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January 1, 2022Atrial Fibrillation (AFib) is a quivering or irregular heartbeat, or arrhythmia, that can lead to blood clots, stroke, heart failure, and other complications.
Some people live for years with AFib without problems or symptoms. Others may experience heart palpitations, lack of energy, lightheadedness, fainting, chest pain or pressure, or shortness of breath even at rest. Untreated AFib doubles the risk of heart-related deaths and is associated with a fivefold increased risk for stroke.
Electrophysiologists are experts in ablation procedures and management of patients with pacemakers and defibrillators. We asked Drs. Walid Saliba and Oussama Wazni from the Cleveland Clinic to give us a glimpse into their world of electrophysiology (EP).
Healthnetwork Foundation: What has changed in electrophysiology during your time in the field?
Dr. Saliba: It used to be that when a person had AFib there wasn’t much doctors could do. Around 1999, a discovery of where most arrhythmias originate led to developments in ablation procedures. Today when someone comes in with AFib, they have several treatment options available. An ablation can be done as an outpatient procedure using catheters (inserted through the groin) that deliver energy to make small scars in the heart tissue to stop abnormal electrical signals. By the next day, patients feel significantly better. It’s life changing!
HNF: What’s on the horizon?
Saliba: We’re studying the effect of ablation on the heart and how newer forms of energy might help us do more effective and safer ablations.
Dr. Wazni: There are a lot of initiatives, especially in advanced cases with patients who have persistent AFib, looking at what do we do next when the usual approach isn’t working. We’re also looking at the way we manage heart failure. There’s a new device being studied that paces the normal conduction system to re-sync the left and right ventricles and improve heart function. It appears to be safer, cheaper, and better because it’s more in line with the body’s natural physiology.
HNF: How does private philanthropy contribute to this innovation?
Saliba: Whenever you have a new modality, you need to experiment in an animal lab or in a clinical trial with humans. That requires funding. This is where philanthropy can really help.
Wazni: Another way philanthropy makes a difference is how it enables us to spend more time with the patient and investigating problems. Many come here for a re-do procedure after an unsuccessful experience elsewhere. They notice this difference, and many then become donors.
I remember a patient who was referred for a defibrillator because his heart was weak. After spending time with him and investigating his case, I told him we can avoid the defibrillator if we perform an ablation instead. That was more than 10 years ago. He has maintained rhythm and his heart became stronger without the need for a defibrillator.
WALID SALIBA, M.D., is medical director of the Center for Atrial Fibrillation and director of the Electrophysiology Lab at the Cleveland Clinic.
OUSSAMA WAZNI, M.D., M.B.A., is section head and director of the Outpatient Electrophysiology Department and director of the Ventricular Arrythmia Center, the Center for AFib,and the AFib Stroke Prevention Center at the Cleveland Clinic.
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