AFib is a common type of heart rhythm disorder that significantly increases the risk of a stroke. — TNS
You may not have known that you had atrial fibrillation (AFib) until your condition was discovered during a physical examination.
For others, AFib can have life-altering symptoms that affect their ability to perform daily activities.
AFib is a common type of heart rhythm disorder where the heart doesn’t beat efficiently.
This makes the heart unable to pump enough blood out to the body with each heartbeat.
People with AFib are at a higher risk of stroke – about one in seven strokes are AFib related – due to clots that can form in the upper chambers of the heart.
Of the strokes resulting from AFib, 90% occur from clots originating in the left atrial appendage in the left atrium of the heart.
Key risk factors for stroke in people with AFib include:
- Age
- Gender
- High blood pressure
- Prior history of stroke
- Chronic health conditions, including congestive heart failure, coronary artery disease and diabetes.
There are three main approaches to treating AFib, which are:
Medications for treating AFib are the front line for managing symptoms and preventing stroke.
These medicines can prevent blood clots, control the speed of the heartbeat and restore the heart rhythm.
They includes beta blockers, calcium channel blockers, digoxin, arrhythmics and anticoagulants.
Your cardiology team will work together to determine which medication will work best for you.
This therapy to reset the heart rhythm is usually done in a hospital as a scheduled procedure.
Patients may still need to take medicines for the rest of their lives to control their heart rhythm and prevent future episodes of AFib.
Even with medicine, AFib could return.
These procedures are aimed at obtaining and maintaining normal heart rhythm.
People who are candidates for procedural options are cared for by a team of cardiologists, including cardiac electrophysiologists and additional specialists as needed.
One potential procedure is left atrial appendage occlusion.
The left atrial occlusion is a pouch-like extension of the heart.
This minimally invasive procedure provides an alternative to long-term blood-thinner medications.
It involves implanting a device, via a catheter, to close and seal off the left atrial appendage.
This decreases the risk of blood clots entering the bloodstream, travelling to the brain or other body organs, and causing a stroke or organ damage.
Patients typically leave the hospital the same day or the next day.
Another procedure is ablation.
Ablation stops the generation of abnormal electrical signals in the heart and keeps it in normal (sinus) rhythm.
During ablation, a catheter is fed into the heart through the groin area using a minimally invasive approach and delivers heat or cold to modify the tissues in the heart that are causing the arrhythmia.
There is also pulsed field ablation (PFA).
PFA stands out from traditional AFib treatments due to its precision and safety.
Unlike radiofrequency or cryoablation, which use heat or cold to destroy heart tissue, PFA uses short electrical pulses to target the myocardium (heart muscle), minimising damage to the oesophagus and nerves.
Benefits to patients include reduced procedure and anaesthesia time, quicker recovery time, and surrounding tissue protection.
For people who have long-standing, persistent AFib, ablation alone is successful half of the time.
Hybrid ablation is an option for people with AFib that’s hard to manage or who have been in AFib for more than a year.
It combines the best of the catheter lab ablation and an open surgical approach.
The procedure is done in two parts.
Part one is performed by surgeons with a scope inserted through a small incision under the breastbone to ablate the back side of the heart, followed by closure of the left atrial appendage.
During part two, a catheter ablation modifies the tissues on the inside of the heart.
This whole-heart approach allows patients to return to normal rhythm with excellent results. – Mayo Clinic News Network/Tribune News Service
