John Dryden was onto something when he coined the phrase "Be still my beating heart" in The Works of Virgil. But little did he know, 300 plus years ago, that doctors would be able to do just that. Electrical malfunctions of the heart-jumpstart racing or erratic heartbeats known as arrhythmias-can now be easily corrected by electrophysiology specialists. In fact, over the past five to 10 years, experts at Torrance Memorial Medical Center have honed procedures to correct cardiac electrical malfunctions, using the most up-to-date technology-allowing for less post-operative recovery times and even helping some patients to discontinue medications permanently.
This is terrific news as, unlike other heart conditions, arrhythmias cannot be prevented or controlled through diet, exercise or stress-reduction activities. Physicians don't know exactly what causes the various types of arrhythmias they treat, which can develop in healthy athletes and the young and old alike.
"For a lot of arrhythmias, we don't know the cause," explains Erol Kosar, MD, of Pulse Arrhythmia Group, a physician with more than 15 years experience in cardiology and electrophysiology. "It's likely genetic in nature. Unlike other heart disease, arrhythmias cut across all types of people: marathon runners, triathletes, young, old."
"We deal mainly with two extremes," adds Matthew Ostrom, MD, who also specializes in cardiology and electrophysiology at Torrance Memorial. "The first is the very young, healthy teens to 30-somethings who show minimal to no symptoms. The second [group with arrhythmias] is the older demographic with pacemakers, defibrillators and structural heart disease."
For the younger set who show no symptoms, clearly it is hard to diagnose and treat until they start showing symptoms that bring them to a doctor. Ostrom shared a story about a woman who was recently successfully treated for her supraventricular tachycardia (SVT), a rapid heart rhythm originating above the ventricular tissue. The 41-year-old woman is now "cured" of her arrhythmia that she has lived with since she was 15.
Ostrom explains that the patient lived with palpitations and racing heartbeats for which she took medication, but they didn't seem to control the issue. Last year she saw Ostrom, who decided to conduct radio frequency ablation to correct her SVT. Radio frequency ablation uses radio frequency energy to destroy abnormal electrical pathways in heart tissue or normal parts that are contributing to a cardiac arrhythmia. The energy-emitting probe (electrode) is at the tip of a catheter, which is placed into the heart, usually through a vein.
"What's so amazing is that a one-hour, simple procedure effectively cured her. She now has a 1% to 2% chance of it ever coming back," Ostrom explains. The patient, who was all smiles at her last check-up in March, boasted to her physician that she was going on a hike and "felt like a completely changed person."
Treating this type of arrhythmia is a dream come true for doctor and patient. There aren't that many heart conditions that can just "go away" with a short procedure. But not all arrhythmias can be treated this simply. Patients with the more dangerous ventricular tachycardia (VT)-rapid rhythms that originate within the ventricular tissue-often have a rockier road ahead. But that road is getting a bit easier with new technology.
Life with a Rapid Rhythm
While the dad of three will always have an ICD, he is now living without pain. "Since the day of surgery, December 27, I feel much better," Quijada says. "Before, I would get a feeling and then a horrible shock. Now, I may get that feeling when I start doing things, but I'm no longer getting shocked."
Before surgery, Quijada says he had a hard time relaxing or even just working in his garden. Now the retired construction worker can finally relax and work in his garden with ease. "Everyone at Torrance Memorial was so good to me. I am very pleased," he adds.
Silence Isn't Always Golden
Through Quijada's violent shocks, the doctors were able to diagnose and treat his additional malfunctioning circuit. But what about those conditions that don't display such dramatic symptoms? While some arrhythmias aren't noticeable, most will experience palpitations of the heart, experts say. Some palpitations may feel like a light fluttering, others like rattling in the chest, and some like a racing heartbeat. Another symptom of arrhythmia is fainting spells. Sadly, some people are wrongly diagnosed with panic or anxiety disorders, says Ostrom, but arrhythmias can be first recognized by a physician taking your pulse and conducting standard tests to record the heart's activity, such as using an electrocardiogram (ECG or EKG).