BUNCHA SUNSANEEWITAYAKUL, M.D.
Medicine - Cardiology (Heart)
Do you experience palpitations, easy fatigue, or an irregular heartbeat? These symptoms may signal an arrhythmia, a common heart condition. Modern, safer treatments are now available, notably Cryoablation (Cold Balloon Cardiac Ablation).
Cryoablation is an advanced technique for treating cardiac arrhythmias, particularly Atrial Fibrillation (AF), a leading cause of stroke. The procedure involves using extreme cold, typically at temperatures of -40 to -60 degrees Celsius, to precisely destroy the heart tissue responsible for abnormal electrical signals. A specialized catheter is inserted into the heart to deliver this cold energy, restoring a normal heart rhythm.
Patients should undergo an electrocardiogram (EKG) during AF episodes for confirmed diagnosis. For sustained AF, a standard EKG is usually sufficient. However, for brief, intermittent AF episodes (seconds to minutes), continuous heart rhythm monitoring using a device that records for 1-2 days is necessary.
This device, resembling an adhesive patch, allows for greater patient convenience, enabling activities like sports and showering, and can record data for up to 14 days. Modern smartwatches also offer EKG monitoring during periods of symptoms.
Additionally, physicians may perform an echocardiogram, an exercise stress test for ischemia, and supplementary blood tests to identify underlying causes and co-existing conditions.
AF has diverse causes, broadly categorized into four groups for diagnostic and treatment guidance:
Substances like caffeine, nicotine, alcohol, ginseng, and certain supplements can trigger AF. Individual sensitivity varies, so AF development depends on the quantity and duration of exposure, co-existing factors, and individual physiological response.
Underlying medical conditions such as hyperthyroidism, gastric issues, pneumonia, hypertension, diabetes, obesity, stress, insufficient rest, snoring, and sleep apnea can precipitate AF.
Specific cardiac conditions, including mitral valve disease, hypertrophic cardiomyopathy, heart failure, coronary artery disease, and myocardial ischemia, can lead to AF.
These are intrinsic abnormalities of the heart's electrical system, either congenital (genetic) or acquired (degenerative). Elderly patients are more susceptible to AF due to age-related degeneration of the heart's electrical system.
Given the multitude of AF causes, some being primary and others contributing factors, a detailed individual analysis is essential.
AF symptoms result from the rapid and irregular heart rate, including palpitations, easy fatigability, chest tightness, heart failure, pulmonary edema, and presyncope/syncope. However, a significant number of AF patients are asymptomatic, with the condition discovered during routine examinations or when presenting for other health issues. Asymptomatic patients may present with AF complications, such as heart failure or embolic stroke from cardiac clots.
Three key, often co-administered, approaches are crucial:
Individual stroke risk varies among AF patients. Low-risk individuals may not require anticoagulation. However, moderate and high-risk patients necessitate oral anticoagulation. This assessment is always paramount.
This includes reducing or eliminating caffeine, alcohol, and tobacco use. Concurrently, manage pre-existing conditions such as hyperthyroidism, diabetes, and hypertension; promote weight loss, stress reduction, and adequate rest.
Effective risk factor modification can significantly improve AF or even lead to remission.
Patients with cardiac arrhythmias, particularly AF, who are unresponsive to medication or desire long-term efficacy, may be suitable. The physician will assess individual patient suitability for this treatment.
Medicine - Cardiology (Heart)
