Best Doctors in India for Atrial Fibrillation treatment

Dr. Murtaza A Chishti
Director, CTVS (Adult Cardiac Surgery and Heart Lung Transplant) Artemis Hospital, Gurgaon, Haryana

Profile Highlights:

  • Dr. Murtaza A Chishti is one of the most well-known and distinguished Cardio-Thoracic and Vascular surgeons in North India
  • He has more than 3 decades of experience in the field of cardiac surgery with a specialization in heart and lung transplantation surgeries.
  • He has performed more than 6000 cardiac procedures that include Total Arterial revascularization, aortic surgery, complex and re-operative coronary surgery, CABG, and several other cardiothoracic surgeries.

Profile Highlights:

  • Dr. Nandkishore Kapadia is one of the leading Cardiothoracic and vascular surgeons in India excelling in heart and lung transplant surgeries.
  • He has 36+ years of experience in the field during which he has performed over 10000 CABGs, 2000 heart valve repairs, and 800 minimally invasive cardiac surgeries.
  • He has also performed more than 5000 open heart surgeries, 200 heart and lung transplant surgeries, and 150 VAD and ECMO implantation procedures.

Profile Highlights:

  • Dr. Rajneesh Malhotra is a distinguished cardiovascular and thoracic surgeon in India with over 30 years of experience.
  • He is an expert in all kinds of cardiac surgeries with a special interest in Robotic Cardiac surgery along with minimally invasive cardiac surgery and other traditional heart surgeries.
  • Dr. Rajneesh Malhotra has performed several complex and high-risk cases and also specializes in heart transplant surgeries and surgeries for heart failure.

Profile Highlights:

  • Dr. Surendra Nath Khanna is a leading cardiovascular and thoracic surgeon specializing in minimally invasive cardiac surgeries, heart valve repairs, and heart failure surgeries.
  • Dr. Surendra Khanna has 26+ years of experience in cardiac care and has performed more than 17000 surgeries that include beating heart surgery, mitral and aortic valve surgery, and double valve replacement surgery.
  • His expertise lies primarily in adult cardiac surgeries and has done some of the most complex cardiac surgeries in India

Profile Highlights:

  • Dr. Suresh Rao is a highly experienced cardiac surgeon specializing in congenital heart diseases and has performed more than 12,000 surgeries for congenital heart diseases and disorders.
  • Dr. Rao holds an extensive experience of over 33 years in Pediatric and congenital cardiac surgery and has performed numerous simple and complex heart defect surgeries with successful outcomes.
  • Dr. Suresh Rao introduced the Modified Ultrafication procedure after congenital heart surgery in India and has used the procedure in the treatment of a large number of pediatric as well as adult patients.

Profile Highlights:

  • Dr. Suresh V Joshi is a cardiac surgeon in Mumbai with expertise in undertaking complex surgeries as a result of congenital heart diseases.
  • He holds an extensive experience of over 3 decades in cardiac surgery and specializes in Coronary Artery Bypass Grafting (CABG); specifically Beating Heart CABG and Minimally Invasive Cardiac Surgeries.
  • He is an expert in all kinds of coronary and interventional cardiac procedures and has performed over 15,000 cardiac surgeries for different kinds of heart defects and disorders.

Profile Highlights:

  • Dr. Sushant Srivastava is a renowned cardiovascular and thoracic surgeon specializing in heart transplantation.
  • He specializes in performing Beating Heart Bypass surgeries and is credited with performing the procedure on the oldest patient in India (96 years old). He also performed the first awake CABG in North India.
  • He has taken up close to 10000 cardiac cases in his career and performed 3000+ cardiac surgeries related to Coronary Artery Bypass Grafting (CABG), redo coronary artery surgery, heart failure surgeries, heart valve surgeries, and various other types of cardiac surgeries.

