The treatment you receive for atrial fibrillation (AF or AFib) is generally dependent on how long you’ve had the condition and how severe it is. Doctors also need to take into account the underlying cause of your atrial fibrillation and how bothersome your symptoms are.
Treatment Goals for AFib
There are three main goals in terms of AFib treatment, these are to:
Prevent blood clots.
Control the rate.
Reset the rhythm.
The strategy you and your doctor choose is dependent on factors like whether you’re able to take medications to control your heart rhythm and whether you have any other heart problems. In some cases of AF, you may need to have invasive treatment, such as medical procedures involving catheters or surgery.
For some people, an underlying condition, for example, a thyroid disorder, can trigger AF. If this is the case, treating the underlying condition may help. If this is the situation, and it’s your first episode of AF or if your symptoms are particularly troublesome, your doctor may try to reset your heart’s rhythm.
Resetting Your Heart’s Rhythm
Depending on the cause of your initial episode of AF, and how long you’ve had it, doctors employ a procedure called cardioversion to rest your rhythm.
Before this is carried out, you might be prescribed a medication to thin your blood, thus reducing the risk of stroke and blood clots. Just before cardioversion, you may also have a transesophageal echocardiography, which allows your doctor to check for blood clots.
This can be done in two ways:
Cardioversion with drugs. Using anti-arrhythmic drugs, either orally or intravenously, your normal heart rhythm is restored. This is usually carried out in hospital with continuous monitoring of your heart. If the rate returns to normal, your doctor will often prescribe the same medication or a similar one to help prevent any further instances of AF in the future.
Electrical cardioversion. In a quick procedure, an electrical shock is delivered to your heart via patches or paddles placed on your chest. This stops the electrical activity of your heart for a moment.
After electrical cardioversion, you may be given anti-arrhythmic medications to prevent future episodes of AF.
Surgical and Surgical Procedures
If medications and cardioversion don’t have an effect on your AF, your doctor may suggest one of the following:
Catheter ablation. This is where a doctor inserts catheters in your groin, guiding them through to your heart via your blood vessels. Hot spots of abnormal activity are destroyed, normalizing the erratic signals that cause AF.
Surgical maze procedure. This is conducted during open-heart surgery. The surgeon creates scar tissue in the upper chambers of your heart. This stops them from carrying electricity. The procedure can also be carried out using cryotherapy or radiofrequency.
Atrioventricular (AV) node ablation. If none of the above works for you, you suffer from drug side effects, or other forms of catheter ablation haven’t worked, AV node ablation could be another option. This involves applying radiofrequency energy through a catheter, destroying a small area of tissue. This stops the atria from sending electrical messages to your ventricles, and you’ll need a pacemaker implanted to keep your ventricles beating correctly.
With treatment, people with AF can lead normal, active lives. If you’re at all worried about the condition, give us a call at Tri-City Cardiology at (480) 835-6100 without delay.