Exciting New Treatment Approaches for Atrial Fibrillation

Atrial Fibrillation

If you experience your heart banging against your chest or skipping beats you’re most likely experiencing arrhythmia. Arrhythmia is an irregular rate or rhythm of the heartbeat, where your heart can beat too fast or slow. This is a type of atrial fibrillation (AFib), when disorganized electrical signals cause the heart’s two upper chambers to fibrillate or contract very fast. Millions of Americans are affected by this disease and the number increases each year.

Men are more likely to experience this condition than women. It’s also more common among whites than any other race. Other risk factors include high blood pressure, coronary heart disease, obesity, diabetes, lung disease, drinking large amounts of alcohol and sleep apnea.

Symptoms:

Symptoms include palpitations, shortness of breath, dizziness, confusion, sweating, fatigue and weakness when exercising. There are different types AFib classifications and all of them increase your risk of stroke.

Treatments:

With the advances in medicine, I wanted to explain some of the exciting new diagnostic and therapeutic advances in atrial fibrillation (AFib) care.

• Implantable loop recorders

There are now monitors available that continuously track a patient’s heart rhythm 24-7-365! While this may sound a little “Big Brother”, it is actually fantastic technology because it allows the treating physician to pick up heart rhythm problems much more rapidly than in the past. In fact, most of the time, this information can be picked up from home! In many cases these devices are even helping us make decisions about whether or not blood thinners, anticoagulants are required.

• Left atrial closure devices (Watchman)

A device called the Watchman is now available to actually “wall-off” the left atrial appendage, the structure where a blood clot, called thrombus, is most likely to form when a patient in in AFib. These devices have proven to be as effective as warfarin in multiple clinical trials. The Watchman, or other similar devices, may be great alternatives for patients who have bleeding problems and cannot tolerate anticoagulants.

• Rotor mapping

This is currently the most exciting technology in the area of AFib ablation. We are now able to map the actual AFib “waves” as they traverse the heart in order to pinpoint rotors. A rotor is as a stable area of electrical activity that allows the AFib circuits to continually propagate. While there is currently some controversy over the most effective way to utilize this information, it is becoming increasingly clear that a strategy focusing on rotor ablation could dramatically improve the outcomes for patients with prior “failed” ablations, or multiple ablation procedures.

• Leadless pacemakers

Pacemakers are not typically designed to treat AFib, but many patients who have AFib also have a pacemaker, and newer pacemaker algorithms are available that effectively reduce the risk of AFib episodes. The most promising pacemaker technology involves leadless devices—meaning that no wires or leads are involved. This reduces the risk of device failure (from the leads failing over time). Leadless devices can be implanted through a vein in the groin without the need to create a chest pocket, which reduced the risk of infection.