Atrial Fibrillation

Atrial fibrillation is an irregular and often rapid heart rate that can increase your risk of stroke, heart failure, and other heart-related complications. During atrial fibrillation, the heart’s two upper chambers (the atria) beat chaotically and irregularly―out of coordination with the two lower chambers (the ventricles) of the heart.

If you are experiencing symptoms of atrial fibrillation, your doctor may order several tests to diagnose your condition including electrocardiogram, echocardiogram, blood tests, stress tests, and more.

Once diagnosed, the treatment that is most appropriate for you will be decided based on how long you’ve had atrial fibrillation, how bothersome your symptoms are, and the underlying cause of your atrial fibrillation. General, the treatment goals are to

1. Reset the rhythm or control the rate
2. Prevent blood clots
3. Decrease the risk of strokes

Some people with atrial fibrillation have no symptoms and are unaware of their condition until it’s discovered during a physical examination. However, those who do experience symptoms may experience the following:

• Palpitations (sensations of racing, uncomfortable, irregular heartbeat, or a flip-flopping in your chest)
• Weakness
• Shortness of breath
• Reduced ability to exercise
• Fatigue
• Lightheadedness
• Dizziness
• Confusion
• Chest pain

BEFORE THE PROCEDURE

Before the procedure begins, a nurse will get you ready. You will lie on a bed and the nurse will start an IV in a vein in your arm. The IV is used to deliver medication and fluids during the procedure, including medication to make you feel drowsy. Your neck, upper chest, arm, and groin will be cleansed with an antiseptic solution. The catheter insertion site(s) will be shaved. Sterile drapes will be placed to cover you from neck to feet.

DURING THE PROCEDURE

After becoming drowsy, the doctor injects medication to numb the catheter insertion sites. The doctor inserts several catheters (long, flexible tubes) into large veins in both side of your groin and possibly your neck. Two catheters are guided into the left atrium through a small hole and placed in the atrial septum.

A catheter in the left atrium is used to find the abnormal impulses coming from the pulmonary veins. Another catheter is used to deliver the radiofrequency energy outside and around the pulmonary veins.

AFTER THE PROCEDURE

After the procedure, the doctor will discuss the results with you and your family. You will be admitted to the hospital and stay overnight for observation. Most patients go home the next morning. Your heart rate and rhythm will be constantly monitored during your recovery. It takes several weeks for the lesions to heal and form scars. So, it is common to have irregular heartbeats for eight to ten weeks.

For at least three months after the procedure, you will need to take anticoagulant medication. This prevents blood clots from forming and reduces your risk of stroke. You may also need to take an anti-arrhythmic medication (to control abnormal heartbeats) for two months after the procedure.

Missouri Heart Center treats atrial fibrillation using Pulmonary Vein Isolation Ablation (PVI Ablation). PVI Ablation is a great treatment option for patients who:

• Still have symptoms of atrial fibrillation, even after treatment with medications
• Cannot tolerate antiarrhythmic drugs, or have had complications from these drugs

PVI ablation is a procedure used to stop abnormal electrical signals in your heart that cause heart rhythm problems. Pulmonary vein isolation is a type of cardiac ablation. Cardiac ablation works by scarring or destroying tissue in your heart that triggers an abnormal heart rhythm. In some cases, cardiac ablation prevents electrical signals from traveling through your heart and thus, stops the heart rhythm problem.