My recent articles have dealt with a common condition known as atrial fibrillation (A-fib). Recently, I received an email that wanted to know a little more about some of the surgical procedures that can correct A-fib. Of course, procedures such as cardiac ablation and implantation of a pacemaker are common in our area. For this reason, it is always a good idea to know some of the terminology and inner-workings.
As a quick reminder, our heart has electrical cells embedded within the tissue that send electrical signals down the line to tell our heart muscle to beat. Usually, this begins at the SA node and then travels down to the AV node in the center of the heart.
From there, the signal is spread throughout the bottom half of the heart by the PJ fiber network. Occasionally, a certain area of the heart that is not a designated pacemaker site will attempt to take over as the dominant pacemaker. Oftentimes, this new pacemaker will send far more signals that the heart can handle at one time. There can be a variety of reasons for this, but when it happens in the top half of the heart, we term it A-Fib.
Cardiac ablation is a surgical procedure that can be used to correct an area of cells that are trying to take over as the pacemaker of the heart. Usually, a patient will try a course of medications prior to a surgical procedure designed to control the irritable cells. However, if the A-fib is severe or if the medications fail, your physician might recommend an ablation procedure. The surgery attempts to scar and destroy the tissue section in the atrium that is causing the cells to misfire.
The hope is that the SA node will take back over as the dominant pacemaker after the offending cells are destroyed. This procedure can be done as open-heart surgery, but it is usually done using a less invasive technique by inserting a catheter going to the heart from an artery in the groin and then passing energy in the form of extreme heat or cold to the target area.
Another common method of treating A-fib or as treatment after a cardiac ablation is the implantation of a pacemaker device. The pacemaker works to take over as the dominate sender of signals to the heart. If the SA node becomes damaged or there is otherwise injury to the electrical pathways, a pacemaker device can be surgically implanted to allow a normal, regulated number of signals to come down the electrical highway to the rest of the heart. Furthermore, the device can send a constant pulse or only take over in the event that the heart rate slows down dangerously.
Of course, pacemakers and cardiac ablation are used to treat more than just A-fib conditions. These procedures can treat a host of heart-related illness such as atrial flutter, SVT, and ventricular dysrhythmias. Now is a great time to take control of cardiac health and reduce your risk factors for A-fib or other cardiac conditions.
Getting control of high blood pressure, sleep apnea, thyroid disease, and diabetes can drastically reduce your chances of developing issues. You can commit to a healthy lifestyle no what age or physical condition you have. As they say, home is where the heart is. Keep your heart healthy and at home for years to come.
Stay safe out there.
M. Eric Williams, MS, NR-P is a Mississippi native and Instructor of Emergency Medicine. He is a Doctoral Candidate in Higher Education and has 15 years’ experience in healthcare. If you have questions or comments, you may contact him at eric.williams@jcjc.edu.
