Heart aflutter signals serious condition

For the past 10 years, Community Medical Centers’ chief financial officer, Steve Walter, has had a heart that occasionally misbehaves. “It’s kind of like a two-year-old throwing a temper tantrum,” he describes.

And while the love-struck write tender poems about fluttering hearts, there’s nothing romantic about the condition called atrial fibrillation, says Walter. “Sometimes it can feel like your heart’s going to jump out – just flopping around like a fish,” he says. “When your heart rate is at 200, it’s not working correctly so the risk is you’ll throw off clots.”

Because of that risk, atrial fibrillation is a condition that requires medical attention if lasts more than a few minutes or returns again and again over a period of days, says Dr. Bipin Joshi, a cardiologist who practices at Fresno Heart & Surgical Hospital.

Such episodes of fast and uneven heart rhythms affect 2.2 million Americans, often without much warning or an identifiable cause. When the heart’s wiring misfires and sends the heart beating erratically and too fast it’s a scary feeling but it also increases the risk of blood clots that cause stroke. Stroke is the leading cause of long-term disability and third leading cause of death in the United States.

Atrial fibrillation is common after heart surgery and can be triggered by other stresses on the body such as illness or injury. Walter said he first noticed his heart arrhythmia after a particularly long and grueling bike ride when he got dehydrated. The condition also tends to be more prevalent as people age, with 10% of those over 80 experiencing erratic heartbeat.

Steve Walter

Walter says he can generally stop the symptoms by compressing his own chest and holding his breath. Most people control atrial fibrillation with medication and others get years of relief from a cardio-version, a low-level electric shock delivered to the heart.

And while Walter knows a quick shock will put his heart back into its normal rhythm, he recently ignored his over-active heart for a whole weekend. What started out as annoying on a Friday night became alarming and potentially life-threatening by Sunday. “Sunday afternoon I was so exhausted I couldn't do anything. I was short of breath walking,” Walter says.

Cardio-version – usually and easy outpatient procedure – is complicated when patients have atrial fibrillation symptoms for longer than 48 hours. At that point patients must often take anticoagulant medication for three weeks or more before a cardio-version, Dr. Joshi explains. Cardiologists also may have to insert a small scope into the body to look for the presence of clots around the heart before administering cardio-version, Dr. Joshi adds.

That’s exactly what happened to Walter. When Dr. Joshi saw him at Fresno Heart & Surgical he had to insert a scope to look for clots behind the heart. Lucky for Walter, the 48 hours of ignoring symptoms hadn’t produced a clot, says Dr. Joshi, so he was able to administer a shock that put things right again. Dr. Joshi also kept Walter overnight at the hospital.

Walter said he enjoyed his stay at Fresno Heart & Surgical, a hospital known for its restaurant-quality food, hotel-like patient rooms and great care. HealthGrades, the nation’s leading, independent health care ratings organization named Fresno Heart & Surgical among the nation’s top 5% in patient experience, giving it the 2009 Outstanding Patient Experience Award.

This story was reported by Erin Kennedy. She can be reached at ekennedy@communitymedical.org.

Thursday, April 02, 2009