Ablation procedure puts an end to atrial fibrillation

Ablation procedure puts an end to atrial fibrillation

Stephan Danik, M.D., Attending physician at the Al-Sabah Arrhythmia Institute and Cardiovascular Service Line at St. Luke’s and Roosevelt Hospitals.

When 61-year-old Franklin had his hip replaced three years ago, routine pre-operative work revealed that he had a heart rhythm disorder called atrial fibrillation (or AFib). Because he never had chest pain and never felt his heart beating irregularly, Franklin didn’t know anything was wrong. But fatigue and having low energy are two of the most common symptoms of AFib that people ignore.

“If you just haven’t been feeling normal, you shouldn’t accept it as a part of aging,” says Dr. Stephan Danik, Cardiac Electrophysiologist and Director of the Electrophysiology Laboratory at the Al-Sabah Arrhythmia Institute at St. Luke’s Hospital. “If you feel fatigued all the time and have cut back on things you used to do, especially if they require exertion, you should definitely talk to your doctor.”

Looking back, Franklin says it’s clear that something wasn’t right. “I had symptoms, but I didn’t know they were from atrial fibrillation. When I exercised, my pulse would race, but it was inconsistent. And sometimes I would get home and I couldn’t do anything but take a nap — and I never needed to do that before,” Franklin says.

Atrial fibrillation requires treatment

Atrial fibrillation is the most common sustained heart rhythm disorder, and occurs when the heart’s electrical system malfunctions and sends chaotic signals to the upper chambers of the heart (the atria). Those chambers are then unable to fully contract, and may beat more than 300 times per minute (average should be 60 to 100). Also, pooled blood in the atria can clot and dislodge, so patients are at a 500% higher risk for stroke. That makes prompt diagnosis and treatment, which can include blood thinners and minimally invasive procedures, very important.

Before Franklin was referred to Dr. Danik, he tried a number of medications and underwent a series of cardioversion procedures, which shock the heart through electrodes on the chest. The goal of cardioversion is to restore a normal heart rhythm, but for Franklin, it was unsuccessful. “I had a pretty stubborn case,” Franklin says. Dr. Danik estimated that Franklin’s heart had been out of normal sinus rhythm for about two years, and diagnosed him with persistent atrial fibrillation.

Cured with a catheter-based approach?

Dr. Danik recommended a more invasive technique called catheter ablation. Ablation procedures use catheters to create lesions of scar tissue on the heart muscle which block erratic electrical currents from traveling through the heart. Franklin’s first ablation, in December 2012, worked for just a few days. Unfortunately, a heart rhythm disturbance returned — this time, in the form of atrial flutter.

“Sometimes, patients who have longstanding atrial fibrillation can have an atypical atrial flutter after the first procedure. Actually, this is usually a positive next step, but some patients can feel more symptomatic, and that was the case with Franklin,” Dr. Danik says. The success rate for first ablations for patients with persistent AFib varies, but is typically about 60-70%; the success rate for second ablations is typically 75-85%.

Second time’s a charm

Franklin’s rapid heartbeat made it difficult for him to do anything because he was so exhausted all the time, so a second ablation was scheduled for April 2013. This one, a procedure at St. Luke’s Hospital, was a resounding success. “We were determined to cure him with the second ablation. We ended up ablating four different atrial flutters and finally, he broke into a normal rhythm and stayed there,” Dr. Danik says. “We just kept working on it and eventually got the outcome we were looking for.”

Franklin is very grateful he pursued treatments that ultimately cured his condition. “I feel like Dr. Danik didn’t give up until he fixed it,” Franklin says. “I feel so much better, and have energy again. It’s pretty amazing.” If Franklin makes it a year without any AFib episodes, his risk of stroke will have decreased and he won’t have to take a blood thinner anymore.

“I highly recommend Dr. Danik — he is a great doctor, and he treats you like a friend. Whenever I would call him, he would call back within about 30 minutes. I’ve never had a doctor do that before. It was outstanding,” Franklin says. “Also, I had a great experience at St. Luke’s. The staff was wonderful.”

To learn more about atrial fibrillation treatments, call 1-855-411-LWNY (5969) or visit the Al-Sabah Arrhythmia Institute website.

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