Fibrillation refers to an irregularly rapid and disordered heartbeat, known medically as an arrhythmia. Arrhythmias stem from issues within the heart's electrical system. A specific type of this irregular rhythm occurs in the upper chambers of the heart, called the atria, and is termed atrial fibrillation, which happens to be the most prevalent form of arrhythmia.

Atrial fibrillation entails not just an accelerated heart rate, but also a chaotic rhythm. The atria attempt to contract at a staggering rate of 200-300 times per minute, in contrast to the normal 60-100 beats per minute. This rapid activity resembles quivering rather than the regular beating motion. Consequently, there's insufficient time for the atria to adequately fill with blood before it is pumped into the lower chambers, or ventricles.

During atrial fibrillation, the pumping rate within the ventricles fluctuates widely. It can oscillate from 80 to 40 to 100 beats per minute, all within a few seconds. This explains why common symptoms include fatigue and breathlessness.

However, atrial fibrillation poses a more significant risk. Because blood tends to pool in the atria instead of being pumped out efficiently, there's an elevated likelihood of blood clot formation. If such a clot travels through an artery to the brain, it can trigger a stroke. This heightened stroke risk is a major concern for individuals with atrial fibrillation. Thankfully, upon diagnosis, treatment measures can substantially reduce this risk.

What is the cause of Atrial Fibrilation?

Atrial fibrillation arises due to a disruption in the normal electrical activity of the heart. Typically, electrical signals follow a specific pathway, orchestrating the heart's contractions. However, in the case of atrial fibrillation, the atria receive an excessive number of signals. Moreover, these signals deviate from their usual routes.

The origins of atrial fibrillation can vary among individuals. The abnormal electrical impulses may be attributed to factors such as:

1. Aging

2. Coronary artery disease (CAD)

3. Elevated blood pressure

4. Heart valve disorders

5. Congenital heart conditions (present from birth)

6. Sleep apnea

7. Excessive alcohol consumption

What are the symptoms of Atrial Fibrilation

Symptoms of atrial fibrillation vary. Some people have palpitations (a feeling that your heart is racing or that your heartbeat is irregular). Other people have fatigue, weakness, or shortness of breath.

What tests could I have?

Your doctor may commence with a blood pressure assessment, as low blood pressure can be an indicator of atrial fibrillation. Following this, your doctor may recommend one or several of the tests mentioned below. These test outcomes will aid your doctor in determining the most suitable treatment options for you.

In certain instances, you might be referred to specialized practitioners for further diagnosis, testing, and sometimes, treatment. For additional information, refer to the Your Treatment Team section.

1. Echocardiogram

2. Electrocardiogram (ECG or EKG)

3. Electrophysiology (EP) Study

4. Event Recorder

5. Holter Monitoring

What is an echocardiogram?

An echocardiogram, often referred to as an echo, provides a dynamic three-dimensional view of your heart. This imaging technique utilizes Doppler ultrasound technology, similar to the ultrasound scans performed during pregnancy. In this procedure, the echo machine emits sound waves at a frequency beyond human hearing. These waves traverse through the chest and heart, bouncing back or "echoing" off the heart's structures. This process allows for the visualization of:

1. The heart's shape and dimensions

2. The functionality of heart valves

3. The effectiveness of heart chamber contractions

4. The ejection fraction (EF), which indicates the volume of blood ejected by the heart with each beat.

What can I expect?

During an echocardiogram, you'll be asked to undress from the waist up and put on a hospital gown. You'll then lie down on an examination table. The technician will apply a gel on your chest and side to aid in transmitting the sound waves. Using a pen-like instrument called a transducer, the technician will gently move it around on your chest or side to capture the echoes of the sound waves. Simultaneously, a dynamic image of your heart will be displayed on a specialized monitor. Throughout the test, you may be requested to change positions, lying on your back or side. There might also be moments when you'll be asked to hold your breath briefly to facilitate a clear image of your heart. It's important to note that an echocardiogram is a painless procedure, with only a mild pressure sensation on your skin as the transducer moves.

What is an ECG?

