Every year, about 450,000 Americans are hospitalized for atrial fibrillation, more commonly known as a-fib.
A-fib is the most common form of heart arrhythmia. An arrhythmia is the heart beating too slow, too fast, or in an irregular way. Atrial fibrillation results when blood doesn’t flow properly from the two chambers at the top of the heart, the atria, to the two chambers at the bottom of the heart, the ventricles.
The atria work overtime to make blood move so that the top of the heart can seem to quiver. In some cases, the atria beat 300 times per minute.
People who have a-fib may not have symptoms all the time. When they do, they may experience:
- Fluttering or pounding sensations in the heart (palpitations).
- Dizziness or lightheadedness.
- Chest pain.
- Shortness of breath.
- Extreme fatigue.
How Doctors Start Out Treating A-Fib
Dr. Ian Weisberg, a cardiologist specializing in the treatment of cardiac arrhythmias, typically starts his a-fib patients on medication. Your doctor will probably give you one medication to control your heart’s rhythm, and another medication to “thin” your blood.
Using blood thinning medications exactly as prescribed is vitally important for people who have a-fib.
The heart’s inability to move blood from its upper chambers to its lower chambers can allow clots to form. These clots can enter general circulation, and travel to the brain. Blood clots in the brain cause stroke.
People who have a-fib have about five times the normal risk of stroke. About one in seven strokes is associated with a-fib. And strokes caused by atrial fibrillation tend to be more severe than strokes linked to other conditions.
When medication is not enough, the cardiologist may try other forms of intervention, such as cardioversion.
Cardioversion and Its Alternatives
One of the most common non-drug treatments for atrial fibrillation is cardioversion.
Cardioversion attempts to normalize heart rhythm and stopping and restarting the heart with electric shock. It’s the same kind of shock that might be used when someone has a cardiac arrest, only there is shock both to stop and restart the heart.
Electric shock hurts. Patients are put under anesthesia for cardioversion.
Although some patients understandably find the idea of having their hearts stopped and restarted to be scary, the procedure itself is very safe. Cardioversion only takes five minutes, and the National Institutes of Health report that between 98 and 99 percent of patients have no complications at all.
Cardioversion improves a-fib in about 90 percent of cases. But if you are one of the few patients for whom cardioversion does not work, your electrophysiologist has many other techniques that may help:
- Catheter ablation, a percutaneous procedure in which the surgeon uses a catheter to destroy diseased heart tissue. This procedure requires just a 3 mm (1/8 inch) incision in your groin.
- A pacemaker, implanted in the chest. Most pacemakers include a defibrillator.
- LARIAT, in which the surgeon ties off the tip of the atrium.
- MAZE, in which the surgeon creates scar tissue to interrupt nerve signals in the heart.
If you don’t get the results you hope for from your first procedure, don’t give up. Your cardiologist can find a way to treat a-fib.