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Atrial Fibrillation

H2H - Fall 2011 Afib

Physicians goal for all of patients is to return to an active, happy lifestyle. This is very achievable for most Afib patients. Emphasizes that treatment is most effective if atrial fibrillation is diagnosed as soon as possible. If atrial fibrillation is left undiagnosed and untreated, it can lead to stroke and other serious complications such as heart failure.

Electrocardiography (EKG) is a painless test that is used to diagnose Afib. Once Afib is confirmed, treatment depends on several factors:

  • How long the patient has had atrial fibrillation
  • The cause of the atrial fibrillation
  • How burdensome the symptoms are

The top priorities for treating Afib includes controlling rhythm so the heart beats normally, and prevent blood clots that can cause a stroke.

There are several treatments for Afib. If one does not work, another can be administered.

  • Antiarrhythmic Medication – These medications affect ion channels of heart cells reducing the number and duration of Afib spells. In some cases the patient begins treatment with these medications in the doctor’s office. In other cases, the patient is admitted to the hospital and receives anti-arrhythmic medication either orally or intravenously. The patient’s heart rate is continuously monitored and his or her dosage is adjusted accordingly.

  • Electrical Cardioversion – Some patients need electrical cardioversion to restore sinus rhythm. This quick procedure delivers an electrical impulse to the patient’s heart through paddles or patches placed on the patient’s chest. The shock terminates the disorganized electrical activity of Afib, resetting the heart into a normal rhythm. Cardiologists use sedation so the patient doesn’t even feel the shock and is comfortable throughout the procedure. It is mandatory for patients to take blood-thinning medications before and after the procedure to prevent blood clots. Transesophageal Echocardiography is also used with some patients to determine if any clots exist in the heart before an electrical cardioversion procedure.


  • Radiofrequency Catheter Ablation – This procedure is performed by cardiologists who are also electrophysiologists who specialize in treating disorders of the heart’s electrical system. During a radiofrequency catheter ablation procedure, the patient is sedated. The electrophysiologist threads a catheter up to the heart from intravenous access in the patient’s groin and then isolates the sources of abnormal electrical signals, which are usually located in pulmonary veins. Many patients who undergo radiofrequency catheter ablation will be able to discontinue or reduce the use of antiarrhythmic medications.


  • Maze Surgical Procedure – Performed as either a traditional, open-chest procedure (usually if another cardiac surgical procedure like a valve replacement is being performed) or a minimally invasive procedure, the surgeon makes precise incisions on the right and left atria that interrupt the abnormal heart rhythm and correct the direction of the heart’s electrical impulses. The procedure is more invasive than the catheter approach, and some patients require a pacemaker for extra support.