An electrocardiogram (ECG or EKG) provides insight into the functioning of your heart's electrical system. It detects and documents your heartbeats, or cardiac rhythms, with the results being printed on a paper strip. An ECG is valuable for your doctor in assessing:

1. Arrhythmias

2. The effectiveness of your heart medication

3. Whether blocked coronary arteries are depriving your heart muscle of blood and oxygen

4. If blocked coronary arteries have led to a heart attack

There are three types of tests for recording your heart's electrical activity, each covering a different duration:

1. Electrocardiogram (ECG) - conducted in the doctor's office, it records your heart rhythms for a few minutes.

2. Holter monitoring - it records and stores all your heart rhythms over 24-48 hours.

3. Holter recorder - it continually records your heart rhythms, but only stores them (in its memory) when you press a button.

What are the parts of an ECG strip?

On an electrocardiogram (ECG) strip, the elevations and depressions are referred to as waves. Collectively, these peaks and valleys offer valuable insights into your heart's performance:

• The P-wave indicates the contraction of the upper chambers (atria) of your heart.

• The QRS complex signifies the contraction of the lower chambers (ventricles) of your heart.

• The T-wave indicates the relaxation of the ventricles of your heart.

What can I expect?

During an electrocardiogram (ECG), you'll be asked to remove clothing from the waist up and wear a hospital gown. You'll then lie down on an examination table. About 12 small patches, known as electrodes, will be affixed to your chest, neck, arms, and legs. These electrodes are linked to wires connected to the ECG machine, which picks up the electrical signals of your heart. Subsequently, the machine records your heart's rhythm on a strip of graph paper.

What is an EP study?

An electrophysiology (EP) study provides a comprehensive examination of your heart's electrical system, going beyond what an electrocardiogram (ECG) reveals. It's particularly useful in pinpointing details about abnormal heart rhythms, known as arrhythmias. This study can determine if you have an arrhythmia, locate where it originates in the heart, and assess your risk for sudden cardiac arrest (SCA).

The EP study commences with the insertion of one or more leads into a blood vessel, typically in the groin area. The doctor guides these leads toward the heart. Once in position, they pick up on your heart's electrical activity. One specialized lead also administers electrical signals to your heart to induce an arrhythmia. This helps gauge how easily your heart can generate arrhythmias on its own.

Throughout the EP study, your doctor diligently monitors your heartbeats. If an arrhythmia occurs, you may receive treatment through medications delivered via the intravenous (IV) line in your arm or hand, or through electrical signals applied to the outside of your chest via patches.

In some instances, ablation (a specific form of treatment) may be conducted concurrently with the EP study. Alternatively, your doctor might recommend other types of treatment based on the findings of the EP study.

What can I expect?

Your test will take place in a specialized room called a "cath lab." You'll change into a hospital gown or be covered with a sheet and lie down on an examination table. An intravenous (IV) line will be inserted into your arm to administer fluids and medications during the test. These medications might make you feel a bit drowsy, but you'll remain awake. Electrodes, which are small patches, will be affixed to your chest to monitor your heart's electrical signals throughout the test. Additionally, a blood pressure cuff on your arm will regularly measure your blood pressure.

The doctor will make a small incision, usually in your groin, to insert the catheter. The area will be numbed to minimize any discomfort, though you might still feel a slight pressure as the catheter is placed. If the doctor administers electrical signals to your heart, you may feel sensations like your heart racing or pounding. You won't be fully asleep, so your doctor or nurse may ask you questions during the test.

Afterward, you might stay in the hospital overnight, although most individuals recover quite quickly.

What is an event recorder?

An event recorder is a compact device that monitors the electrical activity of your heart. It does so continuously over an extended period, typically ranging from a week to a month or even longer. While the recorder is always active, it records and stores your heart rhythms in its memory only when you press a button. Most recorders store recordings of your heart rhythms for about 30 to 60 seconds both before and after you initiate the recording.

This device is invaluable in helping your doctor identify abnormal heart rhythms, known as arrhythmias. Even if these arrhythmias occur infrequently, it's crucial for your doctor to be informed so appropriate treatment can be provided.

