Patients suffering from common heart rhythm disorders are learning from a recent study that removing the cardiac tissue that causes the disorder can be more effective than drug treatment.
Cardiac ablation could be a viable treatment in cases of atrial fibrillation – a common type of heart rhythm disorder. Carlos Morillo, a lead researcher from Canada’s MacMaster Universtity said that the new approach could be useful in cases where patients don’t respond to standard treatment with drugs.
The results of the study were presented in Boston at the meeting of the Heart Rhythm Society and data included 127 patients diagnosed with a common type of disorder called paroxyxmal atrial fibrillation. This is a condition where the bottom chambers of the heart are beating out of sync with the top chambers.
Over a two year period, 72 percent of patients on medication had a recurrence, compared with 52 percent who underwent the ablation procedure. The drugs used in the study included Sanofi, Multaq and other generic medications. Morillo said that side effects were less frequent, and that ablation was “definitely superior” to treatment with various antiarrhythmic medications.
However, although the ablation procedure had reduced recurrences of rhythm disorders, medication was still necessary to combat the recurrences. In some cases drug therapy is the preferred option of patients and can clear the disorder in a short period of time.
The condition can increase a patient’s chances of stroke or heart failure and results in breathing difficulties and chronic tiredness. Nearly 3 million Americans have been diagnosed with atrial fibrillation and the Center for Disease Control and Prevention expects the number to reach 12 million in 40 years time.
There are risks associated with ablation however and Hugh Calkins, from the University of Baltimore suggests that one study is not enough to recommend ablation and that patient choice remains pivotal. But he does note that ablation techniques and methodologies are improving.
The research was undertaken through funding from Biosense Webster, a division of Johnson & Johnson who market catheters used in the treatment of atrial fibrillation. Other companies marketing catheters include St. Jude Medical and Bard Electrophysiology.
Frequently called open heart surgery by those who refer to it in layman’s terms, a heart bypass surgery refers to a surgery that uses a graft in order to reroute the way that blood flows to the heart in order to navigate around blocked arteries.
A heart bypass surgery is considered to be a very intensive surgery as it requires the chest to be cut wide open and for the patient to have his or her blood routed through a bypass machine as repairs are made to the heart. For this reason it is only done when necessary, although it is considered to be the best treatment for advanced coronary artery disease with the best long term results.
The heart is responsible for pumping blood throughout the body by utilizing the coronary arteries. However, sometimes the arteries can become blocked preventing oxygen from reaching the heart resulting in damage. This damage can cause heart attacks if nothing is done before the condition is noticed although most often a heart attack is the only indication of trouble in patients that are not currently being monitored for heart disease. In order to prevent fatal damage to the heart the flow through the arteries must be increased; which is why heart bypass surgery is performed.
The main aim of heart bypass surgery is to remove or bypass the blocked arteries with blood vessels that come from other areas of the body. During the surgery these healthier unclogged blood vessels are grafted into the chest to allow adequate blood flow into the heart. Unless an artery is over 75%-80% blocked, most of the time stents will be used first. However, if multiple arteries show severe signs of disease or if the left main coronary artery is affected then a heart bypass surgery may be indicated.
Before open heart bypass surgery is recommended as the best course of action, a cardiac surgeon will order a series of test including an angiogram, stress test, blood tests, EKG, and a cath test. Prior to surgery a surgeon will also take additional blood tests to determine if the patient is going to bleed heavily during surgery. If the heart bypass surgery is not performed as an emergency surgery then a surgeon will also ask a patient to change their diet, smoking, and drinking habits prior to surgery as well as requesting them to stay off medications that may cause complications during surgery.
When a patient undergoes heart bypass surgery they are placed under general anesthesia which also means that they have to be on a ventilator to assist in their breathing. The surgeon will start by harvesting the blood vessels that are going to be used as the grafts to bypass the blocked arteries.
Many times the saphenous vein in the leg is chosen because it is long and can be used for several grafts. Once the vessel is obtained then the chest is opened via an incision that starts at the breastbone and continues down to the sternum so that the chest cavity is available to the surgeon.
During a typical heart bypass surgery the heart is temporarily stopped with a potassium solution so that the surgeon can work on a vessel that is still and during this time the patient’s blood is circulated and kept in motion via a heart-lung machine.
The surgeon then places the grafts into the chest rerouting the blood around the blocked artery or chooses to remove the blocked artery and replace it with the vein graft. Once the grafts are in place then the heart is restarted and the heart lung machine is stopped as the heart can once again do the work for the body
A new study postulates that a heart disease drug may also help combat racism. As part of the study, volunteers received the beta-blocker that is generally used to keep the heart rate low, and then they were put through a psychological test that measured ‘racist’ attitudes.
