Treatments can include medication, catheter ablation, cardioversion or surgery.
Atrial fibrillation (A-fib) is a heart rhythm condition that isn’t life-threatening, but can lead to other conditions such as stroke and heart failure, so it should be taken very seriously.
A-fib is an irregular heart rhythm starting from the atria — the top of the heart — sending out fast, erratic signals that cause the top chambers of the heart to quiver, or fibrillate. It’s the most common heart rhythm abnormality.
“Patients who have A-fib are at a much higher risk of having a stroke, but not everyone’s risk is the same,” said Tara U. Mudd, APRN, nurse practitioner with the Norton Heart & Vascular Institute Atrial Fibrillation Clinic. To determine the level of risk, practitioners at the A-fib clinic use the CHA2DS2-VASc score to determine stroke risk.
The assessment will return a score based on age, gender, medical history and other factors to arrive at a score of zero to nine, with the lowest score meaning you may not need blood thinners.
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Having A-fib for a long time or having very fast heart rates for a long time can make the heart weaker. Sometimes a weakened heart is the cause of your A-fib.
“It’s our job to figure out which came first, but we also will use some medications to help prevent heart failure,” Tara said.
Once the risks of stroke and heart failure have been addressed, treatments for A-fib can include medication, catheter ablation, cardioversion or surgery.
Medications in the AV nodal blocker family can help get the heart rate down and are the first line of treatment. As a second line of medication treatment, anti-arrhythmic drugs specifically target the A-fib.
The third tier of treatment is ablation — surgical or minimally invasive. It involves cauterizing the abnormal areas of the heart that are causing the Afib.
Cardioversion is a procedure sometimes used in conjunction with medications or ablation. Patients usually go home the same day after cardioversion, which essentially shocks the heart back into normal rhythm.
A newer procedure introduced to the Louisville and Southern Indiana areas by Norton Heart & Vascular Institute is the convergent or hybrid ablation that combines a minimally invasive ablation through a small incision in the chest to cauterize precise spots on the outside of the heart.
“We have a surgeon who is specially trained in this, and all our cardiac electrophysiologists are experienced with the minimally invasive part of the procedure,” Tara said.
“This particular procedure is not for everyone, but there are certain patients who we feel would really benefit, and have benefited from doing this,” she said. “We’ve been doing this procedure at Norton Heart & Vascular Institute since 2017 with lots of patients who are now free from their A-fib or have reduced it enough that it doesn’t bother them anymore.”