How ablation, a treatment you’ve probably never heard of, helped this patient’s heart rhythm return to normal
Two years ago, a cardiologist recommended that Beth, now 76 years old, start monitoring her heart health at home. She had been experiencing periodic episodes of atrial fibrillation (also known as AFib), a condition
marked by an irregular heartbeat. “I’ve had AFib, on and off, for about three years, but it was very infrequent,” says Beth. “I would have an episode for, you know, 20 minutes and then not have one for three months.”
According to the Centers for Disease Control, AFib is the most common type of arrhythmia treated in the U.S. Left untreated, the condition can lead to serious complications such as stroke,
heart failure or even death. In February 2021, Beth noticed
that her episodes of AFib were increasing in both frequency and intensity. Using an app her doctor recommended, she saw that her heart was racing, at 140 beats per minute, even when she wasn’t engaged in physical activity. The National Institutes of Health say that a healthy resting heart rate is somewhere between 60 and 100 beats per minute.
Over the next several weeks, Beth met with doctors at the Hartford HealthCare Heart & Vascular Institute who determined that she had a mitral valve regurgitation, or a leaky heart valve. After initial evaluations, a surgeon advised Beth that if other treatments failed to improve her condition, she would have to undergo open-heart surgery to repair or replace the valve.
Dr. Aneesh Tolat specializes in cardiac electrophysiology at Hartford HealthCare and has been practicing since 2004. He was brought in to explore nonsurgical treatments for Beth.
The medical team first tried cardioversion, a procedure that involves sending electrical waves into the heart to “shock” the cardiac muscle back into a normal rhythm. After
the second cardioversion didn’t produce results, Beth was admitted to the hospital for five days while they tried a course of medication. At first, the medication improved the symptoms of AFib, but the effects did not last.
In May, as a last effort to control the rhythm before scheduling surgery, Dr. Tolat decided to perform an ablation.
“We did what’s called a cryoablation,” Dr. Tolat says. ”We used freezing technology inside the heart to perform an ablation, where we essentially isolate the areas that are firing.”
During an ablation, doctors create scar tissue in highly targeted areas of the veins
on the left atrial side of the heart, which have been found to be triggers for AFib. The procedure is much less invasive than surgery and has a shorter recovery time.
For Beth, the ablation was the treatment that finally returned her heart to a normal rhythm.
“Dr. Tolat was always so calm and so knowledgeable,” says Beth. “He told me that
we would be able to work on this and figure out what to do. And it worked.”
Recognizing the symptoms and risk factors of AFib
Because Beth was under the care of a doctor and regularly monitoring her heart rate, she
knew not to ignore the symptoms of atrial fibrillation. Signs include lightheadedness, extreme fatigue, being short of breath or chest pain. They can range from severe to mild. Some people have no symptoms at all. That’s why it’s vitally important to get
regular checkups and health screenings.
This condition is more prevalent in populations of European descent and older age groups. Because women tend to live longer than men, more women will develop AFib than men.
Dr. Tolat says that preventing AFib is all about staying healthy. “There are now known lifestyle risk factors that we talk to patients about, and weight is the biggest one,” he says. “People who are obese run a higher risk of developing AFib, and we think it’s due to inflammation.”
However, Dr. Tolat points out there are multiple other factors involved like high blood pressure, diabetes, obstructive sleep apnea and excessive alcohol use.
Today, Beth is still carefully monitoring her heart rhythms, but she is back to her normal activities.
“Most days, I’m either walking or I’m swimming laps in the pool, and I’m not out
of breath,” she says. “I will do the cardiac reading every day, and it comes up normal. So that’s reassuring.”
Beth also cautions that because AFib is so common, people may not take it seriously. She says, “One should always follow through and consult a doctor because all AFib, even
if intermittent, is serious.”
For more information about the Hartford HealthCare Heart & Vascular Institute, attend Hartford HealthCare’s Facebook Live event on Sep. 22 at 12:30 p.m. or call 833-444-0014.
—Jessica Chesler for Hartford HealthCare
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