Raising Awareness for Atrial Fibrillation
Common heart arrhythmia to increase over the next 35 years, what you need to know
STONY BROOK, NY, SEPTEMBER 9, 2014— Atrial fibrillation is the most common heart arrhythmia in the United States, affecting between 3-4 million people and numbers are expected to increase by the year 2050 to 12 million to 14 million. Although widely unknown to the general public, atrial fibrillation or AFib needs to be taken seriously. It increases the risk of stroke by as much as five times and can contribute to heart failure and other heart conditions. Because of this reason, Dr. Eric Rashba, Director, Heart Rhythm Center, Stony Brook University Heart Institute, is raising awareness about this condition in hopes to get patients’ hearts back in rhythm.
When someone develops AFib, the upper chambers, the atria, beat rapidly and erratically. “The atria quiver instead of squeezing normally. This causes slow blood flow, which leads to clots and stroke,” says Dr. Rashba.
People with AFib often feel a fluttering in their chest, an unexplained racing of the heart, or that their heart is skipping beats. Other symptoms include fatigue, dizziness, shortness of breath and lack of energy. At the same time, up to 10 percent of AFib patients have no symptoms at all.
AFib, can be related to high blood pressure, an overactive thyroid, congestive heart failure or diseased heart valves, or can occur in patients with structurally normal hearts who do not have an obvious predisposing condition. It is important to be diagnosed and treated as early as possible.
Initial treatment is medication. “To reduce the risk of blood clots and strokes, your doctor may choose to prescribe blood thinners,” says Dr. Rashba. “Anti-arrhythmic medications are used to maintain sinus rhythm.”
Some patients who are at risk for stroke cannot take blood thinners if they have had bleeding problems. New procedures are now available for these patients, who previously had no options to reduce their risk of stroke. The clots that cause stroke in AFib form in the left atrial appendage (LAA), a sac that is attached to the left atrium.
"The LARIAT procedure involves placing a suture over the LAA to close it so that clots cannot form,” says Dr. Rashba. “Open heart surgery was required in the past to close the LAA, but we can now accomplish the same thing using a minimally invasive procedure."
If pharmaceutical therapies fails, ablation, which involves cauterization of abnormal heart tissue, is recommended. “The goal is to eliminate the electrical connections between the pulmonary veins and the left atrium so that the abnormal impulses from those veins cannot stimulate the rest of the heart, the cause of the atrial fibrillation,” says Dr. Rashba. “We tailor the ablation approach to each patient, including radiofrequency catheter ablation (heating the heart tissue), cryoablation (freezing), and hybrid ablation for patients with AFib that is more persistent and difficult to treat.”
For the hybrid ablation, a surgeon ablates the back surface of the left atrium using a minimally invasive laparoscopic approach, and the electrophysiologist ablates the inner surface of the atrium where the surgeon cannot reach. “Success rates with the hybrid approach are high for patients with the most resistant forms of AFib, and Stony Brook is the only center on Long Island that offers this procedure,” says Dr. Rashba. “Although atrial fibrillation is a common arrhythmia, the ablation procedure to fix it is very complex and can only be done at major medical centers with a high level of technical expertise. In Suffolk County, Stony Brook University Hospital fills this role.”
The longer you wait for diagnosis and treatment, the more atrial fibrillation progresses and becomes increasingly difficult to treat. If you have any reason to believe you may have this condition, see a specialist. AFib is a progressive condition. If it’s not treated, it will progress until it is permanent and untreatable. For more information, log on to www.heart.stonybrookmedicine.edu