In summary, there are three types of tests that record your heart's electrical activity, each designed for a different duration:

1. Electrocardiogram (ECG): Conducted in the doctor's office, it records your heart rhythms for a few minutes.

2. Holter monitoring: It records and retains (in its memory) all your heart rhythms over 24 to 48 hours.

3. Event recorder: It continually records your heart rhythms, but it stores the data (in its memory) only upon your command.

When the heart rhythms from any of these tests are printed out, they all exhibit a similar pattern: the electrical signals resemble peaks and valleys. An event recorder may be recommended if you experience symptoms only sporadically, such as once a week or once a month.

What can I expect?

Two adhesive patches, known as electrodes, are affixed to your chest. These electrodes are connected to wires on the event recorder. They serve to detect your heart rhythms, which are then recorded and stored by the event recorder. Your doctor or nurse will provide instructions on how to remove the electrodes for bathing and reapply them afterwards. The event recording device itself is compact, about the size of a small portable tape recorder, and can be easily secured to a belt or placed in a pocket.

When you experience symptoms, you simply press the button. This action prompts the device to save a short segment of the recordings. It's a good idea to familiarize your family and friends with this process, so they can assist you in case you're unable to press the recorder yourself during an episode. Any saved recordings can be transmitted to your doctor's office, clinic, or hospital. The staff will inform you if further consultation with your doctor is necessary.

While using the event recorder, you should be able to carry out most, if not all, of your daily activities at home and work. You won't feel any sensation while the event recorder monitors your heart rhythms. However, be aware that occasionally, the adhesive patches may lead to mild skin irritation.

What is Holter monitoring?

Holter monitoring uses a small recording device called a Holter monitor. The monitor tracks and records your heart's electrical activity, usually for 24-48 hours.

Holter monitoring can help your doctor find out if you have abnormal heart rhythms, or arrhythmias. Arrhythmias might happen rarely, yet it is still important for your doctor to know about them and to treat them.

In all, there are three kinds of tests that record your heart's electrical activity, each for a different period of time:

• Electrocardiogram (ECG)-done in the doctor's office. It records your heart rhythms for a few minutes.
• Holter monitoring-records and stores (in its memory) all of your heart rhythms for 24-48 hours.
• Event recorder-constantly tracks your heart rhythms. But it stores the rhythms (in its memory) only when you push the button.

When the heart rhythms from any of these three tests are printed out, they all look the same: the electrical signals look like peaks and valleys. A doctor may suggest Holter monitoring when you have symptoms at least once every day or two.

Your doctor may ask you to write down any symptoms you have during the test. Symptoms might include faintness, dizziness, or fluttering in the chest. You should note the time and how long the symptoms last. Your doctor might also ask you to write down when you exercise, take medications, or get upset. This can help your doctor see if there is a connection between your heart rhythms and your symptoms or activities.

What can I expect?

You'll have around four to seven adhesive patches, often called electrodes, attached to your chest. These electrodes are linked to wires on the Holter monitor. They are responsible for detecting your heart rhythms, which are then recorded and stored by the monitor. Since the electrodes are not waterproof, it's important to complete your shower or bath before starting the Holter monitoring, and avoid getting them wet during the test. The Holter monitor device itself is about the size of a compact portable tape recorder. It's convenient to secure it to a belt or wear it using a shoulder strap.

While using the Holter monitor, you should be able to carry out most, if not all, of your daily activities at home and work. You won't perceive any sensation while the Holter monitor keeps track of your heart rhythms. After 24-48 hours, you return the monitor. A technician reviews the recordings, makes note of any arrhythmias, and compiles a report for your doctor.

What are the treatment options?

Your treatment depends on your test results. Your doctor may recommend one or more of these medications or procedures.

Medications

• Antiarrhythmics
• Anticoag uIants
• Beta Blockers
• Calcium Channel Blockers
• Inotropes
• Vasodilators

Procedures

• Ablation
• Maze Procedure
• Pacemaker Implant

Tips for Taking Heart Medications

For those with heart or blood vessel conditions, understanding the medications they take is crucial. This section provides information on commonly prescribed medications for such conditions, along with tips on proper adherence.

It's vital to inform your doctor, especially if they prescribe new medication, about all the medicines and supplements you're currently using. This ensures you receive the maximum benefit and prevents potentially harmful interactions.

