Research indicates that controlling the risk factors for atrial fibrillation can help with treatment:
- Obesity: If weight management is an issue, we refer you to a dietician and when appropriate, to our Wellness Center for Fitness assessment and an exercise prescription.
- Diabetes: If diabetes is not well-controlled, you may work with a Patients with Diabetes out of control may be referred to a diabetes specialist
- Sleep Apnea: If you are at risk, you may work with a sleep medicine specialist.
- Hypertension: Often your primary care physician can help regulate your high blood pressure, but specialty cardiologists are available if you need more help.
- Excessive alcohol consumption: Reducing or eliminating alcoholic drinks can have a positive effect on atrial fibrillation.
When lifestyle changes are notinsufficient, we individualize treatment according to the type of atrial fibrillation, impact on your lifestyle and personal preferences.
For some patients, medication can control both heart rate and rhythm. If you have problem tolerating on-going medication for atrial fibrillation, an approach called “Pill in the Pocket”, in which you take the medication only when you are having a run of symptomatic atrial fibrillation to shorten the duration of the attack. However, because sometimes you can’t tell if you are having atrial fibrillation, that approach may not be appropriate.
Catheter ablation (non-surgical)
Uses radio frequency (heat) or cryotherapy (freezing) to interrupt the pathways that cause atrial fibrillation
Hybrid/MAZE procedure for atrial fibrillation
This is a minimally invasive surgery performed through an incision below the breastbone. This is often performed along with catheter ablation in patients with difficult to control AFIB, who may have had prior ablations.
In patients undergoing other open-heart surgeries such as coronary bypass or surgery to repair leaky or narrowed heart valves, a surgical MAZE procedure can be done during the same operative session if your atrial fibrillation requires treatment.
Re-ablation of Arrhythmias related to prior AFIB catheter ablation
Scar tissue from a prior catheter ablation can actually cause newatrial arrhythmias months or years later. Our techniques for catheter ablation for AFIB minimize occurrences of new arrhythmias. However, if patients had prior AFIB ablations with occurrences of new atrial arrhythmias, we have experience in treating these patients in what is considered a difficult procedure.
Atrial fibrillation can cause blood to pool in the left upper chamber of the heart, an area called the left atrial appendage (LAA). That pooling can cause the blood to clot and get into the blood stream, potentially causing a stroke. If you have AFIB and are considered at risk for strokes, you may need medication to thin your blood and prevent blood clots. If you cannot take anticoagulants due to severe bleeding problems, we offer a minimally invasive surgical technique to tie off the LAA to lower your risk of a stroke.
Ventricular tachycardia/Premature Ventricular Contractions
Ventricular tachycardia is a serious arrhythmia that in some patients causes rapid palpitations, in others, loss of consciousness. For some patients, VT can lead to ventricular fibrillation and sudden cardiac death. For those patients at risk for sudden cardiac death, we recommend an implantable defibrillator.
For all patients, we do a comprehensive assessment of their overall cardiac and coronary function and structure. We try to identify a precipitating cause of their ventricular tachycardia or PVCs and treat any underlying condition that may be a causative factor. Depending on the individual, if the VT or PVCs persist, we may then recommend drug therapy, catheter ablation or implantable defibrillator, or a combination thereof.
Cardiac drug or ablation therapy
PVCs are extra premature beats that originate from the bottom chambers causing a premature contraction. While you may have no symptoms, you could also have intolerable palpitations, fatigue or shortness of breath. An excessive number of PVCs can lead to deterioration of heart function and congestive heart failure. Sometimes, treatment by drugs or ablation can be beneficial.
Cardiac Pacemakers/Defibrillators/Cardiac Resynchronization Therapy
Implantable pacemakers or defibrillators may help restore normal rhythm and prevent sudden death.