How do you treat atrial fibrillation?

From HeartHawk 2011-06-22 23:06:48 -0500 2 Comments

The treatments involve both treating the rhythm problem itself so that people don't get the rhythm problem. And if they do get it, also treating the risks associated with the stroke that comes with the rhythm problem.

There's a number of options you have for patients but one of those options should include, for many patients, a blood thinning drug to help prevent stroke if they have atrial fibrillation.

If you want to treat the arrhythmia, there's a number of different options that you have for treating atrial fibrillation. One is medications. And medications are anti-arrhythmic medications and we have about a dozen different rhythm-controlled medications available to us.

The other alternative for patients with atrial fibrillation if medications fail, is catheter ablation. It's basically a minimally invasive procedure. With catheter ablation, a catheter is inserted through a vein in the leg and can be traced up into the heart under x-ray, using three dimensional guidance systems which we have here at JFK Medical Center. We can actually map the electrical system of the heart and identify these usual suspect cells, the areas in the heart where atrial fibrillation tends to come from. Once we have identified, mapped, and identified areas where atrial fibrillation tends to come from, we can then apply the catheter to these areas.

Now, the catheter is a very special catheter. It can navigate in three dimensions. It has a temperature sensor on it. It has an internal cooling system in it and its steerable. So, it's a high technology piece of equipment. It's not just a plastic catheter. Once we have found these areas, we can then pass an electrical current through these areas and actually heat the tissue underneath where the catheter is touching. The catheter has a cooling system in it so it actually doesn't heat the tissue on top of it, but heats the tissue deep to it. You can actually create a series of what's called, catheter ablations, that actually eliminate these abnormal areas using this catheter.

Basically, what you can do is taken an area of the heart where atrial fibrillation is coming from and put it in jail, isolate it electrically by doing a series of ablations around it with the catheter.

There are other treatments available for atrial fibrillation aside from the catheter ablation. One of the treatments is a procedure called the Maze Procedure. With this procedure, the chest is opened surgically, the heart's exposed and the areas causing atrial fibrillation are basically destroyed with a scalp. The heart is then sown back together, the chest is closed, and these abnormal areas which cause atrial fibrillation have been taken out with a surgeon's scalpel. This procedure will work very well for atrial fibrillation.

The problem is that it's a very invasive procedure but understanding that you can fix a-fib surgically has led us to the ability to also fix it in many patients with a minimally invasive procedure with a catheter ablation.

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2 replies

HeartHawk
HeartHawk 2012-11-02 23:13:23 -0500 Report

beachbum

Yeah I have MVP but so far no afib or HBP.

Lariat has only beem done about 140 times but the results are exciting (there are other devices that do the same thing however). Here are two articles. The first is a simple overview while the second gets into the nitty-gritty of a technique more generically known as Left Atrial Appendage Closure (LAAC) closure

http://www.heartconnect.com/news-articles/813-new-minimally-invasive-surgical-procedure-for-atrial-fibrillation

http://www.heartconnect.com/news-articles/814-stroke-prevention-atrial-fibrillation-left-atrial-appendage-closure-lariat-watchman

Looks like they also have you on a quadruple blood pressure drug therapy - Lotrel, a combination Angiotensin Receptor Blocker (ARB) and Angiotensin Converting Enzyme (ACE) inhibitor, Diovan, a Calcium Channel Blocker (CCB) and Lopressor, a beta-blocker. How high was your blood pressure before treatment?

HH

BeachbumLI
BeachbumLI 2012-11-02 19:21:34 -0500 Report

I have heard fo a new procedure called Lariat, for A-Fib. Can you give me any info on this procedure? I have MVP, A-Fib & HBP. I am on Pradaxa, Lotrel, Diovan & Lopressor. Thank you! :)


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