Posted by AnneL on October 28, 2003, at 15:26:51
In reply to Ablation, posted by wiggedout on October 28, 2003, at 12:31:05
Hi John,
I work for a large Cardiology practice as an RN and we specialize in Electrophysiology, or the diagnosis and treatment of electrical disorders of the heart's electrical conduction system. Atrial Fibrillation is one of the most common electrical arythmias and one of the most difficult to control, let alone cure. For those who are unfamiliar with atrial fibrillation it is a "supraventricular tachyarrhythmia characterized by uncoordinated atrial activation with consequent deterioration of atrial mechanical function". This means that the upper chambers of the heart (atrium) contract irregularly and rapidly. The current options are:
anti-coagulation, transesaphageal echocardiogram followed by elective cardioversion to get the heart back into sinus rhythm and/or anti-arrythmic medications for rate control and to help keep a patient in sinus rhythm. The two most important things to remember with afib is anti-coagulation if 65 or older (to prevent stroke) and restoring the heart to normal sinus rhythm asap. After allowing the heart to remain in afib for a long, long time, the heart's electrical system starts to "remodel" which can make conversion to sinus rhythm extremely difficult to maintain, if not impossible. Some causes of afib are disorders of the thyroid, structural heart disease and sometimes afib exists for reasons unknown. It can occur in any age, but if commonly seen in those 65 or older. Many people do not even know they have afib until they are at their annual physical and their doctor notices an irregular pulse and orders an ECG.Now for your question: Why don't more people get treated for Afib using Radiofrequency Ablation? The answer is two-fold. #1 Many Internists treat Afib and do not refer the patient out to a cardiologist, let alone a cardiologist who specializes in electrophysiology and #2 The current success rate for an "Ablation with Transeptal puncture and pulmonary vein isolation" for the treatment of afib remains around 60-70%. It is a low-risk procedure, but is generally offered to those who are drug refractory, highly symptomatic or simply cannot tolerate the meds. For further information go to the North American Society for Pacing and Electrophysiology at www.naspe.org
You can also look at the American College of Cardiology, European Society of Cardiology and American Heart Association Executive Summary "Guidelines for the Management of Patients with Atrial Fibrillation". (Committee to Develop Guidelines for the Management of Patients with Atrial Fibrillation).The Guidelines are a must read for any person with afib who wants to know more than the average joe and wants to be proactive in their care.
Take Care, AnneL
> Is anyone familiar with ablation, particulary what is the criteria they use to consider one a candidate for it? I think it would be good just to get it done and be over with the meds and worrying about going into a-fib at all. Why don't more people explore this alternative? It seems a lot of people on this forum choose to go the medication route and/or just live with the condition!?
>
> Thanks,
>
> John
poster:AnneL
thread:274315
URL: http://www.dr-bob.org/babble/20031025/msgs/274366.html