The heart has a very intricate electrical system that keeps it beating at a steady rhythm. That system can sometimes malfunction and affect the heart’s normal rhythm, creating an irregular heartbeat. The most common type of heart rhythm problem is atrial fibrillation (A-Fib), which often causes a rapid and erratic heartbeat.

“Unfortunately, A-Fib is not trivial and can have life-threatening consequences,” BCH cardiac electrophysiologist Sameer Oza, MD, of Boulder Heart told a crowd of nearly 250 people during a free health lecture on July 31 at the Boulder Jewish Community Center.

“When the heart isn’t beating properly, blood can pool in the heart's upper chambers. This increases the risk of a blood clot forming, traveling to the brain and causing a stroke. That’s why people with A-Fib are five times more likely to suffer a stroke,” he said.

However, 3 out of 4 strokes caused by A-Fib can be prevented if detected and treated early.

What Does A-Fib Feel Like and What are the Symptoms?

  • Fish flopping in your chest
  • Frequent palpitations (skipped beats / fast or slow heartbeats)
  • Fatigue / lack of energy
  • Shortness of breath
  • Dizziness
  • Chest discomfort

A-Fib can start out as short episodes that go away within a few minutes. Later in the disease process, A-Fib becomes persistent.

Silent A-Fib: You Can Have It and Not Know It

Normally, the heart beats 60 to 120 times per minute. A-Fib can cause a very rapid heart rate, sometimes as high as 200 times per minute. Occasionally, it can cause a slow heart rate. In either case, the heartbeat with A-Fib is always irregular.

Although one would think that the signs of an irregular heartbeat might be noticeable, that is not always the case.

“More than 50 percent of those who have A-Fib have no symptoms at all, or have silent A-Fib. It’s often diagnosed during a physical exam,” Dr. Oza said. “That's why it's important to get routine checkups, when a doctor can potentially spot any changes to your heart’s rhythm.”

The Three Pillars of Treating A-Fib

Dr. Oza said there are three pillars to treating A-Fib:

  1. Stroke prevention - Cardiologists often prescribe blood-thinning medications (anticoagulants) to prevent blood clots and reduce the risk of a stroke. Sometimes your doctor may recommend a surgical procedure to seal off your heart’s left atrial appendage.
  2. Heart rate control - Medications are used to control heart rate. Those who cannot tolerate medications can also undergo atrioventricular (AV) node ablation – a cardiac catheterization procedure that is used in conjunction with a permanent pacemaker placement.
  3. Heart rhythm control - Medications or cardioversion, a procedure where an electrical shock is delivered to the heart, can restore normal heart rhythm. If patients prefer to avoid medications or cardioversion, there are two other treatment options: catheter ablation and surgical ablation, which is a minimally invasive procedure.

Electrophysiology Treatment: Catheter Ablation

“Many people don’t want to take medications for the rest of their lives. For those people, catheter ablation offers the best treatment option,” Dr. Oza said. “The procedure selectively destroys the tissue creating problematic electric signals and interfering with the heart’s regular rhythm.”

There are two types of catheter ablation: radiofrequency ablation and cryo-ablation. Foothills Hospital hosts one of Colorado’s most sophisticated electrophysiology (EP) labs for these procedures.

Using an all-digital biplane cardiac imaging system and a three-dimensional cardiac mapping system, the cardiac electrophysiologist inserts narrow, flexible catheters into a vein, usually in the groin area, and then guides the catheters into the heart. Depending upon the type of catheter being used, the physician either applies electrical energy to destroy the malfunctioning tissue (radiofrequency ablation) or freezes it (cryo-ablation).

Sameer Oza, MD, is one of the most experienced cardiac electrophysiologists in the Denver area offering ablation treatments for heart rhythm problems. Call 303-442-2395 or email BHfrontoffice@bch.org to schedule a consultation with Dr. Oza.

Click here to view PowerPoint slides from Dr. Oza’s lecture on the “Latest Treatments for Irregular Heartbeat.”

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