AFIB Treatment Options
During your initial visit, a Summa physician will take a medical history to help determine the severity of your symptoms and assess how other factors may be contributing to your condition, such as alcohol or caffeine intake. Your doctor will also perform an examination listening to your heartbeat and breathing using a stethoscope. An electrocardiogram (ECG/EKG) may also be performed to confirm whether Atrial Fibrillation (A-Fib) or some other arrhythmia is present which may have similar symptoms.
If you are diagnosed with A-Fib or you have been experiencing symptoms such as a fluttering feeling in the chest, shortness of breath, fatigue, etc., you should talk to your doctor about a referral to Summa’s A-Fib Program.
Initial treatment for many patients may include:
- Anti-coagulant medication to prevent strokes and reduce symptoms.
- Electrophysiology studies to help pinpoint the location and type of heart rhythm disturbance present by showing how the electrical impulses are moving through the heart.
- Cardiac ablation to correct rhythm disorders. This involves the use of a specialized catheter that contains a wire and electrode which is inserted into the vein in the groin and is carefully threaded through blood vessels and into the heart. Heat energy is then emitted to scar or destroy tissue responsible for the abnormal heart rhythm.
- Pulmonary vein isolation (PVI), a cardiac ablation where catheters are inserted through the veins in the groin and threaded through blood vessels to the heart to electrically isolate the pulmonary veins from the rest of the heart. About 95% of A-Fib is triggered by cells and muscle fibers found in the pulmonary veins. Isolating the pulmonary veins can greatly reduce the triggers responsible for causing A-Fib.
Alternative treatment for some patients:
WATCHMAN™ LAAC Device. Many AFib patients are prescribed anti-coagulant medication (blood thinners such as Warfarin) to help with stroke risk by reducing the occurrence of blood clots. While medications are effective for many patients, long-term drug therapy is not well tolerated by some, highlighting the need for additional treatment options.
For eligible patients who are seeking an alternative to medication, the WATCHMAN offers a stroke risk treatment option which could free them from the challenges of long-term drug therapy.
WATCHMAN is implanted during a minimally invasive procedure and is designed to close the left atrial appendage (LAA) to prevent migration of blood clots, reducing the risk of stroke and systemic embolism. The implant procedure usually lasts about an hour and your hospital stay is around 24 hours.
The WATCHMAN device might be a good choice if you:
- Have AFib that isn’t related to heart valve disease (non-valvular AFib)
- Are at increased risk for a stroke
- Are recommended for blood thinning medicines
- Have an appropriate reason to seek a non-drug alternative
Talk to your doctor about your options to see if the WATCHMAN is right for you.
If your condition is more severe, your doctor may choose to use other treatment options, including:
- Modified Maze procedure, an open-heart surgical procedure for patients with valvular or ischemic heart disease and/or long-standing persistent A-Fib.
- Implantable Cardiac Defibrillator (ICD) which is a small, battery-powered receiver which is implanted under the skin just below the collarbone. It contains a pulse generator which is comprised of a computer, a battery and lead wires. The leads are in contact with the heart muscle on one end, and the pulse generator on the other end. The ICD helps detect when a patient’s heart is beating dangerously fast and delivers a life-saving electrical shock, often described by patients as a “kick in the chest,” which returns the rapid heart rate back to a normal rhythm. The devices can also act as pacemakers and can prevent too slow heart rhythms by delivering pacing signals to the heart muscle.
ICDs are pre-programmed to send electrical signals to the heart, and can also “communicate” with a special device which provides information about the patient’s heart rhythms and the overall condition of the ICD device. Just as with pacemakers, ICDs require routine monitoring and follow-up care to ensure the device continues to function properly.
- Pacemakers are small, battery-powered devices that are used to regulate the heart beat when it is beating too slowly (bradycardia). The device, which is about the size of a large wrist watch, weighs barely an ounce, and is comprised of leads and a pulse generator. The leads are wires that are carefully threaded through the veins into the heart and touch the heart muscle. The pulse generator is implanted into the body just below the collarbone. When the pacemaker senses the heart is beating too slowly, an electrical impulse is delivered to the heart muscle, causing it to contract and beat faster.
Getting a pacemaker does not require open-heart surgery because the device is implanted in a small pocket made by the physician in the skin under the collarbone. Once implanted, routine monitoring and follow-up care are necessary to ensure the device continues to function properly.
- Convergent procedure, a new minimally invasive hybrid procedure, combines the best techniques of a cardiothoracic surgeon with those of an electrophysiologist to provide a treatment solution in one single procedure. The procedure is especially suitable for patients with long-term, persistent A-Fib and an enlarged left atrium, including those who underwent failed prior interventions like ablations. A major benefit of the procedure: it provides access to the heart without chest incisions or ports, lung deflation or heart dissections, which are all associated with long painful recoveries. First, the surgeon inserts a videoscope to view the beating heart through a single, small incision in the abdomen. A series of linear lesions are created on the surface of the heart using radiofrequency ablation. Then, the electrophysiologist uses three-dimensional endocardial mapping and ablation inside the heart to isolate the pulmonary veins and the posterior left atrium of the heart.
To learn more about Summa’s A-Fib Program, click or call (800) 237-8662 to schedule an appointment for an evaluation.