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Dr Joseph Galichia
Joseph P. Galichia, MD is the founder and Medical Director of the Galichia Medical Group, PA. He is an internationally recognized pioneer in the field of interventional cardiology. In the 70's, Dr. Galichia studied in Zurich, Switzerland with the inventors of the balloon angioplasty technique for treating heart disease. As a result of his experience, he was able to bring this historic technique back to the United States where he was one of the first physicians to perform coronary angioplasty here. A noted medical spokesman, he appears on a weekly Newstalk segment on KWCH Channel 12 and has a weekly syndicated radio talk show on KNSS 1330 AM every Saturday live from 11:00 am to noon. Dr. Galichia may be contacted by sending an e-mail to service@galichia.com
Health & Medicine
2007-07-30 15:23:00
What is atrial fibrillation?
Atrial fibrillation is the most common heart rhythm disturbance that we see in cardiology today. Atrial fibrillation occurs when the reservoir chambers called the right and left atria become irritable and start beating rapidly and irregularly. At this point the atria no longer participate into the pumping mechanism of the heart and blood simply runs passively into these chambers and then eventually crosses into the larger pumping ventricles where it is pumped into the heart, into the lungs and the rest of the body. This results in some decrease in the cardiac output and compromises the function of the heart. At the same time, the regular electrical mechanism, which controls the ventricular response is no longer working, and the larger pumping chambers, called ventricles, then beat more rapidly and completely irregularly. Many patients have no symptoms at all when this occurs, and no awareness that their heart is beating irregularly and rapidly. Other patients notice dramatic changes and find that they feel uncomfortable. They are aware of a rapid heartbeat and feel very weak and rundown. Oftentimes atrial fibrillation occurs intermittently, so that patients may have a period when their heart is beating irregularly and then other periods where they go back into a normal rhythm. Atrial fibrillation may occur completely on its own as an isolated electrical problem. This occurs in approximately 30-40% of patients and is known as “lone atrial fibrillation.” The number one reason for atrial fibrillation is age and it begins to be more and more frequent after age sixty. The second most common cause is hypertension. Aside from that, chronic obstructive lung disease, valvular heart disease, hyperthyroidism, heart failure and enlargement of the atria for any reason may result in atrial fibrillation. The most immediate treatment we have to correct this problem is to do an electrical shock to the heart, called cardioversion. This may or may not be necessary in many patients and is a way of treating the problem immediately. Also, certain medications may help restore the heart rhythm to normal, sparing the need for electrical shock. Unfortunately, in many people, this problem is recurrent and needs to be prevented. Again, there are medications to prevent the recurrence of atrial fibrillation. When medications fail, sometimes ablation procedures may help. A new procedure called Mini Maze has been of great benefit to patients who have a lot of symptoms with atrial fibrillation and multiple recurrences. The Mini Maze procedure will correct this problem in about 80% of cases. It is a minimally invasive surgical procedure which does involve making two small finger size openings in the chest and doing the ablation procedure around the pulmonary veins. Fortunately, most patients do not need either ablation or a surgical procedure, but can be maintained relatively well with medication. It is gratifying to me that we now have the ability to treat this rhythm disturbance in patients who are affected dramatically with this problem and expect a good long term outlook.
 
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