Those that took the medication were found to be less racially prejudiced in their subconscious over those that were given a placebo bill instead of the medication. Scientists believe that these results are due to the fact that racism is most commonly the result the fear.
The drug, propranolol, affects nerve circuits that are responsible for involuntary actions such as heart rate, and the same part of the brain that controls the hear is also heavily involved with emotional and fear responses. For this reason, the drug is also often used to help treat panic and anxiety in patients.
Dr. Sylvia Terbeck from Oxford University and the study leader stated that they planned to take a look at the neuro-biological aspect of prejudice and their results suggest that the brain has a certain process it completes when it creates racial bias. She added that racial bias that is subconscious can occur in people that truly believe that they subscribe to equality because implicit attitudes play a large role in discrimination.
The study included 18 white participants and each member of the trial was asked to take the IAT (Implicit Association Test) a few hours after taking the medication or the placebo. As part of the test, volunteers had to complete 140 mini trials in which they categorised negative and positive words against pictures of white and black individuals.
The results are based on the amount of time that it takes to complete the tasks. Researchers found that it took the volunteers much longer to associate a positive word with a black face then it did with a white face.
This was seen as proof that at a subconscious level many were still biased. However, the gap in time was not seen in the group that took the beta-blocker. The difference was not seen when volunteers were asked in a separate test what they actually thought, signalling that it only affected implicit thought and not explicit thought. This raised the thought that the brain plays a large role in what is characterised as fear, and that certain drugs can help control fear.
The least common form of cardiomyopathy is restrictive cardiomyopathy. This form of the disease occurs when the heart muscle from the ventricles becomes too rigid so that the ventricles cannot fill with blood properly in-between heartbeats. Common symptoms of the disease include swollen feet, fatigue, and shortness of breath.
Another more common form of the heart disease is when fibrous and fatty tissue replaces healthy heart muscle. This is often caused by a heart attack because once the heart muscle is damaged then the area is invaded by bad tissue formation. Most of the time the right ventricle is affected, and eventually this can lead to the right side of the heart dilating. Over time this will lead to unorganized electrical activity and eventually can cause blood flow problems.
Sometimes when tetralogy of Fallot occurs surgery may be required in order to increase blood flow from the hearts to the lungs. This is done by placing a shunt between the pulmonary artery and the aorta. This allows the child to continue to develop at a normal pace and then later in their life the defect can be corrected.
Other times, an arterial switch operation is required in order to promptly reconnect the arteries. When there are holes in the heart then red blood from the lungs that is oxygenated passes into the right side of the heart and mixes with other blood before it arrives back at the lungs. This puts excessive strain on the heart that oftentimes causes the muscle mass to enlarge resulting in blood vessel damage and high blood pressure. In terms of childhood development, it can affect nourishment and growth.
Holes in the heart can generally be closed with a path or two and then the single valve is decided into two so that blood circulation can be stabilized. However, sometimes the reconstructed valve does not function properly, causing the defect to be deemed too risky for repair during infancy. In this case a pulmonary artery band is used to restrict blood flow and prevent high pressure from building in the lungs. When the child is stronger than the band can be taken out and the formal surgery can be performed.
This surgery is called balloon valvuloplasty and requires that a balloon be threaded through the heart valve while it is dilated and can be used to treat pulmonary valvular stensosis without requiring full open heart surgery.
Congestive or dilated cardiomyopathy is very common and is the result of the stretching or enlargement of the heart cavity. This can cause the heart to weaken so that it does not pump correctly. When this happens the heart muscle becomes very flexible and weak stopping it from pumping blood correctly through the body. When the heart becomes dilated or stretched then the valves stop closing correctly and will sometimes start to leak.
As a result, fluids begin to build up in the lungs causing breathlessness and ultimately causing what is known as left heart failure. Sometimes right heart failure can occur when fluid starts to accumulate in the organs and tissues of the body which can show up as swelling in the ankles, legs, abdomen, and the liver. Eventually the heart’s electrical rhythm will be disrupted if left untreated.
It is not known why the condition occurs, but many researchers believe that it is the result of an autoimmune disease like rheumatoid arthritis or a virus infection. It is also believed that pregnancy or excessive consumption of alcohol can cause or dilated cardiomyopathy.
Common symptoms of the disease include palpitations, shortness of breath, swollen ankles, angina, and fatigue. Blood clots are a common side effect because the blood is moving very slowly throughout the heart. There is always a risk that the clots will break free and then travel down to the brain causing a stroke or travel to the lungs causing pulmonary emboli.
Once diagnosed treatment will often include a course of anti-clotting drugs that will help prevent emboli and medication will be given that will help to prevent future arrhythmias so that the heart works efficiently in the future. Any other underlying cause that may be responsible for the development of or dilated cardiomyopathy also needs to be identified and then properly treated. If the disease progresses then a heart transplant may become necessary.
