Atrial Fibrillation

Treating Atrial Fibrillation (AFib) at the DMC

When it comes to your heart, you need someone you can trust. DMC has board-certified heart specialists who provide several atrial fibrillation treatment options and procedures. We have over 30 years’ experience of delivering advanced cardiac care to our community. So rest assured, your heart is in experienced hands at the DMC.

What is AFib?

Atrial Fibrillation (AFib) is a common heart disorder which occurs when electrical signals in the heart become irregular, causing the heart’s upper chamber to beat out of rhythm. This irregularity is what makes people with AFib five times more likely to suffer a stroke, blood clot or heart failure. AFib may either be permanent or may also come and go. It is more common in adults aged 65 and above. AFib is also classified according to how long the condition is experienced:

• Paroxysmal – occurs in irregular intervals and usually resolves on its own.
• Persistent – occurs regularly and has lasted for longer than a week.
• Permanent – occurs continuously and has already lasted longer than a year.

What Happens During AFib?

During AFib, the electrical signals that tell the strong chambers of your heart to beat regularly become disorganized. This malfunction affects two upper chambers of the heart (called atria) and causes them to quiver or “fibrillate.” It also disrupts the blood flow into the lower chambers of the heart or the ventricles and causes them to contract faster or irregularly. The contraction of the atria and the ventricles is no longer coordinated, and the amount of blood pumped out to the body will vary with each heartbeat. Hence, the ventricles may not be able to pump blood efficiently to the body. The trembling in your atria may lead to blood pooling in crevasses and cause blood clots. These blood clots may break loose out of the heart, go to the brain and cause blockages which may then lead to a stroke

Atrial Fibrillation Causes

The exact cause of AFib remains unknown. However, some conditions may negatively affect your heart health and eventually lead to AFib. These conditions include the following:

• Congestive heart failure
• Coronary artery disease
• Heart valve disease
• High blood pressure
• Hypertrophic cardiomyopathy
• Overactive thyroid gland
• Pericarditis (inflammation of the covering of the heart)
• Thyroid disease

Other atrial fibrillation causes may include binge drinking, recreational drugs, and taking certain medications. Atrial fibrillation is a frequent occurrence after thoracic surgical procedures, including open heart surgery.

Atrial Fibrillation Symptoms

AFib may or may not cause symptoms. If it does, atrial fibrillation symptoms may include the following:

• Quivering or fluttering heartbeat
• Irregular heartbeat
• Anxiety
• Chest pain
• Dizziness
• Fainting or confusion
• Fatigue
• Shortness of breath
• Sweating
• Weakness

How Serious Is Atrial Fibrillation?

Some episodes of AFib resolve on their own. This is also called “spontaneous remission.” But since having AFib symptoms is uncertain, you may still want to monitor your heart and consult your doctor. Some cases of AFib also reveal an underlying condition such as an overactive thyroid, hypertension, diabetes, chronic lung disease or heart valve disease, which would need further treatment.

AFib is a serious condition that may lead to a stroke, heart failure, chronic fatigue, inconsistent blood supply and some other heart rhythm issues. Strokes caused by AFib tend to be more severe than strokes from other causes. This happens when a blood clot or plaque (fatty deposits) in the blood vessel lining block blood flow to the brain. AFib can become life-threatening when left untreated, so be sure to speak with a doctor as soon as you see signs and symptoms of AFib.

How Can You Reduce Your Risk for AFib?

Maintaining a healthy lifestyle is one of the best ways to reduce your risk for AFib. Eat a heart-healthy diet (avoid salt, saturated fats and high-cholesterol foods). Maintain a healthy weight and exercise regularly. Manage your blood pressure. Avoid smoking, recreational drugs, and limit your alcohol and caffeine intake. These things can help you keep your heart healthy and prevent other chronic conditions.

Atrial Fibrillation Treatment Options

Many people may not even be aware that they have AFib. Scheduling a heart screening can help our specialists evaluate and diagnose your condition and also offer a treatment plan to help lower your risks for serious complications. Treatments may include the following:

• Anticoagulants (e.g., warfarin, rivaroxaban, dabigatran, apixaban and edoxaban)
• Atrial fibrillation ablation
• Cardioversion
• Open-heart maze procedure to restore regular rhythm
• Pacemaker
  

Changes in lifestyle or medications for heart rate and rhythm, such as anticoagulants or blood thinners, may be prescribed to prevent blood clots or control heart rate. Cardioversion, another treatment option, may also be recommended to help get the heart back to a normal rhythm by delivering a jolt of electricity to the heart. However, if these efforts are unsuccessful, your doctor may recommend atrial fibrillation ablation or a surgical procedure to restore your regular heart rhythm.

Your health can’t wait. Understand your heart health to stay or track or make a plan. Safe care is available to evaluate for electrical issues of the heart such as AFib. Finding out and taking action can be life-saving.

What is Atrial Fibrillation Ablation?

Atrial fibrillation ablation involves threading a long, thin, flexible tube called a catheter into the heart through a blood vessel in the arm, upper thigh or neck. A specialist uses live X-ray images to carefully guide the catheter into the heart. Several flexible tubes with electrodes on the tips are run through the catheter and directed to make radiofrequency lesions designed to block the abnormal pathways of heart electricity.

What Happens During Atrial Fibrillation Ablation?

Patients are sedated during the procedure, but they may still feel some lightheadedness, rapid heartbeat, burning when any medications are injected, or chest discomfort due to energy application. An atrial fibrillation ablation procedure can last anywhere from four to nine hours. Following the procedure, pressure is applied to the site where the catheter was inserted, and patients must lie still for four to six hours. Their heart rate is closely monitored during this time.

How Effective Is Ablation for AFib?

The success rate of the first atrial fibrillation ablation is approximately 75% and will go up to 90% for the second procedure, if a second one is necessary. Atrial fibrillation ablation may be a more effective treatment than medications; however, as with any procedure, there are risks associated with atrial fibrillation ablation.

What Are the Surgical Options if Catheter Ablation is not Successful?

The Cox-MAZE III surgical procedure is an open heart operation where incisions and freezing lines are created on the atria to direct the electrical pathway of the heart into a normal rhythm for patients who have failed other less invasive modalities or are undergoing heart surgery for other reasons.