Q: What is atrial fibrillation?
A: Atrial fibrillation is the most common heart arrhythmia in the U.S. It usually involves a rapid heart rate, where the upper heart chambers (atria) are stimulated to contract in a disorganized and abnormal manner. It is most often caused by abnormal electrical firing in the areas where the veins that drain blood from the lungs (pulmonary veins) connect to the left atrium. Atrial fibrillation can be related to high blood pressure, an overactive thyroid, congestive heart failure or diseased heart valves, or can occur in patients with structurally normal hearts who do not have an obvious predisposing condition. It is important to be diagnosed and treated as early as possible.
Answered by Eric J. Rashba, MD. Dr. Rashba, a cardiologist, is professor of medicine and director of electrophysiology.
Q: What are the signs and symptoms of atrial fibrillation?
A: There are many. Typical symptoms include a racing heart or palpitations, but some patients have more subtle symptoms such as shortness of breath or fatigue, without palpitations.
Answered by Eric J. Rashba, MD. Dr. Rashba, a cardiologist, is professor of medicine and director of electrophysiology.
Q: How is atrial fibrillation treated?
A: Initial treatment is medication. If this fails, ablation, which involves cauterization of abnormal heart tissue, is recommended. The goal is to eliminate the electrical connections between the pulmonary veins and the left atrium so that the abnormal impulses from those veins cannot stimulate the rest of the heart, the cause of the atrial fibrillation. Typically, ablation has been done manually by directing a catheter (a thin flexible tube) within the left atrium (left upper chamber of the heart). Although atrial fibrillation is a common arrhythmia, the ablation procedure to fix it is very complex and can only be done at major medical centers with a high level of technical expertise. In Suffolk County, Stony Brook University Medical Center fills this role.
Answered by Eric J. Rashba, MD. Dr. Rashba, a cardiologist, is professor of medicine and director of electrophysiology.
Q: What are the advantages of the new robotic catheter system to treat atrial fibrillation?
A: With the Sensei® Robotic Catheter System, the catheter is mounted to a sheath, or hollow tube, in the robotic arm and is manipulated quickly and easily using a joystick. Electrophysiologists, physicians who specialize in the diagnosis and treatment of heart arrhythmias, are able to reach areas in the heart that can be difficult to get to using the traditional manual method. The robotic catheter allows electrophysiologists to manipulate the catheter quickly and easily throughout the left atrium, dramatically reducing the length of time the procedure takes, key because it decreases the risk for the patient. Shorter procedure times also mean that both the patient and the physician have less exposure to radiation. Typically, ablations for atrial fibrillation are repeated in as many as 50 percent of cases because the electrical connection between the pulmonary veins and the left atrium is not completely eliminated. The Sensei System allows us to deliver more effective ablation, reducing the need for repeat procedures.
Answered by Eric J. Rashba, MD. Dr. Rashba, a cardiologist, is professor of medicine and director of electrophysiology.
Q: Where is this new procedure being done?
A: Currently, Stony Brook University Medical Center is the only healthcare facility in New York State performing the robotic ablation procedure using the Sensei Robotic Catheter system.
Answered by Eric J. Rashba, MD. Dr. Rashba, a cardiologist, is professor of medicine and director of electrophysiology.
Q: What other cardiac arrhythmia services are offered at Stony Brook?
A: Our electrophysiology service offers comprehensive care for patients with atrial fibrillation, including the latest diagnostic tools, medication management, and ablation, when necessary. Also offered are the latest treatments for patients with other arrhythmia conditions including:
- Implantation of pacemakers and cardiac defibrillators
- Cardiac resynchronization therapy
- Laser extraction of infected or malfunctioning pacemaker and defibrillator leads
- Evaluation and management of syncope (fainting)
- Expert medical management of patients with cardiac arrhythmias
Answered by Eric J. Rashba, MD. Dr. Rashba, a cardiologist, is professor of medicine and director of electrophysiology.