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Atrial Fibrillation

Atrial fibrillation (AFib) is a relatively common heart defect that can lead to dire consequences if left untreated, including blood clots, stroke and heart failure. An estimated 15 – 20 percent of stroke victims suffer from atrial fibrillation. The Florida Institute for Atrial Fibrillation is a multidisciplinary center that brings together cardiac electrophysiologists, a cardiothoracic surgeon and an interventional cardiologist to provide seamless care to atrial fibrillation patients.

What is AFib?

Atrial fibrillation (AFib) is an irregular heartbeat (arrhythmia) caused by faulty firing of electrical impulses in the heart that stem from the development of abnormal tissue. These abnormal signals cause the upper chambers of the heart, or atria, to quiver instead of contracting and relaxing in a regular rhythm. This irregularity in the atria causes them to pump blood inefficiently into the ventricles, the lower chambers of the heart. Because this inefficient pumping can slow down the blood flow, it can increase the risk of blood clot formation, which in turn increases the risk of stroke.

AFib is typically classified into three categories:

Paroxysmal: Paroxysmal AFib symptoms and irregular electrical signals start and stop on their own, often within 24 hours but usually within a week.

Persistent: AFib is considered persistent when the rhythm abnormalities last longer than a week, and require treatment to return to normal rhythm.

Permanent/Long-Standing: AFib is considered permanent when treatment fails to restore a normal heart rhythm. Permanent AFib can result from either frequent paroxysmal or persistent AFib.

Symptoms of Afib

The most commonly recognized symptom of AFib is a “fluttering” heartbeat, or a heartbeat that is rapid and irregular. Other symptoms include:

  • Fatigue
  • Quivering or thumping in the chest
  • Dizziness or faintness
  • Shortness of breath
  • Anxiety
  • Weakness
  • Confusion
  • Exercise fatigue
  • Sweating
  • Chest pain or pressure

Treating AFib

Treatment for AFib can range from medication to surgery depending on the severity of the irregularities, the duration of the atrial fibrillation state and other medical issues happening concurrently.

Medications 

Medications prescribed for AFib often prevent or treat blood clots, in order to reduce the risk of stroke. Other medications may be used to correct the abnormal heart rhythm itself.

Nonsurgical Procedures 

The two most common nonsurgical procedures to treat AFib are electrical cardioversion and catheter ablation. Electrical cardioversion is the application of an electrical shock to the chest in an attempt to reset the heart’s rhythm. Catheter ablation involves the use of a thin, flexible tube (the catheter) to reach the heart by way of the blood vessels. A cardiac electrophysiologist, a physician specializing in heart rhythms, uses the catheter to pinpoint and eliminate the abnormal electrical impulses causing the arrhythmia. 

Convergent Procedure

We offer a new minimally invasive procedure that combines the best of electrophysiology and cardiac surgery treatments to help restore normal heart rhythm for longtime sufferers of atrial fibrillation, or AFib. Early clinical experience has shown that the convergent approach, conducted in a single operating room setting, improves early outcomes for the most challenging patients when compared to approaches where the two disciplines work separately.

How it Works

Our cardiac surgeons and electrophysiologists (EPs) work together to perform cardiac ablation on a beating heart using radiofrequency (focused heat) to produce scar tissue on the heart to block abnormal electrical signals. The surgeon is able to create comprehensive, linear lesions on the outside surface of the beating heart through a small, one-inch incision made just below the breastbone. There are no chest incisions and/or ports, as in other surgical ablation procedures. The EP then threads a catheter through the patient’s femoral vein, in the groin, to reach the heart and fill in any gaps to complete the ablation. The EP utilizes diagnostic techniques to confirm that all abnormal electrical signals have been interrupted. The entire procedure lasts less than the time of a single-discipline ablation procedure.

What to Expect

Following the convergent approach procedure, it is possible that your daily rhythm medications may be reduced or even eliminated. Typical hospital stays last two to three days, compared to five days or more for more invasive heart surgery, and you should be back to your normal activities quickly.

 

 

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