Coronary heart disease occurs when the arteries that are responsible for supplying the heart with nutrients and oxygen narrow as a result of atherosclerosis. The result of this is that oxygen and blood does not flow correctly to the heart, especially when the heart is under higher demand such as during periods of high exertion. The most common symptom that people with CHD observe is angina (chest pain) that is the result of an insufficient amount of oxygen getting to the heart. The chest pain can involve tightness, heaviness, and pain in the chest that can sometimes spread to the neck, arm, back, face, jaw, or abdomen.
There are other symptoms of CHD but they are not always a symptom of CHD and could be caused by other medical conditions or in some instances occur without causing any threat to your health. Regardless of this fact, they do warrant a visit to a doctor to make sure that they are not a symptom of something more serious. Some of the most commons symptoms that are attributed to CHD include consistent breathlessness, heart palpitations, fainting, fluid retention, fatigue, blue lips and blue fingernails.
Fatigue is one of the most common heart disease symptoms, but it can have many different causes such as depression. However, if you continually suffer from fatigue along with other symptoms then it is a good idea to see a doctor. Fluid retention is another common symptom and is usually most noticeable as swelling that occurs around the legs, lungs, ankles, or abdomen. Sometimes swelling in areas such as the ankle can be normal for some people, however, it can also be a sign that the heart is not pumping as much blood as it should be which can lead to eventual heart failure if not addressed.
Sometimes the heart muscle can quickly thicken asymmetrically causing the muscle cells inside of the heart to become randomly organized without any known reason. When this occurs electrical signals no longer pass correctly through the muscle. The disease appears to be hereditary, and is assumed to have been caused from an abnormality in the genetic code. About 125,000 people in the UK suffer from this disease, known as hypertrophic cardiomyopathy.
In one form of the disease known as hypertrophic obstructive cardiomyopathy the left ventricle muscle mass and the dividing wall that keeps it from away from the right septum grows larger than it naturally is supposed to be. The result of this is that the passage that leads through the heart narrows and blood flow from the heart is obstructed. In addition the structure can affect the mitral valve that is located in the middle of the heart chambers causing it to leak. When this happens sometimes it is referred to as idiopathic hypertrophic subaortic stenosis (IHSS) or as asymmetric septal hypertrophy (ASH).
Sometimes the condition develops during pregnancy in the foetus and will cause stillbirth while at other times it will develop later in infancy. Most of the time however, onset begins during early adulthood or childhood.
There is also another form of the disease known as non-obstructive hypertrophic cardiomyopathy that occurs when the enlarged muscle does not interfere with blood flow and is not as serious as the previous mentioned condition.
Symptoms of hypertrophic cariomyopathy include chest pain, shortness of breath, fainting, and dizziness. Sometimes a heart murmur can also be heard when the blood flow from the left ventricle makes the ventricle work harder. Other people will suffer from cardiac arrhythmias on a regular basis that can lead to sudden death or sudden collapse if not regulated.
Cardiomyopathy is a disease that changes the heart’s muscle tissue weakening it so that blood is no longer to pump efficiently. Some symptoms of cardiomyopathy include angina (chest pain), loss of consciousness, rapid heartbeat, or shortness of breath.
There are two different levels of diagnostic cardiomyopathy: secondary and primary. Primary cardiomyopathy does not have any specific cause whereas secondary cardiomyopathy does have identifiable causes that include heart valve disease, congential heart defects, hypertension, and artery diseases. Heavy drug use and alcohol use can also be a cause.
From these levels three are three different types of heart muscle disease defined as dilated cardiomyopathy which is the most common, hypertrophic which is the most common type of heart disease to cause unexpected death in those under thirty, and restrictive which is most often found in the elderly.
There are many heart diseases that can affect the heart, the following are just a few of the most common heart conditions that many people suffer from.
Although they are becoming much rarer due to the use of antibiotics, infections can still damage heart valves and damage tissues inside of the heart. Severe viral infections and those that cannot easily be treated by antibiotics such as staph infections can also travel to the heart damaging heart muscle and eventually leading to heart failure.
Another disease that affects the heart is called cardiomyopathy and can be caused by many different things including high blood pressure, CHD, high alcohol intake, viral infection, and thyroid disease.
Finally, many heart problems are actually the result of birth defects that occur in the womb known as congenital heart disease. These structural problems can impair blood flow throughout the heart and can strain the heart of an infant after it is born.
There are many factors that can make heart disease worse, or can compound the situation. For instance CHD and high blood pressure often present together.
Patients suffering from common heart rhythm disorders are learning from a recent study that removing the cardiac tissue that causes the disorder can be more effective than drug treatment.
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