Atrial fibrillation (AF) is the most common cardiac arrhythmia, or problem with the heart’s rhythm. Federal research shows there are 2.5 million people in the United States with this condition, and an estimated 200,000 more are diagnosed with AF each year. As people age, their risk of developing AF increases.
The atria are the heart’s two upper chambers. AF occurs when electrical signals cause them to contract quickly and irregularly. As a result, the atria don’t beat in concert with the heart’s ventricles and blood isn’t pumped at the rate it should be.
AF might happen rarely, or it could last for years.
Causes and risk factors
Although AF commonly occurs in patients with structural heart disease (such as coronary artery disease, valvular heart disease or hypertensive heart disease), it can also occur in young patients with no apparent structural cardiac abnormalities.
If you have the following symptoms or conditions, you might be more likely to have AF:
- Lung disease
- History of cardiac surgery
- Sleep apnea
- Use of stimulants and/or heavy alcohol abuse
Patients will often have heart palpitations that are either intermittent or persistent. Palpitations include the heart skipping a beat, beating too fast or fluttering.
According to the National Institutes of Health, other common symptoms include:
- Shortness of breath
- Chest pain
Some patients will have no symptoms at all.
A diagnosis of AF usually requires confirmation using one of three tests:
- 12-lead EKG, where 12 different electrical signals are recorded during each heartbeat for a few seconds.
- 24-hour Holter monitor, where small electrodes are attached to the chest to continuously measure the heart’s rhythm.
- 30-day event recorder, which is used to record abnormal heartbeats that happen less frequently.
These tests can also help rule out other causes of palpitations.
There is no “one-size-fits-all” treatment for AF.
Treatment options include blood thinner medications to prevent stroke, cardiac medications to control the heart rate, or more invasive treatment such as pacemaker implantation or catheter ablation to suppress AF.
Therefore, AF requires a thorough physician’s evaluation to choose the most appropriate treatment based on your clinical situation.
Research has shown catheter ablation to be superior to medical therapy in preventing AF episodes and potentially improving quality of life and heart function for the patient.
The procedure involves threading catheters through a blood vessel, usually into the leg and up through the heart. Doctors use the catheter to study the arrhythmia and identify and eliminate the abnormal tissue causing it. The tissue can be in a limited area or it can be more widespread, depending on the nature of the arrhythmia.
Although catheter ablation is an effective treatment for AF, doctors will select the most appropriate patients to achieve the best results.
Surgical ablation, also referred to as the maze procedure or mini-maze procedure, involves the use of radiofrequency waves to create scar lines on the heart's surface. These scars redirect the erratic electrical impulses of atrial fibrillation to a normal electrical pathway through the heart.
Surgery for atrial fibrillation is separated into two surgical techniques, the mini-maze and the full maze procedure. The full maze procedure is an open-chest procedure and is typically performed on patients needing open-heart surgery for other issues, such as coronary bypass or to replace or repair a valve.
For patients with atrial fibrillation only, the mini-maze procedure may be an option. This procedure is done by a cardiothoracic surgeon and does not require a large incision in the sternum. Rather, the surgeon makes three or four small incisions on each side of the chest, and through these incisions places surgical instruments, an ablation device and a thoracoscope.
During the initial consultation the cardiac surgeon will help you decide which procedure will have the best results.
Gill Heart Institute and AF
The UK Gill Heart Institute has a large, multidisciplinary team with extensive experience that includes physicians with expertise in cardiac rhythms (electrophysiologists), general cardiologists, advanced imaging cardiologists, and specially trained nurses and technicians who manage and treat atrial fibrillation effectively and compassionately. With state-of-the-art facilities and advanced equipment and technology (such as intracardiac echocardiography, analysis of cardiac CT and acquisition of 3-D electroanatomic mapping), our Heart Rhythm Treatment Program is now accepting new patients. Our physicians are typically able to see new patients within a week, so they can provide primary care physicians and patients with the support they need in the complex treatment of atrial fibrillation.
Our physicians are on hand to answer your questions and concerns about AF. Call 859-257-1000 or 800-333-8874 (toll free) for more information or to schedule an appointment with a specialist.
About the Gill Heart Institute
The Gill Heart Institute takes a comprehensive approach to heart health. It begins with promoting cardiovascular wellness and extends to treating complex, life-threatening complications.
Our dedicated specialists use the most advanced technology to diagnose and treat patients with leading-edge tools available only at premier medical centers across the country. Gill physicians use the most up-to-date therapies and devices, including Total Artificial Hearts and heart transplants.
Should you require surgery, our heart specialists operate in UK HealthCare’s recently opened robotic hybrid operating room – one of the country’s largest and the first of its kind in the region – or in one of our new, state-of-the-art, multipurpose operating rooms and catheterization labs.
In addition to providing the most comprehensive heart care available in the region, Gill Heart Institute experts also train the next generation of Kentucky’s cardiologists.
At the Gill Heart Institute, our team of doctors and staff provides compassionate care using the most modern treatments and facilities available.