Like any teenager, 19-year-old Rahul’s days were ruled by college, Formula One racing, James Bond and cricket. Shuttling from tuition to cyber café to the gym, he hardly had time to pay attention to the minor discomforts he suffered, like a racing heart without any apparent reason, getting tired easily or unexplained sweating.
But things came to a head when he injured himself after rolling down two flights of stairs, becoming senseless after a bout of rapid heartbeat, and found himself outside the cardiologist’s chamber. Rahul is just one of the many teenagers suffering from paroxysmal arrhythmia, or rhythm disturbance of the heart.
Being endowed with the Herculean task of pumping blood to each and every cell of the body, our heart is provided with its own unique system that generates electrical impulses and conducts them through the muscular pump for that incessant lub-dup.
But just like in our domestic power-supply system, sometimes there is a short-circuit in the electrical system of the heart, resulting in symptoms like palpitation, shortness of breath, chest pain or momentary senselessness. This type of rhythm disturbance can lead to a stroke or even sudden death.
“Although it can be caused by valve disorders or any other underlying heart conditions, arrhythmia can also strike healthy individuals without any significant cardiac pathology,” says A.G. Ravi Kishore, cardiac electrophysiologist and coordinator, electrophysiological services, Asia Heart Foundation (AHF).
Till a few years back, surgery or life-long therapy with anti-arrhythmic drugs was the only option before these patients. These days, the treatment of choice worldwide for cardiac electrophysiologists is radio frequency ablation (RFA).
“It is a minimally invasive procedure, where the diseased portion of the heart muscle is destroyed, using high temperature in the form of radio frequency waves, applied through catheters,” explains Ravi Kishore. He performs RFA on city patients regularly at the Rabindranath Tagore International Institute of Cardiac Sciences, at Mukundapur, off the EM Bypass.
It is performed in the cardiac cath lab under local anaesthesia administered in the groin. Catheters are inserted through the femoral blood vessel and electrical activities of different parts of the heart are studied simultaneously. Efforts are made to induce arrhythmia in controlled environment to identify the diseased muscle.
Once the trouble-shooter is spotted, special ablation catheters are inserted and manipulated precisely over the diseased muscle portion. AC current is applied to raise the temperature to 65-70 degrees Celsius. This heat destroys the abnormal portion permanently, so that it can neither generate nor conduct abnormal impulses. Thus, the rhythm irregularity is cured permanently. The procedure is almost painless. The patient is released after a day and can return to normal active life almost immediately.
“The destroyed area of the muscle usually does not exceed the diameter of a sharply-cut pencil tip and it does not affect the overall pumping ability of the heart,” says Ravi Kishore.