Atrial Fibrillation (AFib) Treatment

Desert Care Network offers an alternative to drug therapy for certain patients with atrial fibrillation (AFib) and other heart rhythm disorders such as arrhythmia.

What is Atrial Fibrillation (A-Fib or AF)

Atrial fibrillation (AF) is the most common type of heart rhythm disorder (arrhythmia) in the United States. AFib occurs when the heart’s electrical system has a problem that causes the heart to fibrillate or beat very rapidly. When this occurs, the heart cannot pump blood properly throughout the body. In some cases, AFib may cause chest pain, palpitations, anxiety and shortness of breath – but some people may not feel any symptoms. Hence, patients are not aware they have AFib. When left untreated, it may be a serious condition. When a clot happens and enters the bloodstream, it may reach the brain and cause a stroke.

AFib Symptoms

People with AFib may experience these symptoms:

  • Palpitations
  • Fatigue
  • Dizziness or light-headedness
  • Chest pain or pressure
  • Shortness of breath

AFib Causes and Risk Factors

The main cause of AFib might be an existing condition such as follows:

  • Cardiomyopathy
  • Chronic kidney disease
  • Congenital heart defect
  • Coronary artery disease
  • Diabetes
  • Heart disease due to high blood pressure
  • Heart failure
  • Heart valve disease
  • Hypothyroidism
  • Previous heart surgery

However, the likelihood of experiencing AFib increases with the following:

  • Advancing age
  • Genetics
  • Heavy alcohol, caffeine or drug use
  • Obesity

When to Seek Treatment

If you have symptoms and they last for more than 24 hours, call your doctor or go to a Desert Care Network hospital for proper diagnosis and treatment. If you do not have symptoms and may be at risk, schedule regular check-ups to monitor your heart.

AFib Treatment at Desert Care Network

AFib treatment options range from lifestyle changes, medicines (for heart rate and rhythm control and blood thinners to prevent blood clots that may result to stroke), medical devices and surgery (traditional and minimally invasive).

Lifestyle change

Having a healthy lifestyle may help prevent and treat AFib. Here are some tips.

  • Eat healthy. Integrate a good amount of fruits and vegetables to your diet.
  • Stop smoking. Drink moderately and do not use drugs.
  • Exercise. Along with your heart healthy diet, it would be of great help if you would also exercise regularly. It increases blood flow, keeps muscle strong and even helps with sleep. Consult your doctor to avoid overdoing it.
  • Avoid stress. 

Medicines

Medications that control the heart rhythm, prevent blood clots and slow heart rate are also called anti-arrhythmics. These include the following:

  • Heart rhythm medicine. These medicines slow down the conduction of electrical signals in your heart to slow down its rhythm.
    • Flecainide
    • Propafenone
    • Quinidine
    • Amiodarone
    • Dofetilide
    • Sotalol
  • Blood thinners. The forming of blood clots may result in a stroke. Blood thinners help in avoiding blood clots. However, taking blood thinner medications may cause you to bruise easily or bleed too much, so consult your doctor for the right dose for you.
    • Apixaban
    • Aspirin
    • Dabigatran
    • Enoxaparin
    • Heparin
    • Rivaroxaban
    • Warfarin
  • Heart rate medicine. Some of these medicines are called beta-blockers. They help reduce blood pressure and thus, slow the rhythm of the heart.
    • Atenolol
    • Bisoprolol
    • Carvedilol
    • Metoprolol
    • Propranolol
    • Timolol

Medical procedures

Pacemaker. This is a small, battery-operated device that is implanted just beneath the skin, under the collarbone. This device helps through sending electric shocks to your heart when it beats too slowly. A pacemaker is used when medications and lifestyle change are not successful in treating AFib.

Cardioversion

This procedure is done by sticking pads to your chest to send electric signals to your heart. Undergoing cardioversion may increase the chance of blood clotting so blood thinners may be prescribed together with this procedure.

Maze procedure

It’s called a maze procedure because the surgeon will create a maze of scar tissue that will relay the electric signals to your heart. This way, there is a clear path and stray electric signals won’t interrupt the heart’s rhythm that results in irregular heartbeat.

Catheter ablation

Catheter ablation is a minimally invasive procedure where a long, flexible tube, called a catheter, is inserted into a blood vessel. The doctor sends an electrical signal through the catheter to determine the exact location where the abnormal tissue is. Once the doctor determines the exact location of the abnormal tissue, the doctor sends a mild, painless pulse of radiofrequency energy which destroys the small part of the heart muscle that causes the irregular heartbeat. This creates a scar tissue inside the heart, which is a good thing because this will help our heart stay in normal rhythm. Doctors can use different energy sources to create the scar tissue. Some of them are the following:

  • Radiofrequency waves
  • Microwaves
  • Lasers
  • Cryothermy

The procedure usually lasts for 2 to 4 hours. You can go home within the day or the next day according to how much abnormal tissue needs to be zapped. When you arrive home, you can expect the following:

  • Fatigue
  • Need to nap
  • Your arrhythmia might seem to feel the same or worse, but this is totally normal. Scar tissue formation takes time, so be patient.
  • Blood thinner and antacids or anti-inflammatory prescriptions from your doctor for about 3 months.
  • If the first catheter ablation for AFib is not successful, you might have to undergo a second procedure.

Catheter ablation for AFib usually works for most people, but it could occur again with these risk factors:

  • Old age
  • Another heart condition
  • High blood pressure
  • History of hard-to-treat AFib

Just like any procedure, catheter ablation also have risks of complications. Your doctor should discuss these complications with you before you undergo the procedure. There is the risk of infection when the catheter is inserted into your skin, accidental damage to the body tissues, accidental damage to the heart and blood clots. To avoid these complications, you should follow the following steps when you arrive home.

  • Avoid heavy exercise
  • Do not drive within 24 hours of leaving the hospital
  • Do not drink alcohol within 24 hours of leaving the hospital
  • You can take a bath, but do not soak your wound
  • Do not use creams or lotions near the surgical site

If you experience these the following symptoms after the catheter ablation surgery, please call 911 or go to the nearest ER:

  • Bleeding does not stop when you press on it firmly
  • Surgical site swells and drains liquid
  • Short of breath
  • Dizziness or lightheadedness to the point where you need to lie down
  • Pain or discomfort that travels through the neck, jaw or arm

Watchman Implant Surgery

The Watchman is a new, minimally invasive procedure, addressing the risks of blood clots and strokes caused by AFib. This device is implanted in the heart, preventing blood clots from collecting in the heart’s left atrial appendage where 90% of blood clots form. This procedure can reduce the risk of a stroke.

The Watchman may be recommended for those with AFib who cannot tolerate blood thinners.

Know more about Watchman Implant Surgery

 

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