by Susan Evans
Mary Ann Enstall, 71, was diagnosed with atrial fibrillation (A-Fib) more than 15 years ago. At the time, she opted to hold off on a surgery her physician recommended.
Last year, however, Enstall’s symptoms suddenly became more evident, particularly the fatigue.
And, during a routine physical, her internist became concerned with her rapid heartbeat.
A-Fib is the most common arrhythmia, or rhythm disorder, of the heart. Approximately three million American adults have been diagnosed with A-Fib, while another three million don’t even know they have it.
The risk of developing A-Fib increases with age. In fact, it’s the most common heart rhythm abnormality in people over 65.
Many people who have A-Fib describe their symptoms as having a sudden flutter in their chest, or unusual fatigue or often being out of breath. Frequently, people mistake A-Fib symptoms for stress, an anxiety attack or just fluctuating hormones.
Exploring A-Fib Treatment Options.
Concerned, Enstall’s internist prescribed anti-arrhythmic medications to help regulate her heart beat.
“I was beginning to worry that I might have a stroke, so I was hopeful these medications could control my racing heart,” she said.
Unfortunately, the drugs made her groggy, lethargic and unable to function.
That’s when her internist referred her to Andrew Krainik, MD, a cardiac electrophysiologist at Missouri Baptist’s Arrhythmia Center. Dr. Krainik reviewed her medical history and performed a total assessment of her condition.
“I knew she had tried several medications before coming to me,” said Dr. Krainik. “However, I recommended she try newer anti-arrhythmic drugs to see if they might help. My goal with patients is to always take a conservative approach before recommending a procedure.”
For Enstall, the first medication proved ineffective, and she couldn’t tolerate the side effects of the second.
That’s when Dr. Krainik recommended cardiac ablation to treat her symptoms and eliminate the need for anti-arrhythmic medications. New research shows that when medications fail to control arrhythmias, the sooner a patient has cardiac ablation, the more likely it is to be successful.
Treating A-Fib with Cardiac Ablation.
“Dr. Krainik really took the time to explain everything to me. He even explained it to my family members who had questions,” she said.
Enstall felt comfortable with the idea of undergoing a cardiac ablation because it’s not surgery. Instead of opening up the heart, it fixes the heart from within by threading catheters (with electrodes on the ends) from a blood vessel in the groin up into the heart under X-ray guidance.
Then, the doctor uses either extreme heat or extreme cold to “freeze” the abnormal heart tissue that generates the irregular heartbeats. It’s a minimally invasive procedure that takes only a few hours and patients feel little to no discomfort.
Enstall had her cardiac ablation in January, 2013. During the three-hour procedure, Dr. Krainik used radiofrequency (heat) to cauterize the abnormal heart tissue responsible for her arrhythmia.
“It was a fairly routine procedure with no complications,” said Dr. Krainik. “More importantly, we believe the cardiac ablation successfully controlled Mary Ann’s A-Fib.”
Enstall responded well to the procedure, experiencing no pain or adverse side effects. After a few hours in recovery, she was able to walk around the halls, and go home the next morning.
She had to take a blood thinner and avoid heavy lifting for two weeks. Otherwise, she could go about her normal routine.
Now, Enstall no longer takes anti-arrhythmic medications or blood thinners, and she will see Dr. Krainik annually to confirm her A-Fib remains under control.
Benefits of Cardiac Ablation.
In Enstall’s case, cardiac ablation was the best treatment option for her A-Fib.
Today, the technology used in cardiac ablation procedures has become more advanced.
Many cardiac electrophysiologists – including Dr. Krainik and others at Missouri Baptist Medical Center – are using a Stereotaxis robotic navigation system to perform cardiac ablations. By improving and extending a doctor’s reach, this system provides greater precision and safety compared to traditional manual ablations.
“I’m really thankful I had the surgery. I’m no longer exhausted and my pulse doesn’t race like it used to,” said Enstall. “Plus, I believe I’ve helped reduce my risk for a possible stroke.”
Fortunately, if treated properly, A-Fib is not usually life-threatening. There are many ways to manage A-Fib and even reverse the arrhythmia, including medication and therapeutic procedures. However, as A-Fib progresses and begins to disrupt a patient’s quality of life, the best option is often a cardiac ablation procedure.
Andrew Krainik, MD, is board-certified in cardiology and electrophysiology, on-staff at Missouri Baptist and a member of BJC Medical Group. He received his medical degree from the University of Illinois in Chicago and completed his internship, residency and fellowship at Washington University School of Medicine.