Newswise — Reporters seeking background information about Vice President Cheney's treatment for atrial fibrillation are welcome to contact the UVA Public Relations office to arrange an interview with:
J. Michael (Mike) Mangrum, MD, Associate Professor of Medicine, and director of the Atrial Fibrillation Center at the UVA Health System Link to video preview:
Dr. Mangrum's Afib FAQ's:
Following is a transcript of a recent interview with Dr. Mangrum
Q. What it is Atrial Fibrillation (afib) and how common is it?
Dr. Mangrum: It's very common. In fact, afib is the most common abnormal rhythm that people have. It affects about 2.5 million people in America alone, and the prevalence is increasing over time. And it's estimated that by the year 2030, about 5.6 million people in America will have atrial fibrillation, which occurs when the atria (the top chambers of the heart) quiver at a rate of roughly 400 beats a minute.
Q. What are the symptoms of Afib?
Dr. Mangrum: Patients are quite symptomatic. They have a reduction in their heart function, and they feel palpitations, may feel dizziness, some may even pass out. Fifteen percent of all strokes are attributable to atrial fibrillation. Patients who have afib are at risk of stroke from the disorder because the atria are quivering and clots can form in the atrium.
Q. What causes Afib?
Dr. Mangrum: There are multiple causes. The strongest factor is aging. In fact about 10 percent of people over the age of 80 have atrial fibrillation. As our population ages, the number of people in America with afib will increase.
Another common cause of afib is hypertension. Over time, hypertension increases the left atrial size and pressure within the left atrium that causes some scarring, and the scarring predisposes a patient for atrial fibrillation. Some people have primarily an electrical problem with their heart that causes afib.
Q. How is Afib treated?
Dr. Mangrum: Medications are the first line of therapy and the most common treatment. Antiarrhythmic drugs try to keep the patient in normal rhythm. Results vary by drug, but in general medications have an efficacy rating of 40-60 percent in maintaining normal rhythm.
If antiarrhythmic drugs do not help, then the next line of therapy is cardiac ablation. Ablation is designed to get rid of the atrial fibrillation. It is a procedure that uses catheters, threaded thru the veins, up into the heart. These areas are mapped with sophisticated imaging equipment, and then ablation is performed, usually in the left atrium. Ablation uses energy to destroy the tissue causing afib and is a highly specialized procedure. It is not available in all places. Success rates for cardiac ablation range from 50-85 percent, depending on the patient. Success rates are typically lower in patients who have long standing atrial fibrillation with a lot of other heart disease. Patients who have a pristine heart and just have atrial fibrillation tend to experience greater success with ablation.
Dr. Mangrum's Bio
J. Michael Mangrum received his B.S. from Rhodes College in 1988 and his M.D. from the University of Tennessee, Memphis in 1993. His post-graduate training consisted of an Internal Medicine Residency at the University of Chicago from 1993-1996, and Cardiology and Electrophysiology Fellowships at the University of Virginia from 1996-2000. Dr. Mangrum is board certified in Internal Medicine (1996), Cardiovascular Disease (1999), and Clinical Cardiac Electrophysiology (2000). He joined the faculty of the University of Virginia in 2000 and is an Assistant Professor of Medicine.
Dr. Mangrum serves at the Director of the Electrophysiology Fellowship program and is the Director of the Atrial Fibrillation Center. His clinical and research interests include ablation strategies for atrial fibrillation.
Afib Treatment at UVA
For a long time, Afib was considered a benign disorder. Doctors now know that Afib patients are five times more likely to suffer a stroke and are also at greater risk for congestive heart failure and cardiac arrest, making proper treatment essential. Unfortunately, traditional medications aren't always effective. And when they do work, the side effects can diminish a patient's quality of life and over the long-term lead to organ damage.
UVa Health System helped pioneer cardiac ablation as an alternative to lifelong drug therapy. Using sophisticated imaging techniques, UVa doctors deliver radiofrequency waves through a catheter to destroy, or ablate, the heart tissue housing the electrical short circuit. Ablation is not only a proven treatment, it has a relatively low risk of complications and typically causes little discomfort to the patient. Most people spend less than a day in the hospital and resume their normal activities within a few days.
UVa doctors have achieved excellent results after performing more than 300 ablation procedures for Afib " one of the highest volumes at any U.S. hospital. Last year, 93 percent of UVa patients who had structurally normal hearts and underwent an ablation procedure to treat paroxysmal Afib remained free of symptoms in the six months after treatment. The national success rate for ablation is about 70 percent.
J. Michael Mangrum, M.D., directs UVa's Atrial Fibrillation Center and is one of five UVa electrophysiologists (heart rhythm doctors) who specialize in Afib. Mangrum and his colleagues helped perfect ablation therapy that was developed at UVa a decade ago and made available to patients within the past five years. "Many patients' lives are needlessly limited by debilitating episodes of atrial fibrillation because they don't know a one-time procedure could provide a cure," Mangrum says.
Ablation is not the best option for everyone with Afib, which affects a wide spectrum of people from young adults to an estimated 10 percent of those older than 80. UVa created the Atrial Fibrillation Center to help patients and their doctors choose the most appropriate treatment among a wide range of options. "We offer very individualized treatment plans based on severity and frequency of symptoms, stroke risk and a person's overall cardiac health," Mangrum says. "Our goal for our patients is always to manage the risk of stroke and other complications while minimizing " and whenever possible eliminating " atrial fibrillation's impact on our patients' lives."