Delhi NCR : Doctors at Paras Health Gurugram successfully treated a 42-year-old man who was brought to the emergency department in critical condition with severely low blood pressure and severe dizziness. The patient had no prior history of major illness and was neither diabetic nor hypertensive. He required immediate emergency treatment after doctors detected a serious heart rhythm disturbance. Timely intervention helped stabilise his condition, and he was later discharged in stable condition after undergoing a planned corrective procedure.
Doctors diagnosed the patient with atrial fibrillation with a fast ventricular rate, a condition in which the heart beats irregularly and very rapidly, reducing the heart’s ability to pump blood effectively. The patient had been experiencing occasional palpitations, described as a sudden racing sensation in the chest, prior to admission. When he arrived at the hospital, his blood pressure had dropped to 70/40 mmHg, indicating a life-threatening situation that required immediate intervention.
Due to hemodynamic instability, the medical team performed emergency electrical cardioversion using a controlled DC shock to restore normal heart rhythm. The patient’s blood pressure stabilised and symptoms improved following the procedure. Following stabilisation, further evaluation including echocardiography showed that the patient had a structurally normal heart. Considering the risk of recurrence and potential complications, doctors advised a definitive treatment procedure, radiofrequency ablation.
The procedure involved an electrophysiological study in the cath lab, where specialised catheters were inserted into the heart to map abnormal electrical activity using advanced 3D mapping technology. The source of the arrhythmia, typically located in the left atrium, was identified and treated using controlled micro-ablation. This procedure, known as pulmonary vein isolation, helps prevent abnormal electrical signals from triggering atrial fibrillation. The procedure lasted approximately 3.5 hours and involved a coordinated team of cardiac electrophysiologists, cardiac anaesthetists, cath lab staff and specialised technicians. The procedure was performed by the electrophysiology team under the supervision of senior cardiologists.
Dr Nadeem U Rehman, Senior Consultant Interventional Cardiologist and Electrophysiologist, Paras Health, Gurugram, said that atrial fibrillation with a fast ventricular rate can significantly reduce the heart’s pumping efficiency, which in this case led to a sharp drop in blood pressure and severe dizziness. He explained that in hemodynamically unstable patients, immediate electrical cardioversion is the recommended treatment to quickly restore normal heart rhythm and stabilise circulation, as delaying treatment in such cases can be life-threatening.
Dr. Amit Bhushan Sharma, Director And Unit Head – CARDIOLOGY – INTERVENTIONAL, Paras Health, Gurugram, explained that even in patients with structurally normal hearts, atrial fibrillation can increase the risk of blood clot formation due to irregular heart rhythm, which can lead to a stroke if the clot travels to the brain. He added that radiofrequency ablation, particularly pulmonary vein isolation, is an established treatment that helps prevent recurrence of atrial fibrillation by targeting the source of abnormal electrical signals, significantly improving long-term outcomes and quality of life for patients.
Atrial fibrillation is the most common type of arrhythmia, especially in individuals above 40 years of age and those with hypertension. In patients with structurally normal hearts, it is often referred to as lone atrial fibrillation, and when episodes occur intermittently and resolve on their own, the condition is termed paroxysmal atrial fibrillation. Radiofrequency ablation is an established treatment for such cases, with a success rate of approximately 60 to 70 percent. There is a recurrence risk of around 30 percent, and patients are usually advised follow-up care, including blood thinners and rate or rhythm control medication when required.
The case highlights the importance of not ignoring symptoms such as palpitations, dizziness, or sudden weakness, even in individuals with no known history of heart disease. Doctors emphasise that early diagnosis and timely treatment can prevent serious complications such as stroke and significantly improve patient outcomes.
