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Treatments for atrial fibrillation

 



Treatment for atrial fibrillation
Treatment differs depending on the type of A-fib and how serious it is. If episodes are mild and not too problematic, your physician may prescribe medications to manage symptoms. However, if medication doesn't control your symptoms, your physician may recommend one of the following procedures:

  • Blood clot prevention through medicines
  • Rate control through medicines to slow down the rate at which the ventricles are beating
  • Rhythm control is used to restore and maintain normal heart rhythm when rate control treatments are not effective
  • Doctors use medicines or procedures to control the heart's rhythm
  • Catheter ablation, a procedure that disrupts parts of the abnormal electrical pathway (tissue) causing the irregular heartbeat
  • Surgery to remove abnormal tissue causing the irregular heartbeat

How can I lower my risk for atrial fibrillation?
Lifestyle changes can help prevent A-fib and lower your risk for heart disease:

  • Follow a heart-healthy diet that's low in saturated fat, trans fat and cholesterol, and includes a variety of whole grains, fruits and vegetables daily.
  • Don't smoke or use tobacco products.
  • Be physically active every day.
  • Maintain a healthy weight.
  • Keep your cholesterol and triglycerides at healthy levels with dietary changes and medications (if prescribed).
  • Limit or avoid alcohol.
  • Control your blood sugar level if you have diabetes.
  • Get regular medical checkups and take your medications as prescribed.

Catheter ablation

What to Expect

  • During the procedure, the electrophysiologist (heart doctor who specializes in the diagnosis and treatment of heart rhythm disorders) places a flexible wire (catheter) in your groin and up into your heart. Before the catheter is inserted, a local anesthetic is injected into the skin with a tiny needle to numb the area. This may cause a stinging sensation.
  • The catheter is used to burn small areas of the heart tissue that causes the abnormal heart rhythm
  • These areas of tissue are found by creating a 3-D map of your heart at the beginning of the procedure
  • The goal of the ablation is to reduce or eliminate the symptoms you have from your heart arrhythmia
  • Most ablation procedures take 1 – 3 hours to complete. In some cases, such as in an atrial fibrillation ablation, it may take longer.
  • Depending on the type of ablation procedure you have, you will be either sedated with medications or put under general anesthesia. This is determined by the type of heart arrhythmia you have and how long the procedure typically takes. Your doctor will talk about this with you during your office visit.
  • After the electrophysiologist has burned the tissue causing the arrhythmia, they will check to make sure the procedure is complete by trying to restart your abnormal heart rhythm. If it comes back, further ablation is needed during the procedure, if it is felt to be safe.
  • The procedure itself is generally not painful, though you may feel some pressure as the catheters are being inserted.

How To Prepare

  • You will receive specific instructions from your electrophysiologist, but you may be asked to stop some of your heart medications a few days before your procedure.
  • Your electrophysiologist may require some blood tests to be done prior to the procedure. It is important to have these done exactly as instructed.
  • Typically, you will not be able to eat or drink anything after midnight, the night before your procedure.
  • Make arrangements with a friend or family member to take you in for your procedure, and to drive you home once you are discharged.
  • On the day of the procedure, the hospital staff will prepare you for the ablation, which will include:
    • Preparing the area of skin where they will insert the catheters.
    • Inserting a needle into a vein in your arm to administer medications
    • Placing you on the table in the electrophysiology lab, where the procedure will be performed.
    • Depending on the length of the procedure, they may insert a urinary catheter to drain your bladder during the procedure.

Aftercare

  • When the procedure is over, the catheters are removed and a bandage is applied with pressure at the catheter insertion sites to prevent bleeding. There are no stitches placed, but it is important to remain still during this time.
  • Generally, you are on bed rest for a few hours immediately following the procedure.
  • In most cases, your heart rhythm will be monitored overnight to help determine how well the ablation worked.
  • Most often, you can return to normal life and activities after the ablation procedure. However, in the first few days, you may be asked to limit your activity and avoid strenuous physical activity.
  • Unless otherwise directed, you can return to work a few days after the procedure if you aren’t having any problems and if your work does not involve strenuous physical labor.
  • In the days following the ablation, pay close attention to the areas where the catheters were inserted. It is normal to have a small bruise or lump at the insertion site. If you notice the area becomes warm, tender, painful or begins to swell, call the office. If you have a fever, dizziness or passing out, call us immediately.
  • In the first several days after the ablation, it is common to experience some occasional palpitations. These will happen less often over time. If they occur and last for more than a few hours, call the office.
  • We may reduce your medications in the weeks following your procedure, depending on how your heart arrhythmia responds. Each type of ablation has its own success rates. Your electrophysiologist will discuss this with you during your office visit.
  • You will follow up in the office approximately 6 weeks after your procedure. Additional visits may be necessary depending on the type of arrhythmia and ablation you had.

How is Atrial fibrillation treated?
Kent E. Morris, M.D., electrophysiologist with Norton Heart Specialists, talks about treatment options for atrial fibrillation.

If you think you may have A-fib or you have noticed any changes in your health, talk with your physician. If you don't have a primary care physician, visit our Find a Doc or call (502) 629-1234 for a physician referral.

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