Answers to Common Atrial Fibrillation (A-Fib) Questions

Premier Health providers answer frequently asked questions about atrial fibrillation.

If using medication is not enough to manage atrial fibrillation (A Fib), what are other options?

Premier Health’s Dr. Abdul Wase talks about alternatives to medication to manage atrial fibrillation (A Fib). Click play to watch the video or read the transcript.

   

When symptoms of atrial fibrillation (A Fib) persist even on medication for heart rate and/or rhythm control, your doctor may recommend a procedure to restore a normal heart rhythm. There are two main types of procedures used to treat atrial fibrillation:

  • Cardioversion
  • Catheter ablation

In cardioversion, controlled electric shocks are delivered to the heart via electrodes placed on the skin. The shocks delivered are strong enough to interrupt the arrhythmia and allow the sinoatrial (SA) node to restore a normal heart rhythm.

Cardioversion has a limited success rate. According to AFib Matters, cardioversion does not work for one in ten patients, and atrial fibrillation returns within one year for 50% of patients for whom cardioversion was initially successful. While the procedure may be repeated, doctors will more likely recommend a different procedure—catheter ablation—to address A Fib.

In catheter ablation, small tubes are carefully threaded through a vein (usually in the groin) to the heart. Electrodes at the end of the tubes are placed on specific sites on the heart muscle that have been identified as causing the arrhythmia. (Errant electrical signals that cause atrial fibrillation are most often traced to sites near the pulmonary veins.) The electrodes deliver either radiofrequency energy or cryoenergy to burn or freeze the heart tissue, creating a scar that isolates the erratic electrical signals, thereby allowing the SA node to restore a normal heart rhythm.

For some patients, the catheter ablation procedure may also be used to destroy the atrioventricular (AV) node, which controls the electrical signals sent to the lower chambers of the heart (ventricles). A pacemaker must then be implanted to restore electrical conduction from the atria to the ventricles.

According to StopAfib.org, the outcomes of catheter ablation may also be achieved through open-heart procedures called the Cox Maze III or the Maze procedure. However, because advances in technology now allow A Fib to be treated with minimally invasive means with reduced risk of surgical complications and allow quicker recovery time, these procedures are done less frequently.

Speak with your health care provider to learn more about your atrial fibrillation treatment options.

Learn more:

Source: Kevin Kravitz, MD, Dayton Heart Center; Mark E. Krebs, MD, Miami Valley Cardiologists; Abdul Wase, MD, The Premier Heart Associates; Sameh Khouzam, MD, Dayton Heart Center

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