Profile Highlights:

  • Dr. Vivek Jawali is a renowned Cardiothoracic and Vascular Surgeon in India and has performed more than 18,000 cardiothoracic and cardiovascular surgeries.
  • He has several firsts to his credit that including the first beating heart bypass surgery in 1992 and the first Minimally Invasive Heart Bypass surgery in 1994 in India.
  • He performed the first Awake Cardiac Surgery in 1999 which is done without general anesthesia or ventilator but under continuous high thoracic epidural. He also performed the first awake open heart surgery in the world without general anesthesia or ventilator on a 74-year-old patient for triple bypass with aortic valve replacement.

Profile Highlights:

  • Dr. Yugal Kishore Mishra is a well-known cardiovascular and thoracic surgeon in Delhi specializing in Minimally Invasive and Robotic cardiac surgeries.
  • He has 3 decades of experience in CTVS and has performed more than 19,000 open heart surgeries to date that including various types of minimally invasive cardiac procedures such as the port access approach for valve surgery and ASD closure.
  • He is the founder of the Robotic Cardiac Surgery Program at Fortis Escorts Heart Institute where he has performed over 500 robotic cardiac surgeries.

Profile Highlights:

  • Dr. Zainulabedin Hamdulay is one of the best cardiac surgeons in Mumbai, India, and specializes in devising new and innovative techniques for cardiac surgeries.
  • He has 24+ years of experience and has performed over 8000 cardiac surgeries that included complex valve repairs, congenital cardiac surgery, CABG, and several minimally invasive cardiac surgeries.
  • With a motive to provide the best, affordable and comprehensive cardiac care to all his patients, he founded the Hamdulay Heart Foundation to provide aid to the economically backward community.

Best Hospitals in India for Atrial Fibrillation treatment

ATRIAL FIBRILLATION

Atrial fibrillation is a problem that occurs with the heart’s electrical activity leading to irregular and rapid heart rate, which can increase one’s risk of strokes, heart failure or other complications.

During this problem, the heart’s two upper chambers beat chaotically as well as irregularly out of coordination with the two lower chambers of the heart. Symptoms of atrial fibrillation usually include heart palpitations, shortness of breath and weakness. One major concern with this ailment is the potential to develop blood clots within the upper chambers of the heart, which can circulate to other organs, leading to blocked blood flow which is termed as ischemia.

Treatments for atrial fibrillation often include medications as well as other interventions to attempt to alter the heart’s electrical system.

Symptoms of Atrial Fibrillation

Some people who have from atrial fibrillation show no symptoms and are unaware of their conditions until they discover it during a physical examination. Other people with this ailment can show symptoms such as :

  • Weakness
  • Fatigue
  • Reduced ability to exercise
  • Dizziness
  • Shortness of breath
  • Pain in the chest

Types of Atrial Fibrillation

Atrial fibrillation can be of multiple types:

  • Occasional- In this case, you can have symptoms from time to time which can last from a minute to an hour. Sometimes the symptoms can show for as long as one week, but it might go away on their own without treatment.
  • Persistent- In this case, your heart rhythm doesn’t go back to normal on its own. When your atrial fibrillation becomes persistent, you will require treatment such as shock or medications to help you restore your heart rhythm.
  • Long-standing persistent- In this case, the atrial fibrillation becomes continuous and lasts longer than 12 months.
  • Permanent- In this type of atrial fibrillation, you can’t restore the abnormal heart rhythm, and you will need to keep taking medications to control your heart rate and to prevent blood clots.

Causes of Atrial Fibrillation

The heart has four chambers- two upper and two lower. Within the upper right chamber of your heart, there is a group of cells termed as the sinus node. This is the natural pacemaker of the heart. The signal that starts each heart back is produced by the sinus node.

This signal normally travels through the two upper heart chambers and then through a connecting pathway which lies between the upper and the lower chambers called the atrioventricular node. The movement of this signal can cause the heart to squeeze which sends blood to your heart and body.

