Arrhythmia/Atrial Fibrillation

Arrhythmia and Atrial Fibrillation

A healthy heart has a regular (rhythmic) pulse and beats between sixty and eighty times per minute. This heart rate is controlled by the heart's conduction system, resulting in a rhythmic contraction of the atria and ventricles of the heart. The frequency of the pulse can adapt to the stress to which the human body is exposed. During arrhythmia or atrial fibrillation, the heart sometimes - or continuously - fails to beat rhythmically, but is instead arrhythmic. In addition, its rate is too low (bradycardia) or too high (tachycardia), and is unable to adapt suitably to stress. This is caused by a disorder of the conduction system of the heart, leading to a partially erratic contraction of the walls of the atrium (heart rate 300-600 beats per minute). The result is a noticeable decline in physical strength, and if left untreated it can even lead to a stroke.

There are many possible causes of atrial fibrillation. These range from a disease of the coronary arteries to heart valve disorders, high blood pressure and diseases of the myocardium. Atrial fibrillation can also develop spontaneously, for no obvious reason.

Treatment for Atrial Fibrillation

In the initial stage, atrial fibrillation is treated with drugs. If it is accompanied by serious symptoms, it is possible to perform a minimally invasive catheter ablation.

Atrial fibrillation is often accompanied by a variety of cardiac disorders. If an operation is required to treat a structural problem, e.g. on the coronary arteries or heart valves, and the patient also suffers from atrial fibrillation, then surgery can be performed to treat the latter in the course of the same operation. This is done by ablating the atria during surgery. Specific areas of the atria are destroyed either externally or internally by applying heat (high-frequency ablation) or cold (cryoablation) to suppress fibrillation in the atria and allow the heart to beat regularly once more. Ablation can be performed during heart valve surgery or bypass surgery. In rare and serious cases where atrial fibrillation persists despite drug treatment and minimally invasive catheter ablation, surgical ablation can be performed independently.

The success of the operation depends primarily on the condition of the tissue and the size of the atrium, as well as on how long the patient has been suffering from atrial fibrillation. On average, the success rate (i.e. the restoration of a regular heartbeat) is between about 50 and 80%.

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Rhythmology
Rhythmology

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How safe is surgical ablation?

Ablation is generally performed during heart surgery, and will add just a few minutes to an operation. Any risk comes primarily from the main operation on the heart valves or coronary arteries. The risks associated with such operations depend upon your age and physical condition, whether you are suffering from any other health problems, and the urgency of the operation (whether it is an emergency or a planned procedure). The surgeon will discuss all the risks that apply in your specific case as part of a detailed consultation.