AFib Sufferers: Take Heart There's Help!

Atrial fibrillation or AFib is the most common heart rhythm disturbance in the U.S. It is typically characterized by irregular electrical activity in the upper chambers of the heart.

This chaotic beating can cause a range of symptoms, including breathing issues, fatigue, weakness, dizziness, palpitations, chest pain, and light headedness. AFib in itself is not life threatening, but it can put patients at risk for a stroke or heart failure if it remains untreated.

Listen in as Sujoya Dey, MD, explains that MarinHealth Medical Center offers a wide range of treatment options, including lifestyle modification, medications, and advanced procedures in our state-of-the-art Electrophysiology Lab.
AFib Sufferers: Take Heart There's Help!
Featuring:
Sujoya Dey, MD
Sujoya Dey, MD, is an Electrophysiologist and Medical Director of Electrophysiology at MarinHealth Medical Center.

Learn more about Sujoya Dey, MD
Transcription:

Bill Klaproth (Host): Atrial fibrillation or AFIB, is the most common heart rhythm disturbance in the US. It is typically characterized by a regular, electrical activity in the upper chambers of the heart, and here to talk with us about AFIB is, Dr. Sujoya Dey. An electro-physiologist and medical director of electro-physiology at MarinHealth Medical Center. Dr. Dey, thank you so much for your time today. So, let’s get into this. What exactly is Atrial fibrillation and what does it feel like?

Dr. Sujoya Dey (Guest): So, Atrial fibrillation is an irregular heartbeat that comes from the top chambers of heart. It’s usually caused by short-circuits in the heart, and people can have a range of symptoms. Sometimes they can feel like a thumping or a sense, like a fish bopping in the heart. Sometimes people can feel a sense of a rapid heartbeat, and other times, people may have no symptoms at all.

Bill: Well, I got to tell you that thumping or fish flopping in the heart has got to be very unsettling. So, who is at risk of developing AFIB?

Dr. Dey: Patients can be at risk for developing Atrial fibrillation because they may have a genetic tendency towards this issue, but the most common risk factors are tendency towards high blood pressure, obesity, sleep apnea, which are disturbances during sleep. Increased alcohol intake, caffeine intake, thyroid disorders or problems with the heart structure and function, that can cause these kinds of problems.

Bill: So, it sounds like there’s a whole range of things that could potentially cause this. And you said earlier, “Some people don’t feel anything”, right? They go in for a regular doctor’s exam, and its picked up on EKG, right?

Dr. Dey: Yes, that’s right. You’re absolutely correct. Some people don’t have any symptoms of this problem at all.

Bill: So, how do you diagnose this then?

Dr. Dey: So, if you have symptoms the best thing to do is bring it to the attention of your physician or medical team, but if you don’t have any symptoms then truthfully, it’s hard to figure out, and sometimes people may present with some of the consequences of Atrial fibrillation, which are, clot formation. Sometimes clots can go to the head and cause a stroke, and other times it can go to different parts of the body as well. So, I think pain attention and being at tune to these symptoms are important.

Another thing that people ascertain when they have Atrial fibrillation is, they may not know exactly what’s going on, but they may be running or biking and say, “Gosh, here I am doing the same hill, the same ride, and I just can’t do what I was doing before.” And it may be hard to figure out, they may not have the classic thumping or fish flopping sensation, but they may just say, “Boy, here I am doing my regular workout and I can’t do what I’m supposed to do.” Those kind of clues, they also help you figure out that something needs to be checked out, and those are often how we come to the diagnosis in the first place.

Bill: Well, that’s good to know, and that does have to be scary if you’re in that situation. So, can you talk about the different treatment options available?

Dr. Dey: Yes, absolutely. So, Atrial fibrillation, as we talked about before, is not life threatening. So, it can affect the quality of somebody’s life or their stamina, and increase the risk of other problems, but it does not… it’s not life threatening.

So, the ways to treat it are first to understand what is the root cause of it? As we talked about, sometimes there are causes that we can’t control, like, how we old are or our genetic background, but other times there are causes that we can control, like, our weight and our lifestyle changes, like, caffeine, alcohol intake, thyroid problems, etcetera. So, first step is understanding what the causes are and then coming up with a game plan to control it. Other causes, like, we talked were problems with the structure of the heart, other medical illnesses that can make the heart more irritable can bring it about too.

