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Breakthrough treatment for A-fib begins in Joliet

ProvenSt Joseph Medical Center- Doctor Portraits August 18 2010

Provena St Joseph Medical Center- Doctor Portraits, August 18, 2010

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At a Glance

Atrial fibrillation is when rapid, disorganized electrical signals cause the heart’s two upper chambers to fibrillate, or contract very fast and irregularly.

Consequences include heart failure or blood clots in the heart that can lead to strokes.

Risk factors that can trigger atrial fibrillation include hyperthyroidism, sleep apnea, obesity, diabetes, lung disease, coronary heart disease, binge drinking, caffeine, psychological stress, metabolic syndrome, genetic factors and possibly inflammation.

Treatments for A-fib include the following:

Blood-thinning medications

Lifestyle changes, such as healthy diet, managing cholesterol, quitting smoking, and addressing sleep and blood pressure issues

Medications to slow the rate at which the ventricles contract

Procedures such as electrical cardioversion, catheter ablation, pacemakers, open heart surgery

New procedure beginning at Presence Saint Joseph Medical Center in August: “the lariat”

Sources: National Institutes of Health and Dr. Ahmad Abdul-Karim

Updated: September 1, 2013 6:05AM

There’s a new treatment in town for a very scary condition called atrial fibrillation, or A-fib, and the first procedure using a “lariat” is scheduled in August.

Atrial fibrillation is not uncommon, affecting about 3 million people in our country. It’s a type of heart arrhythmia that increases with age, although about half of those with the condition are under age 75.

Many with A-fib don’t even know they have it. Others, according to the National Institutes of Health, feel it in palpitations in their chest, fluttering or feelings that the heart is skipping a beat or beating too hard or fast.

Those feelings are caused by rapid, disorganized electrical signals going through the heart that cause its two upper chambers — the atria — to fibrillate, or to contract very fast and irregularly. Because of this, the heart becomes inefficient at pumping blood out of the atria, and some of the blood pools inside. When blood doesn’t move, it clots, and if one of those clots makes its way out of the heart and into the brain, a major stroke can occur.

“This condition increases the risk of stroke approximately five times,” Presence Saint Joseph Medical Center cardiologist Dr. Ahmad Abdul-Karim said.

Karim specializes in cardiac electrophysiology, or managing abnormal heart rhythms, and will be the one performing the area’s first lariat procedure next month.

“There are only a very few centers in Illinois that are trained to do this,” he said. “It’s not an easy procedure to do, but it will give a good option to patients who have no options.”

The lariat will be used on A-fib patients who are not able to tolerate blood-thinning medications, which is one of the ways cardiologists normally treat the condition. Blood thinners prevent the formation of clots in the heart. However, Karim said about 40 percent of his patients are not able to tolerate anticoagulants for long-term use.

“With atrial fibrillation,” he said, “we work on several fronts. No. 1, we try to restore regular rhythm. ... but we also want to reduce the risk for stroke. Some patients need Coumadin or other anticoagulants.”

For the large number of his patients who cannot use anticoagulants, Karim may opt to perform the new lariat procedure, which involves making only small incisions to insert catheters inside the chest. A loop stitch, or lariat, is then made around a part of the left atrium called the left atrial appendage, or LAA, which is where the clots form inside the heart during fibrillations.

The loop is then tightened to close off the LAA permanently from the rest of the heart.

“The LAA then shrinks and disappears in six months to one year,” Karim said.

Advantages to this procedure over others, he said, are that no mechanical devices are left inside the heart, as is the case with surgeries involving occluding devices, and no blood thinners are necessary. The procedure takes two to three hours and only involves an overnight stay.

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