During each instance of receiving a new medication, consider discussing the following with your doctor or nurse:

1. The purpose of the medication, its anticipated advantages, and potential side effects.

2. Proper dosage and timing for taking the medication.

3. Any other medicines, vitamins, supplements, or over-the-counter products you're using.

4. Understand that adjusting to new medications can take time, sometimes several months. Immediate improvements might not be noticeable, and determining the correct dosage may also require some time.

Occasionally, blood tests are essential for individuals on heart medications. These tests assist your doctor in establishing the right dosage, consequently avoiding adverse effects.

Remember, never alter your medication regimen or dosage independently, whether due to perceived ineffectiveness, feeling fine without it, or any other reason.

If you encounter:

1. Queries about the mechanisms of your medications.

2. Unpleasant side effects.

3. Difficulty in adhering to your prescribed regimen.

4. Financial challenges in obtaining your medications.

5. Any other obstacles preventing you from taking your medications as directed.

Make it a point to communicate with your doctor or nurse. Additionally, don't hesitate to consult your pharmacist regarding any queries about the administration and timing of your medications.

Antiarrhyth mics

Antiarrhythmics work on the heart's electrical system. The term itself gives a clue to their purpose: "Anti" means counter or against, and "arrhythmia" refers to an abnormal heartbeat or heart rhythm.

Some generic (and Brand) names

Every medication is sanctioned by the Food and Drug Administration (FDA) for a particular set of patients or conditions. Only your doctor is aware of which medications are suitable for you.

Here are some examples:

• amiodarone (Cordarone, Pacerone)

• disopyramide (Norpace)

• dofetilide (Tikosyn)

• flecainide (Tambocor)

• procainamide (Procanbid)

• propafenone (Rythmol)

• quinidine (Quinaglute)

In some cases, medications from other categories like beta blockers and calcium channel blockers are also employed to help prevent arrhythmias.

What they're used for

To prevent and treat arrhythmias (abnormally fast or slow heartbeats, or heart rhythms) To restore normal heart rhythms

How they work

Antiarrhythmic medications function through various mechanisms to alter the electrical activity in your heart. Different drugs are employed because arrhythmias can originate from various locations in the heart.

The use of antiarrhythmics can:

1. Reinstate a regular heart rhythm.

2. Avert excessively rapid rhythms.

Anticoagulants (Blood Thinners)

You can understand the purpose of anticoagulants by looking at the root words of the term. Anti = counter or against; coagulant = thicken or clot.

Some Generic (and Brand) Names

Every medication is sanctioned by the Food and Drug Administration (FDA) for a particular set of patients or conditions. Your doctor is the only one who can determine which medications are suitable for your situation.

Examples include:

• clopidogrel (Plavix)

• ticlopidine (Ticlid)

• warfarin (Coumadin)

What They're Used For

To reduce the risk of blood clots that could lead to stroke and other medical conditions

How they work

Anticoagulants are commonly referred to as blood thinners, even though they don't actually thin the blood. Instead, they help prevent the formation of clots in the bloodstream.

These medications are prescribed for conditions related to atherosclerosis, where arteries become blocked due to plaque buildup. Plaque accumulation can lead to clot formation.

A clot in the coronary arteries, responsible for supplying blood to the heart muscle, can result in angina (chest pain). This condition, characterized by clots or blockages in the coronary arteries, is known as coronary artery disease (CAD) and can potentially lead to a heart attack.

In the carotid arteries located in the neck, a clot may travel to the brain, potentially causing a stroke.

In the vessels of the arms or legs, a condition known as peripheral vascular disease (PVD), clots can lead to pain.

Taking anticoagulant medications can:

• Decrease the blood's stickiness

• Lower the likelihood of blood clot formation

How They Work

Beta blockers get their name because they "block" the effects of substances like adrenaline on your body's "beta receptors."

Some generic (and brand) names

Every medication undergoes thorough evaluation and approval by the Food and Drug Administration (FDA) based on specific criteria related to patient groups or conditions. Your doctor is the best person to determine which medications are suitable for your unique situation.

