Division of Cardiology at Tel Aviv Sourasky Medical Center (Ichilov) provides diagnostics, treatment, and monitoring for patients with atrial fibrillation.
Atrial fibrillation is one of the most common types of sustained arrhythmia - when the heart rhythm becomes irregular with intermittent heartbeats; either abnormally fast, or skipped. Atrial fibrillation itself usually isn't life-threatening. However, it may lead to other complications, such as low cardiac output and cardiac failure, acute cerebral artery occlusion (stroke), and intellectual deficiency. It also results in deterioration of quality of life and an increased risk of stroke among patients.
Hospital death rates in patients with cardioembolic strokes associated with atrial fibrillation are 30%. This is why prophylactics, diagnostics, and treatment of patients with atrial fibrillation are vitally important.
Certain factors may increase the risk of developing atrial fibrillation, including:
- Age. The prevalence and incidence of atrial fibrillation increases with age. Over 10% of those aged 80 and over suffer from atrial fibrillation.
- Heart disease.
- High blood pressure.
- Other chronic conditions. People with certain chronic conditions such as thyroid problems, sleep apnea, metabolic syndrome, diabetes, chronic kidney disease or lung disease have an increased risk of atrial fibrillation.
- Drinking alcohol.
- Obesity. People who are obese are at higher risk of developing atrial fibrillation.
- Family history.
Some people with atrial fibrillation have no symptoms and are unaware of their condition until it's discovered during a physical examination. Those who do have atrial fibrillation symptoms may experience signs and symptoms such as:
- Chest pain
- Skipped heart beats
- Breathing difficulties
- Shortness of breath
- Faintness or loss of consciousness
- High heart rate
Medication-Based Treatment of Atrial Fibrillation
Treatment of atrial fibrillation depends on its type. Taking into account several risk factors, patients with atrial fibrillation receive medications such as aspirin or anticoagulants such as warfarin, to restore normal sinus rhythm and prevent strokes.
There are two basic approaches to the medication-based treatment of atrial fibrillation:
- Drug treatments aimed to slow down the heart rate and control the irregular heart rhythm using beta-blockers (Normiten, Lopressor, Cardiloc) and calcium blockers (Ikacor, Dilatam, Digoxin).
- Regular drug treatments for the prevention of atrial fibrillation and maintenance of sinus rhythm, including Procor, Rythmex (Profex), Tambocor, Sotalol, and Multaq.
If atrial fibrillation persists despite an appropriate therapy, radiofrequency ablation may be performed in order to restore and maintain sinus rhythm.
Surgical Treatment of Atrial Fibrillation
Surgical methods for treatment of atrial fibrillation include:
- “MAZE” procedure, which entails making multiple incisions in specific sections of the atria. This open-heart surgery is performed under general anesthesia.
- “Corridor” procedure, which involves isolating the left and right atria from the interatrial septum. This surgery is also performed under general anesthesia.
- Radiofrequency catheter ablation (focal, circular, and nodal), also known as cardiac ablation, is typically performed in more severe cases of atrial fibrillation. It is the latest pain-free and minimally invasive method of treatment; yielding the most promising results. Cardiac ablation is used to neutralize small areas of the heart tissue, which generate abnormal electrical signals by delivering small burns to the specific focal areas responsible for triggering the atrial fibrillation. This is performed using a computer navigation system to control and manipulate a special flexible catheter that is inserted into a vein, typically in the groin or neck. The heart’s electrical activity is mapped to show the focus (nucleus) triggering the atrial fibrillation.
In some cases, pacemakers (artificial pace making devices implanted in the atria, helping to regulate the heart rhythm) are used to control abnormal heart rhythms.