Treatment for Atrial Fibrillation (AFib)
Atrial fibrillation (AFib) is an irregular heartbeat (arrhythmia) that increases your risk of stroke. AFib can limit the amount of blood that reaches the lower chambers of the heart and the body. During AFib, blood can also pool in the atria (the upper chamber). This increases the risk of blood clots and stroke.
Quick facts about AFib (irregular heartbeat)
According to the American Heart Association, at least 2.7 million people in the U.S. are living with AFib. This heart condition can lead to blood clots, stroke, heart failure and other heart-related health problems.
Important facts about AFib:
- Roughly 15 to 20 percent of stroke patients have this type of arrhythmia
- Risk factors for AFib include advanced age, high blood pressure, underlying heart disease, family history, binge drinking, and having other chronic health conditions
- Some people with AFib experience no symptoms, while others might feel fatigue, a fluttering or thumping in the chest, dizziness, shortness of breath, fainting, or weakness
- There are both non-surgical and surgical procedures to treat AFib
AFib can be:
- Occasional (starts and stops over brief periods)
- Persistent (continues for more than a week)
- Long-standing (lasts for more than a year)
According to the American Heart Association, medication is the most helpful form of treatment for AFib for most patients. These medications can prevent and treat blood clots, which can lead to a stroke. However, medications are not always effective for treating AFib, or they are not always the best treatment option for every patient.
Atrial fibrillation ablation (or ablation for AFib) is a procedure used to treat this type of irregular heart beat. A cardiac ablation refers to scarring or destroying the tissue in the heart that triggers the abnormal heart rhythm.
Types of AFib Ablation Procedures
There are four main types of AFib ablation procedures:
Catheter Ablation – This procedure uses radiofrequency energy to destroy a small area of the heart tissue. Catheter ablation is used to treat abnormal heartbeats when medicine is not effective. During the procedure, a catheter is inserted into a blood vessel and guided into your heart. Then, a doctor sends a small electrical impulse through the catheter to locate the abnormal heart tissue that is causing the arrhythmia.
Maze Procedure – Maze refers to a technique performed during open-heart surgery. A surgeon creates a pattern (maze) of scar tissue in the upper chambers of the heart (atrium). This type of ablation disrupts the stray electrical signals that might be causing the arrhythmia. The maze procedure might be performed during certain types of heart surgery (like coronary artery bypass surgery), or if a patient’s AFib does not respond to other treatment methods.
AV Node Ablation – During this procedure, a catheter is used to send radiofrequency energy to the pathway that connects the upper chambers (atria) and lower chambers (ventricles) of your heart (AV node). This procedure also destroys a small amount of heart tissue that may be causing the irregular heartbeat. After an AV node ablation, a pacemaker is permanently implanted.
Pulmonary Vein Isolation Ablation – This procedure is done to stop irregular heartbeats that start in the left upper chamber of the heart where pulmonary veins connect. These veins bring the lungs oxygen-rich blood. To stop erratic signals from reaching the upper area of the heart, a catheter is inserted and, using radiofrequency ablation, scar tissue is created, limiting or blocking the signals.
Convergent Procedure – For this procedure, an electrophysiologist and a cardiac surgeon work together to create small scars on the back of the heart and perform complex electrical-anatomic mapping. Together, these work to stop irregular rhythms of the heart.
Are there any risks associated with AFib Ablation?
As with any medical procedure, there are a few risks associated with ablation.
A catheter ablation is considered a low-risk procedure in which most patients have a successful outcome. This procedure typically takes 2 to 4 hours and is performed in an electrophysiology (EP) or cardiac catheterization (cath) lab.
Complications that result from a maze procedure are rare. A patient might be more likely to experience complications (such as bleeding or an infection) if they are older or have other medical/heart conditions. A physician may recommend the maze procedure if a patient already needs open heart surgery. Typically, heart medication, ablation or other, less-invasive methods are used to treat AFib before surgery is discussed.
AV node ablation is performed only if patients do not respond to medications, or cannot take them due to side effects. An AV node ablation with a pacemaker implantation has a high success rate and low risk of serious complications. Following this procedure, the patient does become dependent upon a pacemaker, which helps the heart function more efficiently.
Symptoms of AFib
The symptoms of atrial fibrillation include:
- Irregular pulse
- Shortness of breath
- General fatigue or fatigue when exercising
- Heart palpitations
- Chest pain or pressure
If you are experiencing chest pain or pressure, you could be having a heart attack. Call 9-1-1 immediately if this is the case. Heart attack symptoms can be different than AFib symptoms, but either way, this is a medical emergency and seek help right away.
Expert Care and Treatment for Heart Conditions
Even for those who don’t experience any symptoms, someone with atrial fibrillation is five times more likely to have a stroke than a person who doesn’t have AFib. It’s important to talk to your doctor about heart health.
At Denver Heart, our board-certified surgeons specialize in routine and complex procedures for heart-related conditions. We are a leader in using innovative treatment methods to treat heart disease. Denver Heart provides expert care in a small, personalized setting.