Atrial Fibrillation Treatment and Surgery in India

Atrial Fibrillation

Atrial fibrillation is a heart condition that causes episodes of irregular and often abnormally fast heart rate. It occurs when abnormal electrical impulses suddenly start firing in the atria. These impulses override the heart's natural pacemaker, which can no longer control the rhythm of the heart. This causes you to have a highly irregular pulse rate. When the heart beats normally, its muscular walls contract to force blood out and around the body. They then relax, so the heart can be filled with blood again. This process is repeated every time the heart beats.

In atrial fibrillation, atria or the upper chambers of the heart contract randomly and sometimes so fast that the heart muscle cannot relax properly between contractions.This may lead to a number of problems, including dizziness and shortness of breath. Atrial fibrillation can affect adults of any age, but affects men more than women and becomes more common the older you get. It affects about 10% of people over 75. Atrial fibrillation is more likely to occur in people with other conditions, such as high blood pressure or atherosclerosis. It is not common in younger people unless they have a heart condition.

Symptoms of Atrial Fibrillation

One may have atrial fibrillation without having any symptoms. However, one should be careful about the following symptoms;

• Heart palpitations - Sudden pounding, fluttering or racing sensation in the chest
• Lack of energy or feeling over-tired
• Dizziness - Feeling light-headed or faint
• Chest discomfort - Pain, pressure or discomfort in the chest
• Shortness of breath - Having difficulty breathing during normal activities and even at rest

Types of Atrial Fibrillation

There are three main types of atrial fibrillation:

• Paroxysmal atrial fibrillation. This comes and goes and usually stops within 48 hours without any treatment.
• Persistent atrial fibrillation. This lasts for longer than seven days (or less when it is treated).
• Longstanding persistent atrial fibrillation. This usually lasts for longer than a year.

Causes of Atrial Fibrillation

There is no particular cause of atrial fibrillation, although it is associated with many conditions, including:

Most common causes

• Hypertension (high blood pressure)
• Coronary artery disease
• Heart valve disease
• After heart surgery
• Chronic lung disease
• Heart failure
• Cardiomyopathy
• Congenital heart disease
• Pulmonary embolism

Less common causes

• Hyperthyroidism
• Pericarditis
• Viral infection

In at least 10 percent of the cases, no underlying heart disease is found. In these cases, AF may be related to alcohol or excessive caffeine use, stress, certain drugs, electrolyte or metabolic imbalances, severe infections, or genetic factors. In some cases, no cause can be found.

The risk of AF increases with age, particularly after age 60.

Diagnosis of Atrial Fibrillation

Doctors might use a couple of tests to diagnose atrial fibrillation:

• Electrocardiogram, or EKG - With this painless, non-invasive test, electrodes are placed on the patient’s chest to track his heart rhythm.
• Electrophysiologic tests - These tests “map” the electrical system of the heart. These minimally invasive tests use sensors inserted into blood vessels that lead to the heart to identify what areas of the heart are not working properly.
• Echocardiograph - Following the ECG, and if the patient is diagnosed with Atrial Fibrillation, he may need to have an echocardiogram (a scan) which can assess the structure and overall function of the heart.
• Blood Tests - A variety of blood tests may be needed, depending on the individual’s medical history. In almost all cases, the activity of the thyroid gland is measured through a blood sample, because over activity may provoke AF.

Atrial Fibrillation Treatment and Surgery

The doctor might first try to restore the normal rhythm of the heart with prescribed medications. Because there are many reasons for atrial fibrillation, cardiologists may create a personalized treatment plan and monitor the patient.

• Prescribed Medications: Medicines called anti- arrhythmics can control atrial fibrillation by restoring a normal heart rhythm, and/or controlling the rate at which the heart beats.
• A beta-blocker (such as bisoprolol or atenolol) or a calcium channel blocker (such as verapamil or diltiazem) will be prescribed.
• A medicine called digoxin may be added to help further control the heart rate. In some cases, amiodarone may be tried.
• People with atrial fibrillation who have a high or moderate risk of stroke are usually prescribed warfarin, unless there is a reason they cannot take it.
• People with atrial fibrillation who have a low risk of stroke are likely to be given a low dose of aspirin to take every day instead of warfarin.
• Pacemaker Therapy: It involves the placement of a device under the skin that monitors heart rate and sends stimulating electrical impulses if the heart rates slow too much.
• Electrical Cardioversion: The heart is given a controlled electric shock to try to restore a normal rhythm. The procedure normally takes place in hospital, where the heart is carefully monitored.
• Catheter Ablation: Catheter ablation is a procedure that very carefully destroys the diseased area of your heart and interrupts abnormal electrical circuits. It is an option if medication has not been effective or tolerated.
• Surgical Options: This includes a Maze or mini-Maze procedure, which eliminates the abnormal rhythm by scarring or cutting the heart tissue responsible for atrial fibrillation.

Follow-Up Care Post Atrial Fibrilliation Surgery

• Thirty to fifty percent of patients experience skipped heartbeats or short episodes of atrial fibrillation during the first three months after the procedure. This is common due to inflammation (swelling) of the atrial tissue and is treated with medications. After the heart has healed, these abnormal heartbeats should subside.
• A small number of patients require a pacemaker after surgery due to an underlying rhythm, such as sick sinus syndrome or heart block, which previously was undetected.
• Medications after surgery may include anticoagulant (blood thinner), antiarrhythmic medication to control abnormal heartbeats, diuretic to reduce fluid retention,etc
• The doctor will monitor recovery and determine when or if the medications can be discontinued.
• The patient will have to follow-up with his cardiologist within 4-5 weeks of being discharged to check on his heart rhythm .
• The patient may be recommended to have an EKG at 3 months, 6 months, and 12 months after surgery and then annually thereafter.

