Atrial Fibrillation Treatment
Desert Regional Medical Center Offers Technology Alternative to Drug Therapy for Patients with Atrial Fibrillation (AFib) and other Heart Rhythm Disorders (Arrhythmia) in the Palm Springs, Palm Desert, Rancho Mirage and Coachella Valley region.
What is Atrial Fibrillation (A-Fib or AF)
Atrial fibrillation is the most common type of heart rhythm disorder (arrhythmia) which affects more than 2.7 million people in the United States1.
AFib occurs when the heart’s electrical system has a problem that causes the heart to fibrillate, or beat very rapidly. When this occurs, the heart cannot pump blood properly throughout the body. In some cases, AFib can cause chest pain but some people may not feel any symptoms. The likelihood that someone will have AFib increases with age.
“Among the senior population, the percentage of people with atrial fibrillation can be as high as 8 percent, and that’s a significant number2,” said Dr. Hetal Bhakta, MD, a cardiologist with Desert Regional Medical Center who specializes in electrophysiology, the treatment of heart rhythm disorders. “A lot of the episodes are silent, so these patients don’t know they have atrial fibrillation.”
AFib is a serious illness. When the heart cannot move blood properly, it may pool in the chambers of the heart and blood clots may form. AFib may cause heart failure or stroke, which happens when a clot blocks a blood vessel in the brain. Strokes are a leading cause of disability and death in America.
When to seek treatment
If you are feeling symptoms of a rapid or irregular heartbeat you should consult with a doctor to determine how serious an issue you may have. A doctor may suggest you take medications such as Xarelto (rivaroxaban) or Eliquis (apixaban) -- to reduce the risk of blood clots. Or you may be prescribed antiarhythmic drugs such as Tambocor (flecainide), Procanbid (procainamide), Cordarone (amiodarone) or Betapace (sotalol).
In some cases, you may be a candidate for a more permanent treatment for AFib, called catheter ablation. In catheter ablation, a cardiologist will determine the location of the heart cells that are causing the electrical problem – the circuits that are misfiring -- and eliminate those cells using special technology inserted into the heart through a catheter.
“When people first start having symptoms, they can take medication and wait and see, but really, it’s best to do the ablation early,” Dr. Bhakta said. “If we treat it at the beginning, there is just one area to treat. If you let it run rampant, you run the risk of having other circuits that are damaged. If we treat early, we’ve virtually taken care of the problem – it’s a cure instead of an ongoing treatment.”
Understanding the electrical problems of the heart
The heart is divided into four chambers, a left and right atrium and a left and right ventricle.
To begin a heartbeat an electrical signal is sent from a special area at the top of the right atrium called the sinoatrial node (SA). The electrical signal spreads from that node to other areas of the heart, which causes the regular series of contractions that make up a normal heartbeat. First the atria contract, to pump blood from the top of the heart, into the lower chambers called the ventricles. The electrical signal moves to another node at the top of the right ventricle, called the atrioventricular (AV) node. The signal slows for an instant to allow the ventricles to fill with blood, then fires up again to signal the ventricles to contract, which pushes blood to the rest of the body.
In atrial fibrillation, the atria contract irregularly and too quickly. This disrupts the ability of the ventricles to contract and the heart no longer pushes all the blood to the body, allowing it to pool up in the heart. An irregular heartbeat is created when the electrical signal starts somewhere in the atria other than the SA node. Catheter ablation works by deactivating the cells that are misfiring in the heart, and restoring the heart to a normal rhythm.
How does cardiac catheter ablation work?
During catheter ablation, a cardiologist inserts a catheter (a thin flexible tube) into the blood vessel of your groin, arm or neck. A wire inside that catheter is connected to a special machine that can generate radio-frequency energy at its very tip. Using sophisticated imaging technology, the cardiologist can navigate to the places on the heart that are causing the electrical signals to misfire. The radio-frequency energy heats the problem cells and deactivates them. Electrical signals can then move normally through the heart and a regular rhythm can be restored.
What is Stereotaxis technology and how does it help in catheter ablation?
Desert Regional Medical Center in Palm Springs is the first hospital in the Coachella Valley to offer a technology called the Stereotaxis Electromagnetic Navigation3 System. This technology enhances the cardiologist’s ability to navigate precisely and treat the problem cells that are causing the heart to misfire.
Rather than push the catheter manually through a patient’s blood vessels, using Stereotaxis, the cardiologist can steer the catheter remotely while watching its progress on a high-definition computer screen where the patient’s heart and blood vessels have already been mapped.
This is possible because powerful magnets lock onto the tip of the catheter and allow it to be steered rather than pushed through the blood vessels. This provides excellent precision and safety as well as reducing the use of radiation exposure because the physician needs to take fewer X-ray pictures than manual ablation methods would require.
According to a research study, Stereotaxis technology is less likely to injure a patient than manual treatments that do not use electromagnetic navigation and requires approximately one-third less time exposed to radiation.4
The computerized tracking allows the catheter tip to match the movements of the beating heart, increasing the precision with which the surgeon can target the problem areas.
“Manual ablation is like trying to paint a canvas on a small fishing boat in the middle of the ocean with all the waves, compared with painting that same canvas on a steady cruise ship,” Dr. Bhakta said. “The painting will be better in the more stable environment. Similarly, the magnetic navigation allows for a more stable catheter position which results in better lesion delivery, which ensures the circuits are fully cut.”
What to expect during your catheter ablation procedure at Desert Regional Medical Center
When undergoing a Stereotaxis procedure a patient would be sedated and feel minimal discomfort. Most patients will require only a one-night’s stay at Desert Regional Medical Center and can return to normal life quickly. A patient may be asked to refrain from heavy lifting or vigorous activity for one week.
How do I know if I’m a candidate for catheter ablation?
An electrophysiologist will assess your case to determine if you are a candidate. The physician will diagnose the type of arrhythmia you have, your tolerance for medications versus ablation, and whether your electrical problem puts you at risk for ventricular fibrillation, which is a life-threatening arrhythmia that may lead to sudden cardiac arrest and even death.
To schedule an assessment with a specialist in cardiac electrophysiology, call (800) 491-4990.
1 Center for Disease Control and Prevention, Division for Heart Disease Stroke and Prevention (accessed on 2016/09/23) “Atrial Fibrillation.” https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/docs/fs_atrial_fibrillation.pdf
2 Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation. 2015; 131: e191.
3 Email from Rod McCrimmon of Stereotaxis. Dated January 31, 2013.
4 Bauerfiend, et. al. The magnetic navigation system allows safety and high efficacy for ablation of arrhythmias. Eurospace. European Society of Cariology. April 11, 2011.