How the most common cardiac arrhythmia is treated

*The article is signed by the gentleman Ioannis Rassias, Interventional Cardiologist, Director of the Arrhythmias-Electrophysiology and Pacing Clinic at Metropolitan General.

Atrial fibrillation is the most common cardiac arrhythmia. In Greece, the number of patients is estimated at approximately 300,000, a number that is expected to increase in the coming years, due to the increase in life expectancy of the general population. It is estimated that in 2050 patients with atrial fibrillation in Europe will exceed 20,000,000, so we are talking about a very important medical problem that will continue to concern us in the future.

What is atrial fibrillation and what can it cause to patients?

In atrial fibrillation our heart contracts irregularly due to the rapid and chaotic contraction of the atria resulting in abnormal heart function. The symptomatology varies as patients may experience dizziness, easy fatigue, tendency to faint, shortness of breath and precardiac discomfort.
It has unpleasant complications, as it can cause stroke, heart failure and even death. To give you an idea of ​​the magnitude of the problem, it is estimated that every 15 seconds a patient with atrial fibrillation suffers a stroke even today with the tremendous advances in medical science.

How is atrial fibrillation treated?

The therapeutic approach of patients with atrial fibrillation has two goals:
1. The prophylaxis of patients from thromboembolic events and especially strokes which are the main complication of arrhythmia with the use of anticoagulant drugs.
2. The maintenance of the normal rhythm and the reduction of its recurrences which is achieved either with antiarrhythmic treatment or with ablation.

What is ablation

Atrial fibrillation ablation is an operation which aims to isolate the arrhythmogenic foci of the heart and mainly the pulmonary veins which are responsible for the majority of this arrhythmia.

With special catheters inserted from the veins of the lower extremities and guided into the heart, we find the foci we suspect are responsible for the arrhythmia and isolate them. This operation is performed with local anesthesia and mild sedation.

In the Μetropolitan General depending on the characteristics of the patients and the design of the operation, we use all the methods that are used internationally in the best nursing institutions, and more specifically the cryoablation method, the 3D mapping method and the use of catheters that deliver high-frequency current as well as the farapulse ablation which is the most modern is circulating internationally. The operation lasts from 1 to 2 hours and the next day the patient is discharged and goes home.

Which patients are suitable for this operation?

According to the guidelines of the European and American Heart Association, all patients can undergo this operation even as a first therapeutic approach without trying any antiarrhythmic treatment, especially when we refer to young patients with frequent episodes and severe symptoms.