Benefits of Atrial Fibrillation Surgery and Treatment

Catheter ablation can restore normal sinus rhythm and avoid the need for drugs. There is also early evidence that catheter ablation of patients with AF and heart failure can have their heart function improved by restoration of sinus rhythm by catheter ablation.

Some centers have also achieved this 80% success rate for patients with permanent AF. In order to achieve these results up to 50% of patients need to have repeat procedures. The disorder is usually controllable with treatment. Improvements in surgical techniques over the years have produced successful results in most patients which includes rapid recovery from minimally invasive ablation, long-term freedom from atrial fibrillation, decreased symptoms, greatly reduced embolic events (such as blood clots or stroke), decreased atrial (top chamber of the heart) size in those with enlarged atria pre-surgery, particularly those who undergo Maze procedure with mitral valve repair procedure.

Atrial Fibrillation Surgery and Treatment in India

In India, cardiac surgeons have extensive experience in diagnosing and treating people who have atrial fibriliation and other heart rhythm disorders. Most Indian hospitals have doctors who are trained in evaluating and treating heart conditions (cardiologists), doctors who are trained in heart surgery (cardiovascular surgeons) and other doctors who work closely to evaluate and treat people who have atrial fibrillation and other heart rhythm conditions. Indian hospitals actively conduct research in atrial fibrillation and other heart rhythm disorders and conduct clinical trials and use the most current technology in atrial fibrillation and heart rhythm disorder treatment, including catheter radiofrequency ablation.

Cities in India offering Atrial Fibrillation Surgery and Treatment at some of the best cardiac hospitals are as follows;

Cost of Atrial Fibrillation Treatment or Surgery in India

India is the most cost effective medical tourism destination of the world. The cost of atrial fibrillation in India is very low as compared to the cost of the similar procedure charged in other western countries. This applies to treatment and surgeries associated with atrial fibrillation. Even after adding travel and accommodation costs, treatment of Atrial Fibrillation in India can result in up to 50 to 80% cost savings. All surgery and treatments are tailored to consider the needs of the travelling patient. India gives you the opportunity to have high class immediate surgical and medical treatments which includes Atrial Fibrillation at low cost.

Some of the common countries from which patients travel to India for surgery are:

ABOUT INDIA

Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh offers best medical tourism service.

• Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many things, including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a superb choice of restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a great place to start exploring this great city.
• Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a continuous growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of tourists during past few years. Hyderabad has a well-founded reputation as one of the safest cities in the world.
• Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a particularly compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that the state has much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving.
• Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then Bangalore is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City of Gardens'. Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own attraction for travelers as one of the most charming cities in India,
• Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good jumping-off point for a series of trips into the far eastern corner of Maharashtra..
• Kerala - Welcome to Kerala, state in India's southern tip and a state known as God's Own Country. Kerala is one of the ten 'Paradises Found' by the National Geographic Traveler, for its diverse geography and overwhelming greenery. It is a land much acclaimed for the contemporary nature of its cultural ethos, and much appreciated for the soothing, rejuvenating paradise that it is.
• Delhi - Delhi, the capital of India is situated in the northern part of the country. Apart from being the capital of India, Delhi is also the travel hub of northern India. It serves as an excellent base for visiting the colorful state of Rajasthan, and Agra, the city of the Taj Mahal, is less than three hours away. Discover the many tales behind Delhi’s ancient, bewitching existence. Feel the excitement of stepping foot on a piece of the world’s oldest land!
• Pune - Pune is the eighth largest city in the India state of Maharashtra. The city derives its name from Punya Nagari, which means 'the city of virtuous deeds.'Pune or the 'Queen of Deccan' is known for its educational, research and development institutions. This beautiful city has many exotic locales attracting innumerable tourists.
• Jaipur – Jaipur is located in India and attracts a flurry of tourists from all over the world. Sited within eastern Rajasthan, North India, the city of Jaipur is famed for its hilltop fortresses, magnificent royal palaces and historic pink-painted sandstone architecture, earning it the affectionate nickname of the 'Pink City'.
• Chennai - Chennai formerly known as Madras is the capital city of the Indian state of Tamil Nadu. It is famous for its culture and tradition. Chennai hosts a large cultural event, which includes performances by hundreds of artists. The city has a vibrant theatre scene and is an important centre for the Bharatanatyam, a classical dance form.
• Gurgaon – It is one of the four important satellite cities of the National Capital Region and is often referred to as the 'Millennium City.' Gurgaon has recently emerged as the latest hub for Medical Tourism. Apart from being IT hub and a favorite haunt for MNC offices, the city has a number of world class hospitals that not only treat Indian citizens but also people from outside.
• Chandigarh - Chandigarh is a rare epitome of modernization co-existing with nature's preservation. It is here that the trees and plants are as much a part of the construction plans as the buildings and the roads. India’s first planned city, Chandigarh is a rich, prosperous, spic and span, green city rightly called “THE CITY BEAUTIFUL”.