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Atrial Fibrillation

Atrial fibrillation (AFib) is a  common heart disorder that occurs when electrical signals in the heart become irregular, causing the heart’s upper chamber to beat out of rhythm. Atrial fibrillation requires immediate medical attention because it could lead to a life-threatening stroke.

Atrial fibrillation may or may not cause symptoms. Some people with the disorder can experience the following symptoms:

  • Palpitations
  • Chest pain
  • Shortness of breath
  • Fatigue
  • Dizziness or confusion

The condition is diagnosed through an electrocardiogram, which measures the heart’s electrical impulses.

In some cases, AFib resolves on its own. Other times, an underlying condition such as an over-active thyroid, hypertension, diabetes, chronic lung disease or heart valve disease must be treated.

Medications may be prescribed to prevent blood clots or control heart rate. Cardioversion, another treatment option, can be recommended to shock the heart back to a normal rhythm by delivering a jolt of electricity to the heart. However, if these efforts are not successful, doctors could recommend atrial fibrillation ablation.

Health Fact:

Approximately 2.5 million Americans experience atrial fibrillation each year

How does atrial fibrillation ablation work?

Atrial fibrillation ablation involves threading a long, thin, flexible tube called a catheter into the heart through a blood vessel in the arm, upper thigh or neck. Live X-ray images are used to carefully guide the catheter into the heart. Several flexible tubes with electrodes on the tips are run through the catheter and placed in different small blood vessels in the heart.

Sections of the heart are then mapped to locate abnormal tissue. Energy is applied to destroy targeted tissue that has been identified as causing the irregular heartbeat. Two types of energy that can be used in the procedure are:

  1. Radio frequency — to generate heat.
  2. Liquid nitrogen — to freeze the targeted area of the heart.

The resulting scar line then acts as a barrier between affected tissue and the rest of the healthy heart, stopping abnormal electrical signals that cause an irregular heartbeat.

Patients may not eat or drink anything after midnight the night before the procedure. Although sedated during the procedure, a patient could still feel some lightheadedness, rapid heartbeat, burning when any medications are injected or chest discomfort when energy is applied.

An atrial fibrillation ablation procedure can last anywhere from four to nine hours. After the procedure, pressure is applied to the site where the catheter was inserted, and patients must lie still for four to six hours. Their heart rate is closely monitored during this time.

A chest X-ray, electrocardiogram or transesophageal echocardiogram may be ordered to check the heart and prevent complications. Some patients are discharged the same day, while others need to stay in the hospital overnight. Most people resume normal activities within a few days.

Atrial fibrillation ablation may be a more effective treatment than medications. However, as with any procedure, there are risks associated with atrial fibrillation ablation. For more information about atrial fibrillation and different treatment options, talk with your doctor or visit the National Heart Lung and Blood Institute website at www.nhlbi.nih.gov

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