Discourse such as palpitations, compression in the left chest, and ping of the heart are always observed in arrhythmia cases. Temporary and harmless arrhythmias may occur as well as severe increases. Our heart makes approximately 100,000 to 150,000 beats per day, usually 500 or less of these beats are arrhythmia, usually no treatment is needed.
What is Atrial Fibrillation?
Atrial fibrillation (AF) is the most common cardiac arrhythmia. (1) Although it is usually seen in the elderly, it may also occur in young people with no heart disease. In AF, there is an irregularity in the warnings that allow the heart to operate in certain order. This irregularity is more like anarchic alerts. The electrical impulses of the heart, instead of properly moving in the atrium (the small chamber of the heart), try to pass through the atrioventricular node and reach the ventricle (the large chamber of the heart) by competing with each other, with an increased number of warnings (300-600 units / min) resulting from many foci. Many of these warnings are anarchic beats originating from tissues other than the electrical system of the heart. With these irregular beats, the heart is accelerated and the heart rate in AF is usually 100-150 beats / min. It rises. The aim of the heart in this way is that the fast operation can disrupt the pump function. If the necessary treatment cannot be applied for a long time, it may cause paralysis due to heart growth, heart failure and thrombosis to the brain, which is the most feared result of arrhythmia.
Symptoms of Atrial Fibrillation:
Severe palpitations, shortness of breath, chest pain, dizziness, and rarely faint signs are common in patients. The most common symptom is heart palpitations. The patient may be fainted when the heart starts to beat too fast or throws more slowly. Sometimes there are pauses, and in cases where the heart does not accelerate, the patient complains of fatigue.
Why Is Atrial Fibrillation Important?
- Atrial fibrillation (AF) is one of the major causes of stroke in the elderly. The probability of paralysis in patients with AF increased by 5 times. At the same time, the rate of disability and mortality in patients with AF-related stroke is much higher than in patients with non-AF-induced stroke. (2) ¼ of the causes of paralysis in the elderly.
- AF may reduce the ability of the heart to pumping. Irregularity can cause the heart to operate less effectively. Furthermore, long-lasting AF can severely weaken the heart and lead to heart failure.
- 1/3 of the patients who were hospitalized with arrhythmia constitute AF.
- Its prevalence is around 0.4%, while it is seen in 3-4% of adults. 70% of patients with AF are between 65-85 years of age.
The therapeutic goals of AF are to regain a normal heart rhythm (sinus rhythm), control heart rate, prevent blood clots, and reduce the risk of stroke. Many options, including drugs, catheter-based procedures and surgery, can be used in treatment. Surgical ablation therapy will be discussed here.
If a patient has atrial fibrillation and surgery is needed to treat other heart problems (valvular disease or coronary artery disease), surgical treatment of AF can be easily performed without any additional surgical risk. This treatment can be done for the last 20 years. In scientific guidelines, isolated aortic valve diseases, isolated heart bypass operations or the same AFRs are recommended to treat this rhythm disorder. (3) Nowadays, the techniques used in the treatment of AF by radiofrequency, microwave, laser, ultrasound or cryothermia (freezing) designed to create transmission blockage lines are widely used. the lesions are blocked and the transmission of abnormal electrical impulses through the heart is blocked and normal warning transmission of the correct path is encouraged. Radiofrequency and cryoablation are the most popular ones during surgery.
Cryoablation (Freezing) Method:
Cryoablation or cryoablation is the name given to the process of freezing the problem area between minus 150 and 170 degrees by the method which has less complications compared to the old methods applied in the world in recent years. The most important advantage of this method is the low risk of perforation (tear) and thromboembolism.
Radiofrequency Ablation Method:
The use of arrhythmias after ablation techniques has opened a new chapter in the treatment of AF. The principle in this technique is to produce full-thickness lesions in
specific regions of the atrium endocardium using heat generated by RF energy. In this way, the isolation of both AF triggering focal points; In addition, large re-entry circuits which are progressing in the form of waves are prevented from being inserted into newly formed lesions and natural anatomical obstacles.