He was interested in catheter ablation due to intolerance of medications, and was referred to our facility. The patient was taken to the electrophysiologic laboratory. We performed electro-anatomic mapping in the right atrium with demonstration of late activation times. We then accessed the left atrium through a standard double trans-septal access. The circular catheter was then placed at the os of each pulmonary vein. The left superior pulmonary vein demonstrated the earliest potentials 40msec in advance of the surface p wave Figure 3.
We decided to ablate in this region, which was anatomically on the mid posterior wall of the left atrium at the os of the left superior pulmonary vein. Within several seconds of ablation, there was complete cessation of tachycardia. Atrial fibrillation is the most common type of tachycardia. Atrial flutter. In atrial flutter, the heart's atria beat very fast but at a regular rate.
The fast rate results in weak contractions of the atria. Atrial flutter is caused by irregular circuitry within the atria. Episodes of atrial flutter may go away themselves or may require treatment. People who have atrial flutter also often have atrial fibrillation at other times. Ventricular tachycardia. Ventricular tachycardia is a rapid heart rate that starts with abnormal electrical signals in the lower chambers of the heart ventricles.
The rapid heart rate doesn't allow the ventricles to fill and contract efficiently to pump enough blood to the body. Ventricular tachycardia episodes may be brief and last only a couple of seconds without causing harm.
But episodes lasting more than a few seconds can become a life-threatening medical emergency. Ventricular fibrillation. Ventricular fibrillation occurs when rapid, chaotic electrical impulses cause the lower heart chambers ventricles to quiver instead of pumping necessary blood to the body.
This can be deadly if the heart isn't restored to a normal rhythm within minutes with an electric shock to the heart defibrillation. Ventricular fibrillation may occur during or after a heart attack. Most people who have ventricular fibrillation have an underlying heart disease or have experienced serious trauma, such as being struck by lightning. Mayo Clinic electrophysiologist Fred Kusumoto, M. When your heart is beating too fast, it may not pump enough blood to the rest of your body.
This can starve your organs and tissues of oxygen and can cause the following tachycardia-related signs and symptoms:. Some people with tachycardia have no symptoms, and the condition is only discovered during a physical examination or with a heart-monitoring test called an electrocardiogram. A number of conditions can cause a rapid heart rate and tachycardia symptoms. It's important to get a prompt, accurate diagnosis and appropriate care.
See your doctor if you or your child has any tachycardia symptoms. If you faint, have difficulty breathing or have chest pain lasting more than a few minutes, get emergency care, or call or your local emergency number. Atrial fibrillation is associated with many cardiac conditions, including cardiomyopathy, coronary artery disease, valvular heart disease, ventricular hypertrophy and other associated conditions.
Atrial fibrillation has been associated with hyperthyroidism, acute alcohol intoxication, changes in the autonomic nervous system and is common after cardiac surgery. The most common condition associated with atrial fibrillation is high blood pressure.
Some people have atrial fibrillation with no obvious source or associated condition. This is more frequent in younger people and it is called "lone" atrial fibrillation.
It is likely that people who have this form of atrial fibrillation have had some inflammatory process or trauma to the atrium. Some people have a focal source that originates from the pulmonary veins.
Atrial fibrillation is a very rapid irregular rhythm in the top two chambers of the heart. If one were to look at the heart as it were fibrillating, it would look like a bowl of Jell-O quivering. Atrial fibrillation can be associated with a heart attack or a stroke. A heart attack is when an artery supplying blood to the heart blocks off, causing damage to the heart muscle. A stroke occurs when an area of the brain does not get enough blood supply, in some cases due to a blocked artery supplying blood to the brain.
This leads to brain damage and neurologic dysfunction. The reason that atrial fibrillation can be associated with, or cause, a stroke is because blood clots tend to form in the upper chambers, so-called atria, of the heart and these blood clots can break off and travel throughout the body, plugging up blood vessels. It can also travel to the heart and clog up a vessel creating a heart attack or it can travel to any other area of the body causing a blocking in an artery—to the leg, for example, in the eye or any other organ.
One form of atrial fibrillation that is treatable is so-called paroxysmal atrial fibrillation. This form of atrial fibrillation is more common in younger people and in people without serious underlying structural heart disease. In fact, this form of atrial fibrillation often occurs without any other underlying heart disease present. This paroxysmal form occurs when episodes of atrial fibrillation come for a short period of time and go away suddenly, to return later.
This form is often associated with frequent extra beats in the atrium. In the electrophysiology laboratory, much the same kind of a place as a cardiac catheterization laboratory, catheters with electrodes on the tips can be placed into the heart to "map" the initiation of atrial fibrillation. The technology in this regard is advancing rapidly. Much of this form of atrial fibrillation originates from the pulmonary veins so the procedure is quite involved.
It requires "transeptal puncture" to get the catheters to the left side of the heart. When the source is identified, an application of radiofrequency energy, or more recently, ultrasonic energy, is delivered to eliminate the spot creating the problem.
For this form of atrial fibrillation, the success rate has been reported to be as high as 80 percent. If multiple applications of energy are delivered into the site that triggers atrial fibrillation and if these sites are from the pulmonary vein, then it is possible to cause blockage of the pulmonary vein and this is a very dangerous situation.
I would not want to dissuade you from therapy since this therapy can be curative, but there are significant risks such that it would make sense to consider other therapies first to keep the rates low or to suppress episodes of atrial fibrillation.
Atrial fibrillation also can be cured by a surgical procedure known as a MAZE procedure. Percutaneous approaches in the electrophysiology laboratory have been tried to recreate this MAZE procedure to cure atrial fibrillation in people who have it more chronically, or persistently, than a person who has paroxysmal atrial fibrillation.
Atrial fibrillation can also go away on its own in some people. It tends to do this when there is a specific trigger such as coronary artery bypass surgery, hyperthyroidism, pericarditis, alcohol intoxication or other stimulants such as some of the over-the-counter supplements and even caffeine , other acute illnesses that cause extreme vomiting and some conditions that lead to overexertion.
In general, it is not a good idea to workout too vigorously with atrial fibrillation unless you have been carefully evaluated for underlying heart conditions by a doctor. Some people who have atrial fibrillation have significant problems with their heart and with exercise, the heart rate can race tremendously during atrial fibrillation, thereby exacerbating the underlying heart condition and may lead to problems such as very low blood pressure, heart failure or a loss of consciousness.
If the problem of atrial fibrillation has been well managed so that the rate is under control, or the rhythm is under control, it is possible to go back to standard physical activity in many cases. In fact, there are several professional athletes, including basketball players, who have atrial fibrillation present at times. New research from the U. Those who practice…. Avoiding or limiting certain foods can reduce the risk of an AFib episode. Take care to sidestep these food items if you live with the condition.
Researchers recently released study results where they used artificial intelligence to look over hundreds of thousands of EKGs and found a way to…. New guidelines are recommending newer drugs due to concerns over potential severe bleeding from warfarin use. Atrial fibrillation, or AFib, is an irregular heartbeat arrhythmia that can lead to blood clots, stroke, heart failure, and other heart-related….
Implants and devices are often able to control AFib and reduce blood clots. Learn more about this alternative to taking blood thinners. Health Conditions Discover Plan Connect. Atrial Fibrillation vs. Ventricular Fibrillation. Medically reviewed by Graham Rogers, M. What are the atria and ventricles? How does AFib affect the body?
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