DEAR DR. DONOHUE: I have been a heart arrhythmia patient since 1994. I have had electric cardioversions and various drugs. Amiodarone has controlled it for two years, but now my heart is fluttering again. I am to have an ablation procedure. If that is successful, what would it do for me? -- H.D.
ANSWER: I assume you have the most common heartbeat irregularity -- atrial fibrillation.
To initiate every heartbeat, the heart's natural pacemaker generates an electrical impulse that travels to the heart's pumping chambers, the ventricles, and causes them to contract and pump blood.
With atrial fibrillation, electrical impulses are in disarray. The result is a quivering of the upper heart chambers, the atria. Without contracting atria, the heart can lose up to 30 percent of its pumping capacity, and that often makes atrial fibrillation patients short of breath. Furthermore, the quivering atria pool blood. Pooled blood forms clots, and pieces of clots can break off and travel to the brain, where they cause strokes. That's why people with atrial fibrillation are put on blood thinners.
Medicines can sometimes get the heart back to a normal rhythm. Short of that, they slow the erratic heartbeat so the heart can at least pump blood more efficiently. A shock to the heart can often eliminate atrial fibrillation. It did not do so for you.
Ablation is a procedure where a soft, pliable tube is inched into the heart via a blood vessel. When it reaches a precise spot, the doctor activates its tip, which emits radio-frequency waves to destroy the connection between the atria and ventricles. That stops the jumble of electric messages from reaching the lower heart chambers and restores a normal beat. Sometimes a pacemaker must be implanted.
The benefit for you? If the procedure restores normal rhythm, you can go off your medicines. Your capacity for exercise will increase.
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