Atrial fibrillation (AF) is the most common type of arrhythmia requiring treatment. In AF, the atria cannot contract but only quiver due to abnormal electrical impulses often originating from the left atrium. This can lead to palpitations, shortness of breath, and easy fatigue. There can be many causes of AF. The most well-known risk factors are: Coronary artery disease, hypertension, diabetes, obesity, advanced age, sleep apnea syndrome, genetic predisposition, and engaging in strenuous sports. Because the atria do not contract in AF, blood movement decreases in the pouch of the left atrium (LAA). Blood in a stagnant area is prone to clotting. One day, this clot may break loose, travel through the vessels to the brain, and cause a stroke. One out of every four stroke patients in the world has suffered a stroke due to this rhythm disorder (AF). AF can also reduce the heart’s pumping power, meaning it can cause heart failure. Since the heart can no longer provide the sufficient oxygen the body needs, easy fatigue, shortness of breath, and pulmonary edema may develop.
How is atrial fibrillation (AF) treated?
In the treatment of AF, reducing the risk of stroke and controlling abnormal electrical activity are of critical importance. The classic blood thinner, warfarin, or new-generation anticoagulants (NOACs: Dabigatran, rivaroxaban, apixaban, and edoxaban), which have fewer side effects, prevent clot formation. Antiarrhythmic drugs also eliminate the patient’s symptoms by blocking the foci producing abnormal impulses or their effects. If rhythm medications do not work or cause side effects, a cauterization procedure called ablation can be performed. This procedure generally takes 1–2 hours. During the procedure, a catheter is sent to the heart through the groin vein. The septum between the right atrium and the left atrium is punctured with a needle to pass through. The catheter has sensors that measure the heart’s electrical activity; in this way, an electrical map of the heart is created. Abnormal foci are usually located at the inlets of the pulmonary veins. These abnormal foci are then cauterized using hot (radiofrequency) or cold (cryo) techniques. After a successful ablation, the heart begins to beat normally; that is, the rhythm becomes regular. In some patients, this procedure can be applied as the first choice without trying medication. In AF treatment, it may also be necessary to restore the rhythm by giving a controlled electric shock to some patients (cardioversion) or to close the pouch in the left atrium with a plug (LAA closure).
Informing a patient in a short and clear language, backed by scientific data, is of great importance for treatment success. Because a well and correctly informed patient makes a conscious choice between the different treatment methods offered for such a vital organ as the heart (surgical or non-surgical). This way, hope increases, anxiety decreases, and the patient develops accurate expectations about the outcome. This website was created for this purpose by Prof. Sukru Akyuz, MD.