Here is a list of some commonly prescribed beta-blocker medications:

• acebutolol (Monitan)

• atenolol (Tenormin)

• betaxolol (Kerlone)

• bisoprolol (Zebeta)

• carteolol (Cartrol)

• carvedilol (Coreg)

• metoprolol (Lopressor, Toprol)

• nadolol (Corgard)

• penbutolol (Levatol)

• pindolol (Visken)

• propranolol (lnderal)

• sotalol (Betapace, Sorine)

• timolol (Blocadren)

Remember, only your doctor can determine which of these medications, if any, are suitable for your specific needs.

What they're used for

These medications are prescribed for various cardiovascular purposes:

1. Managing elevated blood pressure.

2. Slowing down rapid arrhythmias, which refer to abnormal heartbeats or heart rhythms.

3. Alleviating angina, a condition characterized by chest pain arising from restricted blood flow to specific areas of the heart.

4. Mitigating potential long-term repercussions following a heart attack.

5. Addressing heart failure and associated conditions, including cases of low ejection fraction (EF).

What they're used for

Beta blockers function by inhibiting the activity of your sympathetic nervous system. This system is activated during periods of stress or in the presence of specific health conditions. When triggered, it leads to an accelerated and forceful heartbeat, along with an increase in blood pressure.

By intercepting signals from the sympathetic nervous system, beta blockers induce two effects:

1. Reduction in heart rate

2. Prevention of blood vessel constriction

These combined actions typically lead to:

• Decreased heart rate

• Lowered blood pressure

• Alleviated angina (chest pain associated with heart conditions)

Calcium Channel Blockers

Calcium channel blockers help relax the heart muscle and blood vessels.

Some generic (and Brand) names

Every medication receives approval from the Food and Drug Administration (FDA) based on its suitability for specific patient groups or conditions. Your doctor is the best person to determine which medications are suitable for you.

Here are some examples of medications and their brand names:

• Amlodipine (Brand name: Norvasc)

• Diltiazem (Brand names: Cardizem, Dilacor, Diltia, Tiazac, Taztia)

• Isradipine (Brand name: DynaCirc)

• Nicardipine (Brand name: Cardena)

• Nifedipine (Brand names: Adalat, Procardia)

• Verapamil (Brand names: Galan, Covera, Isoptin, Verelan)

What they're used for

• To treat high blood pressure
• To treat angina (chest pain) which can result from atherosclerosis (blocked blood vessels) and coronary artery disease (CAD)
• To treat some arrhythmias (abnormal heartbeats, or heart rhythms)- usually fast arrhythmias

How they work

Calcium channel blockers hinder the entry of calcium into specific cell regions within blood vessels. This action leads to the relaxation of both the blood vessels and the heart. Consequently, calcium channel blockers:

1. Reduce the heart's workload by facilitating increased blood and oxygen supply to the heart muscle.

2. Diminish the heart rate.

3. Lower blood pressure.

lnotropes

The word "inotrope" refers to the strength of the heart muscle's pumping action, or contractions.

Some generic (and Brand) names

Every medication is sanctioned by the Food and Drug Administration (FDA) for a particular patient group or condition. Your doctor is the sole authority to determine which medications are suitable for you.

digoxin (Digitek, Lanoxicaps, Lanoxin)

What they're used for

• To improve symptoms of heart failure and related conditions, such as low ejection fraction (EF)
• To slow the heart rate in response to atrial fibrillation (fast rhythm in the heart's upper chambers)

How they work

The term "inotrope" describes the strength and force of the heartbeat. Taking inotropic medications can:

• Make the heart beat more strongly and efficiently
• Make the heart beat more strongly and efficiently

Vasodilators

Vasodilators serve the purpose of reducing blood pressure. To grasp their mechanism, envision the flow of the same volume of water through a 1-inch diameter hose compared to a 2-inch diameter hose. The larger hose exerts less pressure on its walls.

Vasodilator medications work by aiding in the relaxation and dilation of narrowed (constricted) blood vessels.

Some generic (and Brand) names

The Food and Drug Administration (FDA) approves all medications for specific patient groups or conditions. Your doctor is the best person to determine which medications are suitable for you.

