Atrial Fibrillation (AF or A-fib)
Atrial fibrillation (AF or A-fib) is the most common heart rhythm disorder (arrhythmia) in which the heart beats at an irregular and often rapid pace. During atrial fibrillation, multiple electrical impulses travel through the hearts two upper chambers, causing it to “quiver” rather than contract. This causes the upper chambers, known as the atria, to beat at a much faster pace than the two lower chambers, known as the ventricles. This irregular heart beat results in poor blood flow to the body. Complications of atrial fibrillation can be life-threatening, including stroke and heart failure.
Patients with atrial fibrillation prognosis have five times the risk of stroke than those without the arrhythmia. In addition, A-fib patients who have suffered a stroke have two times the risk of being bedridden than patients who suffered a stroke without the disorder.
What are the symptoms of a-fib?
Atrial fibrillation affects more than 2 million people in America each year. Be aware of symptoms, which include:
- Heart palpitations
- Shortness of breath
- Chest pain
What are the risks of a-fib?
Atrial fibrillation can be triggered by many factors, ranging from medical conditions to lifestyle choices, including:
- High blood pressure
- Heart problems, including coronary artery disease, abnormal heart valves, heart failure, heart attacks, congenital (born with) heart defects and prior heart surgery
The surest way to detect atrial fibrillation is with an electrocardiogram (EKG). In some cases, a Holter Monitor or Event Recorder may also be used for diagnosis. If you have atrial fibrillation, you may have to go for additional cardiac testing, including an echocardiogram, a stress test or blood tests.
Artrial Fibrillation Treatment Guidelines and Procedures
As a patient of The Heart Institute, you’ll have access to the most cutting-edge treatments for atrial fibrillation. Your cardiologist will ultimately determine which procedure is best for you. Possible A-fib treatments include:
LARIAT (left atrial appendage occlusion) surgery is an innovative catheter-based percutaneous procedure that uses sutures to tie off the left atrial appendage (LAA). This process helps to prevent blood clots that can lead to stroke in patients with atrial fibrillation, or “AFib” (an abnormal heart rhythm). This procedure is the only minimally invasive treatment option for patients who have AFib but cannot take blood thinners due to an underlying medical condition.
The WATCHMAN Device is a permanent implant designed to close the left atrial appendage in the heart in an
effort to reduce the risk of stroke.
This treatment can be conducted two ways, by sending an electric current to the heart or by using anti-arrhythmia medication. Some patients may need to take blood-thinning medication before and after cardioversion.
In some cases, when heart rate cannot be converted, a combination of medications may be prescribed to slow the heart rate down.
The maze procedure utilizes a scalpel to make several precise incisions that create a pattern of scar tissue, blocking the abnormal electrical impulses that cause atrial fibrillation. Radiofrequency and cryotherapy can also be used to create the scars, as these are variations of the surgical maze technique. Generally, this procedure is reserved for those who don’t respond to other therapies or when it can be done during other heart surgery. Some people may require a pacemaker insertion.
Cryoballoon ablation is a balloon-based technology that blocks the conduction of the arrhythmia in cardiac tissue through the use of a coolant rather than heat, by way of a catheter. This freezing technology allows the catheter to adhere to the tissue during ablation, allowing for greater catheter stability.
AV node ablation
AV node ablation applies radiofrequency energy to the pathway connecting the upper and lower chambers. When applied, the atria are prevented from sending electrical impulses to the ventricles. The atria will continue fibrillating and will require anticoagulation medication. A pacemaker will also be inserted to establish normal rhythm and to regulate the heart rate. This type of ablation is typically reserved for people with serious symptoms or when other treatments have failed.
Radiofrequency catheter ablation directs radiofrequency energy through a catheter to the areas of heart tissue that cause erratic electrical signals. Scarring the tissue will correct the arrhythmia. In other cases, catheters that freeze the heart tissue, known as cryotherapy, can be used to get the same result.
PVAI (pulmonary vein antrum isolation)
Pulmonary vein ablation, also called pulmonary vein antrum isolation, is another procedure in which energy is delivered through the tip of the catheter to tissue that is targeted for ablation. The energy is applied around the connection of the pulmonary veins to the left atrium. Small circular scars are formed within two to three months blocking any impulses firing from within the pulmonary veins and isolating them from the heart. If successful, PVAI eliminates the need for medications.