have any symptoms and find out only from a physical exam or EKG. Others first become aware by experiencing symptoms such as an irregular heartbeat, a rapid or pounding heartbeat, lightheadedness, extreme fatigue, shortness of breath, and in some cases chest pain.

Jake Peterson, a San Rafael firefighter, experienced his first episode of AFib at just 29 years old. Doctors were able to reset his normal heart rhythm by delivering a low voltage electric current to his heart. Careful monitoring and Jake’s lifestyle modifications kept his AFib under control. Then after about 10 years without experiencing any symptoms, Jake had another episode, followed by another one month later, then two more over a short span of time. For Jake, electrical impulse procedures, medications and lifestyle modifications were not keeping his AFib at bay. AFib was interfering not only with his job with the fire department, it was keeping him from enjoying the active lifestyle he was accustomed to. Additional intervention was needed and Jake was referred to me.

As a cardiac electrophysiologist, I treat patients who have problems related to the electrical system of the heart. With an electrophysiology lab at Marin General Hospital, Jake, who was born at Marin General Hospital, as were his children, didn’t have to go far to find another treatment option. The lab, one of only a dozen in Northern California, offers a minimally invasive treatment called transcatheter cardiac ablation to patients like Jake whose AFib is not responding to medications or other treatments.

In the ablation procedure, the source of the irregular electrical impulses is located through three dimensional computerized mapping of the heart. A catheter is then threaded to the heart through the patient’s groin in the same manner as when placing a stent into a cardiac artery. A thin wire, with an electrode at its tip is then guided through the catheter to the dysfunctional area. The electrode delivers heat to the area, destroying the tissue and causing scars to form. Scar tissue interrupts the abnormal heart rhythms and prevents them from reaching the heart.

Ablation is a low risk procedure with a high rate of success. The procedure takes a few hours and once patients are stabilized, they can go home the next day. Patients are typically prescribed a blood thinning medication to take for a short period after surgery.

A few months after the procedure, Jake was given the all clear to return to the fire station and has worked a normal schedule after since.

Abnormal heart rhythms such as atrial fibrillation, are not life threatening but the side effects and complications can be. If you are experiencing one or more of the symptoms of AFib, make an appointment with your primary care physician or cardiologist. Untreated atrial fibrillation doubles the risk of heart related deaths and means a four to five times higher risk of stroke.

Marin General Hospital electrophysiology program takes a comprehensive approach to arrhythmia management. In addition to the latest procedural treatments, the program offers a unique "Get Into Rhythm: Living Well With Atrial Fibrillation” program which focuses on key lifestyle modifications important to ensure success and freedom from arrhythmias.

The good news is that when advanced technical expertise is combined with comprehensive plan for lifestyle modification, success rates and freedom from atrial fibrillation is markedly higher.

For more information about the “Get Into Rhythm” program call 1-415-925-7688.