Treatments for AFib can range from medication to surgery depending on the severity of the irregularities, the duration of the atrial fibrillation state and other medical issues happening concurrently.
- Medications prescribed for AFib often prevent or treat blood clots, in order to reduce the risk of stroke. Other medications may be used to correct the abnormal heart rhythm itself.
- The two most common nonsurgical procedures to treat AFib are electrical cardioversion and catheter ablation. Electrical cardioversion is the application of an electrical shock to the chest in an attempt to reset the heart’s rhythm. Catheter ablation involves the use of a thin, flexible tube (the catheter) to reach the heart by way of the blood vessels. A cardiac electrophysiologist, a physician specializing in heart rhythms, uses the catheter to pinpoint and eliminate the abnormal tissue causing the arrhythmia.
WATCHMAN Procedure and AtriClip
- When a blood clot develops in the heart of a patient with Atrial Fibrillation, it is most often found within the left atrial appendage. This is a small pouch that empties blood into the left atrium, one of the upper chambers of the heart. In patients with AFib this pouch does not empty normally and the blood can form clots which may be pumped out and can travel to the brain causing a stroke. Treatment can involve the exclusion of the left atrial appendage from the circulation through minimally invasive surgery by applying a special clip (AtriClip) to its base or by use of the WATCHMAN device. Both methods act as a barrier to prevent blood clots from entering the blood stream and potentially causing a stroke. AFib patients have a five time greater risk of stroke and typically have to take a long-term blood thinning drug with potentially serious side effects. After a successful procedure, patients can potentially stop taking blood thinning drugs such as warfarin.
Hybrid Convergent Procedure
- For persistent AFib, your physician may recommend the hybrid convergent procedure – a multidisciplinary approach that combines the efforts of both the cardiothoracic surgeon and the cardiac electrophysiologist. The cardiothoracic surgeon accesses the outside of the heart and uses radiofrequency energy to create interruptions in the abnormal tissue, thereby preventing irregular electrical impulses from forming. Then, the cardiac electrophysiologist uses a catheter to reach the inside of the heart and close any gaps inaccessible from the outside of the heart that could otherwise allow the conduction of irregular electrical impulses.