Atrial Fibrillation
Atrial fibrillation (AFib) is the most common heart rhythm abnormality in the U.S.; although AFib is usually not life threatening, it can lead to other serious problems such as stroke and congestive heart failure. Working with your physician and the team at Northwest Health, AFib can be controlled to significantly reduce your risk factors.
Types of AFib:
- Paroxysmal – Episodes start and stop on their own and last for less than seven days.
- Persistent – Episodes lasting longer than seven days that typically require treatment to stop them.
- Permanent – Ongoing symptoms that resist most treatment attempts.
Diagnosis
An EKG is performed to record the electrical activity of your heart. Additional blood tests and cardiovascular testing may be performed to aid in diagnosis.
Treatment Options
The goal of atrial fibrillation treatment is to reduce the risk of stroke through anticoagulation (or blood thinners) and by controlling the heart's rate and rhythm.
- Anticoagulation – To reduce your risk of stroke, your doctor will likely prescribe medication to prevent blood clots from forming in your heart due to atrial fibrillation. Warfarin and aspirin are the two most commonly used, but there are also new oral antithrombotic agents which may be prescribed.
- Rate – To control your heart rate, your doctor may prescribe medications to slow down the rate at which your heart beats. These medications may include a beta-blocker, calcium channel blocker or digoxin.
- Rhythm – To restore a regular rhythm, your doctor may prescribe an antiarrhythmic medication. These medications are also given to sustain a regular rhythm.
Beyond Medication
- Electrical cardioversion – If the medications are not successful in restoring your heart's regular rhythm, your doctor may elect to do an electrical cardioversion. This is an outpatient procedure where a small electrical shock is delivered from outside the chest wall.
- Catheter ablation – A catheter ablation is another option to restore your heart's regular rhythm. A catheter is inserted through a blood vessel in your heart. It delivers radio frequency energy to destroy abnormal electrical pathways.
- Surgery – Another alternative treatment for atrial fibrillation is a surgery called a maze procedure. A surgeon makes incisions in the heart muscle during open heart surgery to block abnormal electrical pathways.
Alternative Treatment
Northwest Health offers a left atrial appendage closure procedure which involves implanting a device that closes off an area of the heart called the left atrial appendage (LAA). The goal is to keep harmful blood clots from the LAA from entering the blood stream and potentially causing a stroke. This device is an alternative to long-term anticoagulation medicine such as warfarin for stroke risk reduction in patients with non-valvular atrial fibrillation (AFib).
Stroke is more severe for patients with AFib, as they have a 70% chance of death or permanent disability. The most common treatment for stroke risk reduction in patients with AFib is blood-thinning warfarin therapy. Despite its proven efficacy, long-term warfarin therapy is not well-tolerated by some patients and carries a significant risk for bleeding complications.
How It Works
The device closes off an area of the heart called the left atrial appendage (LAA) to keep harmful blood clots from the LAA from entering the blood stream and potentially causing a stroke. By closing off the LAA, the risk of stroke may be reduced and, over time, patients may be able to stop taking blood-thinning medications.
This first-of-its-kind implant, about the size of a quarter and shaped like a jellyfish, is inserted into the heart using a minimally invasive procedure. A flexible tube, or catheter, is inserted through a small incision in a vein in the groin and travels to the left atrial appendage of the heart where the implant is placed. This is a one-time procedure that usually lasts about an hour. Typically, patients are released from the hospital the next day.
For more information about the implantable device as well as to determine if you are a candidate for this type of therapy, you can contact Northwest Cardiology – Bentonville at (479) 553-2200 or Northwest Cardiology - Springdale at (479) 750-2203. You can also read more about left atrial appendage closure here.