Matt: Dr. Artang last week we talked about the slow heart rate. What about the about the fast heart rate.
Artang: There are many different kind of the fast heart rate conditions. The most common one that many in the audience may recognize is called Atrial Fibrillation. Atrial Fibrillation is a condition where the heart starts to beat fast and irregular. The exact cause of we really don't know but we know that it is more common in the elderly, patients with high blood pressure and patients with coronary artery disease or valve disease. It is becoming increasingly common condition with aging population. In the year 2000 over 2 million Americans had atrial fibrillation. It is projected that in 2050 more than 5 million Americans will have this condition. That is a lot of people with significant burden to the health care system.
Matt: So what are the symptoms of this condition?
Artang: it is really different from patient to patient. The one group of patients they know immediately that there is something that feels wrong in the chest. They may feel palpitation, shortness of breath, dizziness, fatigue.
We also experience people who have been in this condition in unknown amount of time but once they see their doctor for some other problems or annual physical, the doctor realizes that they are in Atrial Fibrillation.
Matt: What are the dangers having this condition?
Artang: The most devastating problem with this condition is, it increases the risk of getting a stroke. We know that average healthy 60-70 year old person's risk of having stroke is close to 1% or less. With atrial fibrillation this risk increases to up to 7% per year. That means out of 100 people with this condition, 7 of them will have a stroke within 1 year if untreated.
Matt: What do you do to treat this condition?
Artang: There are 2 goals in treating atrial fibrillation, one is to prevent stroke with a blood thinner medication such as warfarin also known as Coumadin, or newer drugs you might have seen the add for called dabigatran or pradaxa. The second goal is to try to make the heart go back to regular if possible with medication and an electric shock if necessary.
Matt: What else can be done for these patients?
Artang: In certain cases that do not respond to medication or even electric shock, we can place catheter in certain corners of the left upper chamber and make small burn marks that scars the tissue and stop the fast signal that comes from there. This is a procedure that may take up to 5-6 hours and the success rate is somewhere between 70-90% after one year. At this point most patient respond to the medical management or shocking. This procedure is only for minority of symptomatic patients.
