Advanced Atrial Fibrillation Treatments
Before starting her career in wine imports, Erin Drain's life was preoccupied by a mysterious condition.
I would get bad headaches and get really dizzy, see stars, and pass out every once in a while or feel like I had to faint. So it was pretty confusing and also — I mean, I thought I was having a heart attack.
Erin Drain was a teenager when she first began to experience a feeling inside her chest. But she couldn't pinpoint what it was.
It almost felt like switching gears in a car, like downshifting too soon or something. I would feel this physical sensation in my heart. And all of a sudden, it was almost like maybe a skipped beat, and then suddenly my heart rate would just skyrocket.
The episodes continued on for 14 years, often lasting up to 10 hours at a time, affecting Erin's everyday life, contributing to anxiety, even panic attacks.
Because I never could predict it, it was just hanging over my head all the time. I would be out with friends or on vacation or walking around a park or doing anything — or having dinner, drinking wine, anything, and it would just strike.
Aaron was actually having heart palpitations, giving the sensation of a rapid heartbeat. Erin's physician recommended she look into a procedure called an ablation. That's when she found Dr. Roderick Tung, cardiologist and the director of electrophysiology at UChicago Medicine. Dr. Tung could relate personally to Erin's condition.
I went into cardiac electrophysiology because, when I was 18 years old, I had a rapid arrhythmia that would shoot my heart rate up to about 240 beats per minute when I was a freshman in college. And when it first happened, I actually thought I was going to die and went to the emergency room. And eventually, I was diagnosed with a very common arrhythmia called AV node reentrant tachycardia.
By injecting an implantable microchip under Erin's skin, which monitors her heart, Dr. Tung diagnosed her with Wolff Parkinson White syndrome, an arrhythmia he said of which 99 percent of cases can be cured with an ablation.
Hers was a very unique kind of WPW because her extra pathway, this extra little connection that conducts electricity and gets caught into a circuit, it didn't conduct forward. It only went backwards. So you actually can't even see it on her EKG. And we call that a concealed pathway. Erin's ultimate solution was something called catheter ablation, which is a little flexible tube on a pulley and wires system that we can steer. And it's a non-surgical approach. There's no cutting. There's no sewing. There's no stiches.
And we go up through the veins of the leg, and we find where that extra little connection is that creates the electrical circuit that causes the little short circuit and makes our heart rev up so fast. And then we zap it. We burn it. It's cauterization. And for hers, she's completely cured.
Erin was able to go home the same day she had her procedure. She noticed a new, strange sensation afterwards — the feeling of a normal heartbeat.
I was sitting on the couch and I remember thinking, I feel different because I can't feel my heart beating, which is normal. And so, it actually was sort of freaky at first and I was questioning if I was a ghost.
It was a new feeling for Erin, finally providing the freedom to pursue her passions.
I feel great. I definitely feel like it's just part of my life I don't have to think about anymore, which is awesome.
Atrial Fibrillation Medical Procedures
Electrical Cardioversion
Electrical cardioversion is a treatment that involves delivering a short electrical shock to the chest, which helps reset the heart to a normal heart rhythm. A special external defibrillation machine is used, and this treatment is performed while the patient is under sedation in our electrophysiology lab. Patients can often go home the same day.
Pacemaker
A pacemaker is a small device that monitors heartbeats and emits electrical impulses to regulate heart rhythm. For people with atrial fibrillation, a pacemaker will be used in conjunction with another treatment for the condition, but does not actually cure atrial fibrillation. You may need a pacemaker after having certain types of ablation therapy, or when heart medication may cause the heart to beat too slowly.
Learn more about pacemakers.
Radiofrequency Catheter Ablation
Radiofrequency catheter ablation is a treatment that uses high frequency radio waves to destroy the tissue source of atrial fibrillation. Catheter ablation can cure atrial fibrillation — especially in patients with paroxysmal atrial fibrillation (occasional episodes of atrial fibrillation) — with success rates reaching 70 to 80 percent.
The procedure involves the use of a specially designed catheter that is threaded through the leg into the heart. The catheter is used to locate the arrhythmia source and a device attached to the tip of the catheter delivers high-frequency radio waves to heat the tissue and eliminate the source.
Learn more about our expertise in ablation.
Ablation Surgery Treatment
Some people with atrial fibrillation may have other heart conditions like mitral valve disease, which requires valve repair/replacement, or atherosclerosis, which necessitates coronary bypass surgery. In select cases, our electrophysiologists may determine that a surgical approach is the best method to treat the arrhythmia because of the patient's anatomy, prior unsuccessful catheter treatments or other concerns.
At UChicago Medicine, our cardiac surgeons perform the modified Maze procedure, which delivers radiofrequency energy to heart tissue to redirect the electrical pathways through the heart. This treatment is performed during open-heart surgery or using minimally invasive techniques done through small incisions in the chest.
Learn more about atrial fibrillation surgery.
Pulsed Field Ablation (PFA)
University of Chicago Medicine's arrhythmia team launched pulsed field ablation (PFA). This innovative, new technology which uses electrical fields to treat and neutralize atrial tissue that can give rise to atrial fibrillation (AFib). The system creates electroanatomic maps, which are made real time during electrophysiology (EP) procedures, and helps guide therapy by moving small tools inside the heart without needing to make an incision.
Left Atrial Appendage Occlusion
We are one of the few centers to offer both left atrial appendage closure (LAAC) implant devices, FDA-approved WATCHMAN and AMULET, to prevent stroke-causing blood clots from escaping from the heart for patients who cannot take oral anticoagulants. This minimally invasive procedure uses a permanent implant to seal off the pouch in the heart where blood clots commonly form. Tissue grows over the implant and patients are able to eventually come off of blood thinners.
By using the latest LAAC technologies, including 4D intracardiac echocardiography (ICE), we can deliver high-quality care to all our patients without requiring general anesthesia or the more invasive transesophageal echocardiogram (TEE). Additionally, because roughly 20% of patients are not ideal candidates for WATCHMAN, we offer an equally effective alternative in AMULET to prevent strokes without requiring anticoagulants. Advanced LAAC devices are designed for maximum flexibility, with several shapes and sizes to provide an unparalleled seal around the left atrial appendage. These devices feature unrestricted maneuverability during the procedure to easily reposition the implant for optional placement, which offers our patients long-term success.
Atrial Fibrillation Services
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