How We Treat AFib

Atrial fibrillation, commonly known as AFib, is the most common sustained heart arrhythmia that heart patients live with.

For people with AFib, the top chambers of the heart are quivering, which prevents blood flow to the lower chambers from being as efficient as it should be. This affects how well blood is pumped to the rest of the body and causes a whole range of symptoms, including:

• shortness of breath
• rapid heartbeat
• fluttering feeling in your chest
• dizziness/lightheadedness
• fatigue

Each patient with AFib comes to their healthcare provider with a unique set of symptoms, personal health history, and family history. There are many treatments and therapies available for patients, and each one is tailored specifically depending on a variety of factors.

Meghan Wright, PA-C, is a physician assistant with the Sands-Constellation Heart Institute’s AFib Center at Rochester General Hospital and explains the various treatments available to patients with AFib.

Factors to consider for AFib patients

After meeting with a heart care specialist, several factors are taken into account when considering which treatments may work, including:

• How long you have had AFib
• Condition of your heart/body due to AFib symptoms
• Other pre-existing health conditions (diabetes, kidney disease, hypertension, etc.)
• Family history of heart conditions

Treatments for AFib patients

Lifestyle changes

Making changes to how you eat, drink, exercise, and monitor your health make a significant difference in your heart health. This is the first step patients can take to lessen the symptoms and effects of AFib.

These changes include:

• weight management
• physical activity
• blood pressure management
• eliminating alcohol use

“The biggest way patients are able to make a meaningful difference in managing their AFib is by managing their lifestyle factors,” Wright said.

Medications

In conjunction with those lifestyle changes, antiarrhythmic medications can be prescribed as needed.

Medications like sodium channel blockers (flecainide, propafenone) help to reduce the heart’s ability to conduct electricity. Other medications like potassium channel blockers (amiodarone, dofetilide, dronedarone, sotalol) help to slow down the electrical signals that cause AFib.

Non-invasive procedures

Cardioversion

Offered as a first line of AFib treatment, cardioversion is a procedure performed on patients by delivering a tiny electrical shock to the heart to get it out of AFib and back to a normal rhythm.

This procedure takes about 45 minutes from start to finish. Cardioversion is not a long-term solution for AFib but is a highly successful treatment option for patients with early-stage AFib.

Ablation

Ablation is a low-risk procedure that can be done in an outpatient setting. During an ablation, heart specialists will use heat or cold energy to create tiny scars in areas of the heart that prevent electrical signals from causing fibrillation.

Ablation is a minimally invasive procedure performed using catheters. It can be done multiple times as needed.

“We try to maximize our use of ablation,” Wright said. “Ablation is very effective at helping to manage AFib.”

Surgery

If a patient has recurrent AFib and has undergone multiple ablations, our heart care team will discuss surgical options with patients who may meet the criteria for surgery.

In these cases, the surgeon will target areas outside of the heart with the goal of reducing instead of the inside of the heart, which would be treated by electrophysiologists.

Other patients may undergo surgery to implant a pacemaker. Using a pacemaker ends communication between the top and bottom chambers of the heart and allows your pacemaker to set your heart’s rhythm.

“Using a pacemaker does not treat AFib, but it treats the fast and irregular heart rhythm associated with AFib,” Wright said.

Where to seek treatment for AFib

Patients who may be experiencing early symptoms of AFib and are looking to their primary care provider for a referral can look to Rochester Regional Health.

Through the Sands-Constellation Heart Institute’s Atrial Fibrillation Center, patients are able to meet with a team of highly trained heart specialists who can give them the personalized care they need.

“We can meet with patients early on in the disease course, which gives us a lot of time to form a relationship with them and focus on lifestyle modification early on,” Wright said. “This can ultimately give patients the best opportunities for long-term in AFib management.”