During Atrial fibrillation, the signals in the upper chambers of one’s heart are chaotic; this causes them to quiver. This causes the AV node to be bombarded with impulses trying to get through to the ventricles. The ventricles beat rapidly as well, though not as much as the atria and not all the impulses get through.

Damage or abnormalities in the structure are the most common causes of this condition. Some possible causes that lead to atrial fibrillation are:

  • Heart attack
  • High blood pressure
  • Abnormal heart valves
  • Coronary artery disease
  • An overactive thyroid gland or other metabolic imbalance
  • Heart defends that come with birth
  • Too much exposure to stimulants such as medications, caffeine, alcohol and tobacco
  • Lung diseases
  • Viral infection
  • Previous heart surgery
  • Stress caused by surgery or illnesses such as pneumonia
  • Sleep apnea

 

However, some people have atrial fibrillation but don’t have any heart defects or damage, a condition called lone atrial fibrillation. In this condition, the cause is often unclear and serious complications are rare. Some factors that might reduce the risk of atrial fibrillation include:

  • Age- As you get older, your risk of developing atrial fibrillation increases.
  • Heart disease- Anyone with heart diseases such as congenital heart disease, congestive heart failure, coronary artery disease, a history of heart attack or heart surgery also has an increased risk of atrial fibrillation.
  • Drinking- Too much drinking can also trigger atrial fibrillation, for some people.
  • High blood pressure- If you have high blood pressure, it puts you at risk, especially if you are not controlling it with lifestyle changes or medication.
  • Family history- Some families show an increased risk of developing atrial fibrillation.
  • Obesity- Obese people are at a higher risk as well.
  • Chronic conditions- People who suffer from certain chronic conditions like sleep apnea, metabolic syndrome, diabetes, thyroid problems, chronic kidney or lung disease also have a greater chance of having atrial fibrillation.

Diagnosis of Atrial Fibrillation

For diagnosing this condition, your doctor will review your signs and symptoms, review your medical history, after which a physical examination will be conducted. Some of the tests the doctor may order include:

Electrocardiogram

An ECG or electrocardiogram uses small sensors attached to your chest and arms in order to sense and record electrical signals, as they travel through the heart. This is considered a primary tool for the diagnosis of atrial fibrillation.

Event Recorder

This portable ECG device can monitor your heart activity over a few weeks to a few months, and when you go through symptoms of a faster heart rate, you can push a button. After this, an ECG strip of the preceding few minutes as well as the following few minutes will be recorded.

Holter Monitor

This is a portable ECG device, is carried in your pocket or can also be worn on a belt or shoulder strap. It can record your heart’s activity for 24 hours or longer which can provide your doctor with a prolonged look of the rhythms in your heart.

Echocardiogram

This is another kind of test that uses sound waves in order to create moving pictures of the heart. A device that looks like a wand is usually held on your chest. A flexible with the transducer is guided down your throat through to your esophagus. Your doctor might also use an echocardiogram in order to diagnose structural heart disease or blood clots in your heart.

Blood tests

Blood tests can help your doctor to rule out thyroid problems or other such issues or substances in your blood, which might lead to atrial fibrillation.

Stress test

Stress test also termed as exercise testing, stress testing needs you to exercise, during which tests are run on your heart.

Chest X-ray

X-ray images can also aid your doctor in seeing the condition of the lungs as well as the heart. Sometimes your doctor can use X-ray to diagnose conditions other than atrial fibrillation that might explain your symptoms.

Treatment of Atrial Fibrillation

Initially, your doctor will give you medicines that can help in preventing clots and strokes as well as control the heart rhythm.

Blood thinners are a type of medication that thins your blood to lower your risk of having such problems. However, they can increase your risk of bleeding, which is why you might need to cut back on some activities that lead to injuries. You’ll also need to visit your doctor at least once every month in order to make sure that the medication is working and you are on the right dosage.

