Arrhythmias – or heart rhythm disorders -- affect an estimated 1.5% to 5% of the population, with the likelihood increasing with age. The heart may beat too fast or too slowly or the rhythm can be erratic or even chaotic, and originate in any section of the heart. They can cause disturbing symptoms or go unnoticed until they show up incidentally or in a health crisis.
All that to say: arrhythmias are not normal. And they should be treated, not simply tolerated.
“To follow the sequence of the heart, especially from a rhythm standpoint, it’s a sequential beat, top to bottom,” explained cardiac electrophysiologist Raffaele Corbisiero, MD. “What we worry about the most is the bottom. Abnormal rhythms in the bottom part of the heart can be life-threatening, and need to be treated aggressively, and prophylactically, if possible.”
That’s the dreaded Ventricular fibrillation, or VFib, a major cause of sudden cardiac arrest. The upper chambers, or atria, can also produce accelerated or uncoordinated heartbeats. Left untreated, they can increase the risk of stroke, heart failure, and other cardiac complications.
The most common arrhythmia of the upper chambers is atrial fibrillation, or AFib, a condition that Dr. Corbisiero says can be diagnosed but not cured, and for which he also recommends early intervention.
“You want to be proactive,” he said. “So, as soon as AFib is diagnosed, the best treatment with the best long-term outcomes, is to go for the ablation. That’s the Number One therapy now.”
The heart’s internal electrical system routes precisely timed signals that regulate heartbeats; when there’s a fault in the circuit, ablation can correct it by delivering energy to the trouble spot from a catheter threaded into the heart.
While there have been major advances in ablations and the catheter-delivered devices that keep hearts in sync, cardiologists continue to demand ever more precision, to make these minimally invasive procedures even less so: smaller catheters for smaller incisions, combination devices and tools for fewer forays through the veins, more compact and longer-lived implantables, and even “organoid” heart models from human stem cells to test tissue response to new therapies.
Patients are already benefiting from cutting edge treatments at Deborah, and Dr. Corbisiero talks with KYW’s Rasa Kaye about them and the fascinating developments he expects to add to his tool box very soon.
Raffaele Corbisiero, MD.