Here is a list of some commonly used vasodilator medications:

1. Doxazosin (Cardura)

2. Guanabenz (Wytensin)

3. Guanfacine (Tenex)

4. Hydralazine (Apresoline)

5. Isosorbide mononitrate (Imdur, ISMO, Monoket)

6. Methyldopa (Aldomet)

7. Minoxidil (Loniten)

8. Nitroglycerin (Minitran, Nitro-Bid, Nitro-Dur, Nitrogard, Nitrolingual, NitroQuick, Nitrostat)

9. Prazosin (Minipress)

10. Reserpine (Serpalan)

11. Terazosin (Hytrin)

You might have come across other types of vasodilators, including beta blockers, which are a common medication for heart and blood vessel conditions. Another category is calcium channel blockers. Remember, it's crucial to consult with your doctor before starting any medication.

What they're used for

• To treat high blood pressure
• To treat/prevent angina (chest pain related to the heart) which can result from atherosclerosis (blocked blood vessels) and coronary artery disease (CAD)

How they work

Vasodilators work by relaxing and widening the blood vessels, facilitating smoother blood flow. This serves to:

1. Reduce blood pressure.

2. Ease the workload on the heart.

3. Alleviate angina (chest pain).

What is ablation?

Ablation is a procedure that involves the deliberate destruction (ablation) of specific areas of the heart muscle. The doctor selects precise regions of the heart muscle for treatment and administers controlled amounts of energy to create beneficial scars, known as lesions.

This procedure can be performed either as a surgical intervention or by using a catheter, which is a flexible tube inserted into a blood vessel.

Your physician will determine whether catheter ablation or surgical ablation is the most suitable option for you. This section provides information on both catheter and surgical ablation procedures.

Ablation is also referred to by other names, including cardiac ablation, cryoablation, microwave ablation, radiofrequency ablation, and surgical ablation.

How is it done?

Catheter ablation

This form of ablation doesn't necessitate any chest incisions. It commences with a catheterization, wherein a pliable tube known as a catheter is inserted through a blood vessel, usually in your groin (or occasionally in your neck). Your doctor guides the catheter into your heart. Real-time images, or dynamic x-rays called fluoroscopy, enable your doctor to visualize the catheter's movement.

The electrode at the catheter's tip detects your heart's electrical signals and records electrical readings. Your doctor assesses your heart's function and subsequently performs "ablation" by treating specific sections of the muscle tissue using the catheter. Catheter ablation can be conducted through:

Extreme cold, referred to as cryoablation

High-frequency energy, known as radiofrequency ablation

In specific instances, particularly when ablation targets particular regions of the heart, you might require a pacemaker following the procedure.

Minimally invasive surgical ablation

For the first type, which is minimally invasive surgical ablation, your doctor makes six small incisions on the sides of your chest. These incisions are typically between % to % inches in size, considerably smaller than those required for traditional open-heart surgery. Through these openings, a tiny camera is inserted to provide a visual of the heart. Small instruments are then used to examine and ablate the necessary tissue.

The second type, minimally invasive surgical ablation, involves a lengthier incision down the middle of the chest, through the breastbone (sternum). This form of ablation is typically performed when additional treatments, such as valve replacement or bypass surgery, are also required.

Both forms of surgical ablation involve your doctor ablating specific sections of the heart muscle tissue by administering energy to the heart, thereby creating lesions or scars. Various methods of energy delivery can be employed in surgical ablation, including:

1. Cryoablation, which uses intense cold.

2. Microwave ablation, utilizing microwave energy.

3. Radiofrequency ablation, employing high-frequency energy.

4. Ultrasound energy.

5. Laser energy.

What can I expect?

Typically, you'll receive instructions to refrain from eating or drinking for a specified number of hours prior to the procedure. Catheter ablation takes place in a specialized room known as the "cath lab," while surgical ablation is conducted in an operating room. Once you're settled on the examination table, a needle is inserted into your arm to establish an intravenous (IV) line, which will deliver essential fluids and medications.

Below, we'll delve into some specific details about each type of procedure or surgery.

