When medication is not enough
Editor’s Note: Vanderbilt has long been a regional referral center for ablation treatment of SVT. Recently it opened a comprehensive program to treat atrial fibrillation, the most common arrhythmia in clinical practice.
Andrea Boyce’s heart started racing more than 20 years ago, when she was 17.
Boyce eventually was diagnosed with supraventricular tachycardia (SVT), a condition that caused her heart to speed up to 220 beats per minute.
Although her episodes were not frequent, the intensity of her symptoms prompted her doctor to put her on medication, which made her extremely tired and did not prevent the episodes. She continued to have them at least once or twice a year.
“When your heart rate was as fast as mine, all you are thinking about is—am I going to have a stroke or a heart attack? It was very frightening,” she says.
So Boyce asked for ablation, which uses high frequency radio waves to “short-circuit” the abnormal electrical impulses in the heart.
A thin tube or catheter is usually inserted into the femoral vein in the groin and threaded up to a key point in the abnormal circuit in the heart. A burst of radiofrequency energy is delivered to the area to destroy the tissue and prevent the arrhythmia. Patients generally can go home the day after the procedure.
“Catheter ablation therapy has been around for 20 years, but it has only come into prominence in the ’90s,” says Dawood Darbar, M.D., Ph.D., director of the Arrhythmia Service at Vanderbilt University Medical Center who performed Boyce’s ablation this winter. “It is increasingly becoming the first line of therapy for many forms of arrhythmias.”
“People like Dawood, who perform this procedure, are the only cardiologists who are allowed to use the word cure,” adds Dan Roden, M.D., an internationally known expert on arrhythmia at Vanderbilt. “In many cases the likelihood of a recurrence is very, very low. Everyone else in the field of cardiology just fights back disease.”
“It’s amazing,” says Boyce, who has not had an episode of tachycardia since her procedure. “I was talking to the technician who did my heart ultrasound before the procedure and he was telling me that 15 to 20 years ago it was unheard of to fix electrical parts in the heart unless it was a life-or-death situation.”
Another ablation patient who had good results is Bobby Page of Bowling Green, Ky.