Heart rate medicines are another form of treatment that is used to treat atrial fibrillation. These can help in slowing your rapid heart rate so that your heart can pump better. You might also need some other drugs called beta-blockers, such as Atenolol, Metoprolol and Timolol.

Your doctor might also prescribe heart rhythm medicines, which can slow the electrical signals in order to bring your heartbeat into what we call a normal sinus rhythm. Sometimes this kind of treatment is called chemical cardioversion.

If medicines fail to work or they cause side effects, your doctor might recommend one of two procedures which are called cardioversion or ablation. These can treat without surgery.

Electrical cardioversion

The doctor will give your heart a shock to regulate your heartbeat, after which he will use paddles or stick patches called electrodes onto your chest. You’ll be initially given medicine that will make you fall asleep. Then your doctor will be putting the paddles on your chest and sometimes on your back. This can give you a mild electrical shock in order to get your heart’s rhythm back to normal.

Most people need only one shock and since you’re sedated, you probably won’t remember being shocked and you should be able to return home the same day. Sometimes your skin might be irritated where the paddles touched it. Your doctor can recommend a lotion to ease pain or itching.

Cardiac ablation

This includes two major options-

Catheter ablation

Also termed as radiofrequency or pulmonary vein ablation, this is a less invasion option as compared to surgery. Your doctor will put a thin and flexible tube into a blood vessel in your leg or your neck. It will be guided to the heart. When it reaches the area that is causing the arrhythmia, it will be sending out electrical signals which will destroy these cells, and after this, the treated tissue will help your heartbeat get to regular again.

There are also main types of catheter ablation which include:

  • Radiofrequency ablation In this method, the doctor will be using catheters to send radiofrequency energy which will create circular scars around each vein or group of veins.

 

  • Cryoablation- A single catheter sends a balloon-tipped with a substance that will be able to freeze the tissues, causing a scar.

Surgical ablation

This involves involve cutting into your chest and it is of different types:

  • Maze procedure- This procedure is usually performed while you are having open-heart surgery for another problem such as a bypass or a valve replacement. The surgeon will then make small cuts in the upper part of the heart, which will be stitched together eventually in order to form the scar tissue which will help to stop abnormal signals.

 

  • Mini Maze- Most people who suffer from atrial fibrillation usually don’t need open-heart surgery and that’s where this less invasion option’s effectiveness can be seen. The doctor will make several small cuts between your ribs, after which he will use a camera to guide catheters for cryoablation or radiofrequency ablation. There are also some hospitals that are known to offer robot-assisted surgery, which uses smaller cuts allowing more precision. Your doctor will next put a video camera or tiny robot into your chest, which will guide the creation of scar tissue, in order to help keep your heartbeat at the right place.

Convergent Procedure

This procedure pairs catheter ablation with a mini maze. The doctor uses radiofrequency ablation in the pulmonary vein, after which a surgeon will make a small cut under your breastbone in order to use radiofrequency energy on the outside of the heart.

AV node ablation

This procedure can be recommended if your medications don’t work or you are unable to take them due to side effects. If you aren’t a good candidate for the other procedures, this one is considered as the last option. In this procedure, your doctor will be inserting a catheter into a vein in your groin and slide it up the AV node, a nerve that conducts electrical impulses between the top as well as bottom chambers of the heart. Your doctor will also send radiofrequency energy through your ventricle and then will implant a pacemaker into your chest. It will deliver electric pulses that will make your heartbeat.

Prevention of Atrial Fibrillation

There are also steps that you can take to prevent atrial fibrillation and there’s nothing more important than living a lifestyle that will help to reduce your risk of heart disease. A healthy lifestyle should include:

  • A diet which is healthy for the heart
  • Increasing your physical activity
  • Not smoking
  • Maintaining a healthy weight
  • Limiting or restricting caffeine and alcohol
  • Reducing stress, as intense stress and anger might lead to heart rhythm problems.

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