For 15 years, Richard Meyer lived with infrequent episodes of atrial fibrillation, sometimes only experiencing two episodes a year before he developed an unusual trigger. Suddenly, swallowing started making his heart skip beats and flutter inside his chest, putting him in a nearly constant state of atrial fibrillation.

“It was really starting to become a nuisance,” Richard says. The frequency was also putting his health at risk because it is during these episodes, when the heart is beating

irregularly, that people with atrial fibrillation are at risk of having a stroke or a heart attack. “I knew then that I may need to talk to a doctor about ablation.”

“What causes it is the million-dollar question,” says Rahul Doshi, MD, associate professor of clinical medicine at the Keck School of Medicine of USC. “We know it is associated with age and that there is some genetic component to it, but we are far from being able to predict who will get this.” Atrial fibrillation is just as unpredictable in the way people experience the disorder. Some people with atrial fibrillation may get so light-headed and nauseated during episodes that they cannot function. Other people live with atrial fibrillation for years, never noticing that their heart is beating irregularly. The episodes can last for hours or they may carry on for weeks at a time. The frequency of these episodes is also unpredictable and can come along every month, for example, and then not recur for years.

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It is this inability to predict episodes that makes atrial fibrillation, while not considered extremely life-threatening, so hard to live with.

“You tell yourself that you don’t have a life-threatening condition, but the first half-hour of every episode I would have a lot of anxiety,” Richard says. “You start to learn to live with it, but it is the kind of thing that is always on your mind.”

Richard loves the outdoors and in his free time can be found mountain biking in the hills around Los Angeles. He and his family also love to scuba dive, and their family vacations are typically in an exotic location where they can enjoy diving together and exploring the ocean.

“I was always worried that I would have an episode on top of a mountain somewhere and not be able to get down,” Richard says. “Or that I would have an episode when we were scuba diving and I wouldn’t have access to my doctor.”

Some people eventually identify triggers, such as alcohol or coffee, and manage their episodes by avoiding them. There are also medications that can help control the heart rate during atrial fibrillation to help reduce the risk of stroke.

When his atrial fibrillation started to be triggered by swallowing, he consulted with Dr. Doshi, who is also director of cardiac electrophysiology at the USC Cardiovascular Thoracic Institute at Keck Medicine of USC, who determined that Richard should undergo ablation, a procedure that can correct the condition. The procedure involves threading a catheter to the heart and using radiofrequency waves to destroy the heart tissue that is causing the atrial fibrillation.

Dr. Doshi, who has been performing ablation for nearly two decades, notes that the technology has changed rapidly in recent years, allowing physicians to treat complex

arrhythmias, like Richard’s. Because the swallowing trigger is unusual, it required precise mapping of the heart in advance of the procedure. Dr. Doshi said the team at Keck Medicine has a variety of mapping and imaging technologies, as well as years of experience, to help them individualize the procedure for each patient.

Shortly after his ablation procedure in February of 2016, Meyer had two short episodes of atrial fibrillation, which is common right after ablation for many patients. Now, however, it has been more than a year since the last occurrence.

Facts About Atrial Fibrillation

  • Most common type of heart arrhythmia
  • 5 million+ people affected in the U.S.
  • More common among:
    • older people
    • people with leaky heart valves, thyroid
    • problems or structural heart defects
  • Also can affect people like Richard who are otherwise healthy and young.

By Hope Hamashige