So, step one is identifying what’s bringing this about, and then step two is saying, “Okay, I’ve treated all the things that are potentially reversible and I’m still having this issue. Now, what am I going to do?” And the treatment options of Atrial fibrillation fall in two camps, one is trying to get the heart back to the normal rhythm that you were born with, and that strategy is called rhythm control. Another camp is to say, “I’m in Atrial fibrillation”, and note, make sure that the heart doesn’t get any extra strain from being in Atrial fibrillation, and calm down the heartbeat, and be on a blood thinner called a rate control, an anti-coagulation or being on a blood thinner. So, there’s two different strategies and two different large thinking of how to deal with Atrial fibrillation.

Bill: Okay, Dr. Dey. Can you talk more about medication versus ablation, and ablation is resetting the heart back to normal rhythm without using medication, is that right?

Dr. Dey: Right, medications can also be used to get the heart in the right rhythm, those are rhythm controlling medicines. Some medicines don’t work on controlling the heart rhythm, they just calm down the heartbeat, but leaving somebody in Atrial fibrillation and some medications really try to get the person back in the right rhythm. So, those are rhythm controlling medications or anti-arrhythmic, and another option for getting people in the right rhythm are ablation, cardioversions or even different kinds of procedures to do that. Cardioversion is an electrical zap to the chest, to try to reset or re-shock the heart back into the right rhythm, so that’s one-time procedure that’s done, that can help to reset the heart kind of resetting your computer, rebooting it.

Another way to do resetting the heart or getting back to a control of the rhythm of the heart is an ablation, where it can be done through catheter techniques, which are small IVs placed in blood vessels that access into the heart, map the locations where those problems are coming from, and really focus on targeting those particular places to get rid of these short-circuits in the heart.

Bill: And can you talk about the Get into Rhythm lifestyle management program, offered at MarinHealth?

Dr. Dey: Absolutely, as we talked about before, Atrial fibrillation can happen because of many issues. So, one of the things that I always talk to patients is that focusing on things that they can control and keeping that as a center point for their treatment for this problem. And Get into Rhythm is exactly that. It’s focusing on my cell modifications, such as weight control, stress management, high blood pressure, exercise management, to try to get people back into their own natural rhythm. So, it’s actually one of a kind, and it was garnered by community support in our Marin County because this was something that was so vital to really treat the patient holistically. Use the most advanced procedures and techniques, ablations, and also treat the patient’s lifestyle modifications that can really make an impact on the long-term recurrence of these problems.

Bill: And at MarinHealth Medical Center you’re very prepared for this. Can you talk about the electro-physiology laboratory there?

Dr. Dey: Absolutely. The electro-physiology laboratory has the latest techniques and procedures to treat Atrial fibrillation amongst other arrhythmias. We also focus on comprehensive approach for Atrial fibrillation, including appendage occlusion, all the latest techniques and most advanced mapping techniques for identifying the areas that are problematic, and then really focus on a tailored, targeted approach to what the particular patient needs.

Bill: And Dr. Dey, once you’re diagnosed with this, is this something you have for life or can it go away on its own? How does that work?

Dr. Dey: Sometimes it can go away on its own and it dissipates, but other times it may recur. Depending on what’s done to treat the problem and the underlying causes, either A or B may have it.

Bill: Very interesting. Well, I think one of the important things you said is, “You’re not going to die from this”, right? And I imagine a lot of people get very scared when they feel that in their chest.

Dr. Dey: Absolutely. I can only imagine that… the heart is such a beautiful thing. Here it is, pumping away and most people are completely unaware that this happening. Anywhere between 60 to 100 beats a minute at rest, but the moment you get that sensation that it’s beating or beating funny, it can cause a lot of unrest and uneasiness, and no matter where you are, whether you’re in a meeting at school or exercising. So, knowing that that’s not life-threatening and that we have a game plan, we can have a comprehensive approach to treat it is really reassuring for people.

Bill: And hearing you say, makes me think, the minute you feel that sensation in your chest don’t wait, right? You should probably call the doctor and make an appointment and get it checked out.

Dr. Dey: Absolutely, it’s the best thing to do is get attention, get it figured out, keep a log of your symptoms, and figure out what triggers it if anything. And then get it checked out straight away, and then you and your doctor can come up with a good game plan of how to help you.

Bill: Well, that’s terrific advice, and Dr. Dey, thank you so much for your time. For more information about AFIB, and the programs available at MarinHealth, visit www.mymarinhealth.org, that’s www.mymarinhealth.org. This is the Healing Podcast, brought to you by MarinHealth, I’m Bill Klaproth, thanks for listening.