James Daniels, M.D. Answers Questions On: Arrhythmias and Atrial Fibrillation

One of the most common misconceptions about arrhythmias is that anything that feels like an irregular heartbeat is dangerous and needs to be treated – even if the patient isn’t particularly bothered by it.

The truth is, there can be a range of what constitutes a normal heart rhythm and a number of other things – digestion or muscle spasms, for example – that can feel like an irregular heartbeat. It’s not uncommon for people to feel what they think are irregular heartbeats, but when we monitor them, we find nothing abnormal in their heart rhythms.

Another common misconception is that getting a pacemaker, cardiac defibrillator, or other implantable device radically changes or intrudes on patients’ lives. This isn’t true; today’s smaller device sizes and ability for remote device monitoring mean that patients’ lifestyles can return to virtually normal about a month after devices are implanted.

One reason we’re hearing more about atrial fibrillation is that AFib is largely a heart rhythm disorder of older patients, and as people live longer, it’s likely to become more prevalent. In addition, advances in cardiac monitoring are enabling us to better diagnose AFib and other cardiac arrhythmias.

Furthermore, atrial fibrillation treatment has progressed a lot in the last decade. There are more drugs to treat it, and a number of catheter-based procedures have been developed to help hearts maintain healthy rhythms. This has resulted in more AFib-related media coverage and advertising.

Thanks to ongoing advances in electrophysiology mapping systems, we’re now able to perform many procedures with minimal to no radiation exposure to the patient.

In addition, the advent of GPS-based systems will ultimately allow cardiac electrophysiologists to implant pacemakers and defibrillators with almost no X-ray exposure.

The continued miniaturization of pacemakers, defibrillators, and other implantable cardiac devices is another important advance. Within the next decade or two, many are likely to be about the size of a coin and will be placed directly onto the heart or in the heart wall, eliminating the need for any wires.