Pat Robertson Recovering from Heart Surgery

Evangelical Christian broadcaster, and founder of the Christian Broadcasting Network, Pat Robertson, 79, is recovering well after a 10 hour surgical procedure to treat atrial fibrillation. During the procedure, at FirstHealth Moore Regional Hospital in North Carolina, Robertson underwent a procedure called catheter radiofrequency ablation as well as undergoing the removal of an abnormally enlarged Left Atrial Appendage (LAA) (see explanations below).

Atrial Fibrillation is an abnormal heart rhythm, characterized as fast and irregular, and caused by a faulty electrical circuit in the heart. It is the most common type of sustained arrhythmia in the US, affecting 2 million people a year. The risk of developing AF rises dramatically with age, with 70% of affected individuals being between 65 and 85 years of age.

Normally the heart maintains a regular heartbeat because the contraction of its four heart chambers is coordinated by a set of electrical “instructions.” The first electrical impulse starts in the right upper chamber (right atrium) at the SA Node. Impulses then spread in a wavelike progression across both atria, causing the upper chambers to contract. The impulses then reach a second node at the junction of the upper and lower heart chambers called the AV node. Special nerve fibers, called Purkinje fibers spread out over the lower heart pumping chambers (ventricles) and cause them to contract in an organized manner, propelling blood from the heart to the rest of the body. In Atrial Fibrillation (AF), abnormal cells in the atria cause electrical impulses to circulate all over the atrial in an irregular fashion, causing the atria to quiver instead of contract. In addition, not all of the impulses will reach the AV node leading to irregular contraction of the ventricles.

Symptoms include a rapid or irregular heartbeat, lightheadedness, shortness of breath, weakness or fatigue. Some patients are asymptomatic. One of the most dangerous conditions association with AF is an increased risk of blood clots that can form in the quivering atria. These blood clots (emboli) can exit the heart and become lodged in blood vessels of the brain, lungs or any other vessel in the body. The left atrial appendage is a small, ear-shaped tissue flap located in the left atrium. This tissue is a common source of blood clots in patients who have atrial fibrillation.

Treatment is dependent on many factors, including the length of time the AF has been present, and whether other heart problems exist. A variety of medications, such as beta-blockers, and antiarrhythmics can control AF in many patients. Often an anticoagulant (blood thinner) is added to prevent the formation of blood clots in the atria. For those resistant to drug therapy, more invasive treatments include:

• Cardioversion- an electrical or chemical shock to the heart to “reset” the system
• Radiofrequency ablation-Using small catheters, the areas of heart tissue thought to be causing abnormal electrical impulses are “cauterized” or cut, using the heat generated by a special radio frequency.
• Pacemaker- a device that is implanted to head the heart from beating too slowly
• Maze procedure- small precise cuts are placed in the atrial wall to design a new pathway for electrical signals to travel.

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