Wednesday, October 15, 2008

Cheney's heart problem resurfaces

Doctors found recurrence of abnormal rhythm, White House says

WASHINGTON - Vice President Dick Cheney will receive an outpatient procedure later Wednesday to restore his normal heart rhythm after doctors found a recurrence of atrial fibrillation, the White House said Wednesday.

"During a visit with his doctors this morning, it was discovered that the vice president is experiencing a recurrence of atrial fibrillation, an abnormal rhythm involving the upper chambers of the heart," his office said in a statement.

"Later this afternoon, the vice president will visit George Washington University Hospital for an outpatient procedure to restore his normal rhythm," it added.

Cheney last November received the same procedure, which involves an electrical shock to his heart.

"Atrial fibrillation is extremely common," Dr. Zayd Eldadah, an electrophysiologist and director of cardiac arrhythmia research at Washington Hospital Center, said at the time. "The way to get rid of it right away is to do what he did today. This is standard practice, low risk, easy to do."

67 and 4 heart attacks
Cheney, 67, has a history of heart problems including four heart attacks, quadruple bypass surgery, two artery-clearing angioplasties and an operation to implant a defibrillator six years ago. In July 2007 he had surgery to replace the defibrillator that monitors his heartbeat.

Eldadah said Cheney's underlying heart problems were probably a factor in his atrial fibrillation. Aging is a common factor, too.

"He'll probably have other episodes," said Eldadah, who was not involved in Cheney's care. "Atrial fibrillation in and of itself is not threatening. The problem is that it has long term consequences. It increases the risk of stroke."

About 2.8 million Americans have atrial fibrillation, the most common type of irregular heartbeat, and cases are increasing as the population ages.

The condition occurs when the heart's top chambers, called the atria, get out of sync with the bottom chambers' pumping action. It is not immediately life-threatening, and the heart sometimes gets back into rhythm on its own. Many times, patients aren't aware of an episode of atrial fibrillation.

Blood clots a danger
But if the irregular heartbeat continues, it eventually can cause a life-threatening complication — the formation of blood clots that can shoot to the brain and cause a stroke.

The main treatment is to try an electrical shock to restore normal heartbeat. If that doesn't work, patients may need to take the blood thinner warfarin to reduce stroke risk.

The type of defibrillator Cheney has is used to prevent sudden death from a very different type of irregular heartbeat that starts in the bottom of the heart. The atrial fibrillation, in contrast, requires a different type of treatment.

In 2005, Cheney had six hours of surgery on his legs to repair a kind of aneurysm, a ballooning weak spot in an artery that can burst if left untreated. In March, doctors discovered that he had a deep venous thrombosis in his left lower leg. After an ultrasound in late April, doctors said the clot was slowly getting smaller.


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