Atrial fibrillation is a common heart rhythm problem. It can affect your quality of life and puts you at risk for strokes.
There are now many treatment options for patients with afib. In terms of prevention of stroke we can use medications, such as blood thinners to reduce the risk. There are upcoming treatment options, such as atrial appendage closure.
In terms of the treatment of the symptoms related to afib, there are also many options available. The initial treatment is typically done with medications. For patients that cant tolerate medications or when meds fail, atrial fibrillation is the treatment of choice.
St Vincent's Hospital in downtown Birmingham has a specialized team of cardiologists, electrophysiologists and cardiovascular surgeons for the treatment of patients with afib.
2.
The Normal Electrical System of the Heart
What is atrial fibrillation?
What are the problems caused by Afib?
Treatment Options
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3. Sinus Node:
I.
I.
Controls the heart rate
Atrioventricular node:
II.
I.
Connects Atria and
Ventricle and controls HR
during afib
His-Purkinje System
III.
I.
Conducts the electrical
impulse from the AV node
to the entire
ventricle, which will cause a
heart contraction
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4. I.
Fast and chaotic impulses
everywhere in the atria
II. No meaningful contraction in
the atria, increasing risk of
blood clots Stroke risk
III. Impulses will conduct via the AV
node, causing fast heart beats
and symptoms.
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5. Afib is the most common heart rhythm disorder
Mayo Clinic data (assuming a continued
increase in AF incidence)
Mayo Clinic data (assuming further increase
in AF incidence)
ATRIA study data (50% >80 yo)
16
14
12
Patients
with atrial
fibrillation
(millions)
15.9
15.2
14.3
13.1
11.7
10.2
10
11.1
8.9
6.1
4
6.8
5.6
3.8
2
2.08
2.26
2.44
5.61
8.4
7.5
5.1
5.1
5.42
9.4
6.7
5.9
6
12.1
10.3
7.7
8
11.7
2.66
2.94
4.34
4.78
5.16
3.33
0
1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050
Year
3000838-6
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6. What Problems does it cause?
• Lack of contraction
in the atria
• Stagnant blood
Fast Heart Beat
Decreased Blood
Flow
Stroke Risk
Symptoms
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7. Fast and irregular heart beat:
• Palpitations
• Chest pain
• shortness of breath
• Dizziness
• Fatigue
• Congestive Heart Failure
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8. Afib and Stroke
•Afib Inadequate blood
flow in some areas of the
heart blood clot
•Blod clots can dislodge and
travel to the brain stroke
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9. Cumulative stroke incidence (%)
◦ 5-fold increase in the risk of strokes
12
8
Women AFib+
Men AFib+
Women AFib-
Men AFib-
4
0
1
2
3
4
5
1
2
3
4
5
Years of follow-up
Wolf PA, et al. Stroke (1991) 22: 983
Go AS, et al. JAMA (2001) 285: 2370
Friberg J, et al. Am J Cardiol (2004) 94: 889
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10. What are the risk factors for stroke?
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11. What are the treatment
options?
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12. 1.
Reduce the Risk of Stroke
2.
Improve Quality of Life
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16. Symptoms
◦
Vary from patient to
patient
◦ Severity dictates treatment
choice
In some patients with little or
no symptoms it is ok to
stay in Afib permanently
Stroke prevention
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17. Improve Quality of Life
Medications
◦
◦
decrease number of
episodes
slow down the heart
Procedures to eliminate
Afib
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18. 1.
2.
Abnormal electrical
impulses firing from the
pulmonary vein may
trigger Afib
Eliminating the abnormal
impulses will eliminate the
triggers for afib.
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19. 1.
Goal of procedure is to
electrically isolate the
pulmonary vein
a. Ablation is performed at
the mouth of the
vein, which causes scar
tissue
b. Scar tissue does not
conduct electricity
c. Electrical firing from the
vein won’t get into the
atria
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23. • Improved Quality of Life
• Reduction of symptoms and
increase in energy
• Decreased risk of Stroke
• In some patients we are able to
stop some of the medications
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24.
Affect your life significantly
◦ Increased risk of stroke
◦ Symptoms that may decrease quality of life
Many treatment options are available
◦ Medications
◦ Procedures
Treatment Goals
◦ Reduce stroke risk
◦ Improve quality of life
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25. To learn more about atrial fibrillation, please
check our website:
www.theafcenter.com
To schedule a consultation please call:
205-939-0073