Catheter ablation

The intravenous (IV) medications induce a state of grogginess, but not complete unconsciousness. When inserting the catheter, the doctor makes a small incision in the groin (or occasionally the neck), but not in the chest. The area will be anesthetized to minimize any potential pain, although you might still experience some pressure as the catheter is inserted. Throughout the ablation procedure, your doctor or nurse may inquire about your well-being. Following the procedure, there's a possibility of an overnight stay in the hospital.

Minimally invasive surgical ablation

During a surgical ablation, you will receive medication that makes you unconscious. You will not be aware of the incisions made in the side of your chest, or of the ablation itself. After surgery you will probably be in the hospital for one to two days.

Open-heart surgical ablation

In a surgical ablation, you'll be administered medication that induces unconsciousness. Consequently, you won't be conscious of the chest incision or the ablation procedure itself. Post-surgery, you might stay in the hospital for a few days. You could experience discomfort at the incision site for a few weeks. Your recovery process will be influenced, in part, by any other concurrent heart surgery you underwent alongside the ablation.

Ablation References

Atrial Fibrillation: In a report by the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences, guidelines for managing patients with atrial fibrillation were outlined (Fuster V, Ryden LE, Asinger RW, et al. Circulation. 2001;104:2118-2150).

Supraventricular Tachycardia: An executive summary from the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines provided guidelines for managing patients with supraventricular arrhythmias (Blomstrom-Lundqvist C, Scheinman MM, Aliot EM, et al. J Am Coll Cardiol. 2003;42:1493-1531).

Ventricular Tachycardia: The North American Society of Pacing and Electrophysiology (NASPE) issued a Policy Statement on Catheter Ablation, offering recommendations on personnel, policy, procedures, and therapeutics for treating ventricular tachycardia (Scheinman M, Calkins H, Gillette P, et al. PACE. 2003;26:789-799).

Maze Procedure

A maze procedure is a method for halting erratic electrical signals within the atria. It involves creating numerous small incisions in the heart tissue to disrupt these irregular signals. Despite being referred to as a "procedure," it is often conducted as a form of open-heart surgery necessitating general anesthesia.

The physician crafts a labyrinthine pattern of minuscule incisions in the atrial tissue, resulting in the formation of scar tissue. This scar tissue acts as an obstacle to the flow of electrical signals. Due to the multitude of small incisions, the electrical signals can no longer induce chaotic rhythms. Instead, they are compelled to follow a single pathway from the top to the bottom of the atria.

Following a maze procedure, some individuals may require a pacemaker to assist in regulating their heart rhythm.

What is a pacemaker?

A pacemaker is a petite implanted apparatus designed to address irregular heart rhythms known as arrhythmias, particularly the sluggish variety referred to as bradycardia. By and large, a pacemaker is adept at alleviating symptoms like breathlessness, weariness, and lightheadedness that stem from bradycardia.

Arrhythmias emerge from irregularities in the heart's electrical system. Electrical signals trace a defined route through the heart, propelling it to contract. However, during bradycardia, there is a dearth of these signals coursing through the heart. For a more comprehensive understanding of your heart's electrical system, please consult the Heart & Blood Vessel Basics section.

A pacemaker reinstates your heart's rhythm to its natural state. Moreover, it can adapt to the requirements of your body, courtesy of its built-in sensors that can discern:

• Periods of rest necessitating a slower heart rate.

• Instances of exertion calling for a swifter heart rate.

Perhaps your heart capably regulates its rhythm most of the time. A pacemaker serves as a supplementary measure, only intervening when your heart demands it.

Alternatively, certain situations may impede a person's heart from generating its own electrical signals or transmitting them along the correct routes. For instance, the aging process or an ablation procedure targeting specific heart regions may mandate pacemaker therapy. In such scenarios, the pacemaker might administer continuous treatment to orchestrate each heartbeat.

The pacemaker dispatches electrical signals to the heart, achieving this by delivering minute amounts of electrical energy (too minuscule to be perceptible) to either the upper or lower chambers of the heart, or to both.

The implantation procedure involves localized numbing, with general anesthesia generally being unnecessary.

Routine check-ups are imperative for monitoring the device's settings and reviewing the stored information.