Atrial Fibrillation & Arrythmia
Atrial fibrillation (Afib) is a progressive disorder that causes the upper chambers of the heart to beat in a sporadic, rapid, or uncontrolled manner. This irregular heartbeat (arrhythmia) affects proper blood flow throughout the heart, which can worsen in severity over time and lead to blood clot. Afib is not life-threatening on its own, but should be treated in order to control symptoms and prevent further heart complications like stroke. The cardiac electrophysiology (EP) specialists at Baptist provide state-of-the-art treatment options.
Conditions – Heart Rhythm Disorders
Your heart’s electrical system makes sure it contracts (squeezes) in an orderly way. When something interferes with your heart’s natural pacemaker, arrhythmias can occur. If you or your physician are concerned about your heart rhythm, the cardiac electrophysiologists at Baptist are here to help with the latest diagnostic tools and treatment options.
Conditions we treat include:
Symptoms may include heart palpitations, shortness of breath, fullness in the throat, lightheadedness, dizziness, paleness, sweating, and in some instances, chest pain. You may or may not notice symptoms when the arrhythmia is present – or you may only experience them during physical activity.
Symptoms can be very mild or they may be severe. Irregular heart rhythms can be harmless or a sign of other heart problems. While mild rhythm disorders may not even require medical attention, a very serious condition called ventricular tachycardia, an extremely fast and chaotic rhythm, can cause sudden cardiac death and requires emergency care.
If you have heart palpitations, what can you do for self-care? Avoid or limit caffeine, alcohol and nicotine, take any medications prescribed by your cardiologist, report any suspected drug interactions or side effects affecting your heart rate or function to your doctor or pharmacist, and take steps to manage your stress and stay calm—anxiety is not good for your body. Contact a medical professional if you have been diagnosed with an arrhythmia and your symptoms worsen or do not improve with treatment.
Progression of Afib
There are not specific “types” of Afib, but rather, a series of advancing stages that can occur if symptoms are left untreated – therefore, taking a “wait and see” approach is not always best for the patient. For patients with heart failure or a weak heart and Afib, it is very important to see an electrophysiologist because treatment of Afib can significantly decrease the chances of mortality.
These stages are:
- Paroxysmal: Signs or symptoms occur spontaneously and heart restores to normal rhythm within 7 days of onset.
- Persistent: Irregular rhythm lasts consistently for longer than duration of 7 days.
- Longstanding Persistent: Irregular rhythm lasts consistently for longer than duration of 12 months.
- Permanent: Irregular rhythm lasts indefinitely.
Treatment Options - Afib
Many options are available to treat Afib, including lifestyle changes, medications, catheter-based procedures and surgery. The type of treatment that is recommended for you is based on your particular heart rhythm and symptoms. The goals of treatment for Atrial fibrillation include regaining a normal heart rhythm (sinus rhythm), controlling your heart rate, preventing blood clots and reducing the risk of stroke. Baptist Heart is proud to offer the full spectrum of advanced treatment options and cutting-edge technologies not often provided elsewhere.
There are, generally, three types of medications to help manage Afib:
- Anticoagulants are used to reduce blood clotting and prevent stroke in Afib patients. They can range from aspirin, which causes platelets to become less adhesive, to prescription medications like warfarin, which thins the blood to prevent coagulation.
- Rate controllers such as beta blockers, calcium channel blockers and cardiac glycosides, can be used to bring the heart rate down to reduce Afib symptoms.
- Antiarrhythmics are rhythm control medications. From sodium channel blockers to potassium channel blockers, they can impede the electrical signals that cause Afib, thereby keeping it suppressed to maintain normal rhythm.
When medications do not work to control Afib, or when they are not well tolerated, a procedure may be needed to treat your abnormal rhythm.
Cardioversion is an outpatient procedure performed under short- acting sedation that electrically “resets” the heart. A low dose of energy reactivates normal rhythm, although its effect may not be permanent.
Catheter ablation is a minimally invasive procedure that typically applies radiofrequency energy to eliminate the small areas of heart tissue that are causing your Afib. Catheter ablation is designed to restore the heart’s normal rhythm on a long-term basis. An electrophysiologist (EP) performs the procedure, guiding catheters to the heart usually through a vein in the groin or neck. The procedure can take up to several hours and is performed under sedation with an anesthesiologist. Patients typically go home the following day and return to normal life and activities in one to two weeks. Medications for controlling the arrhythmia may be reduced or even eliminated following successful catheter ablation.
Baptist offers pressure-sensing ThermoCool SmartTouch© Catheter to burn the sources of Atrial fibrillation in the heart, and the Cryoballoon Catheter that uses miniature balloons at subzero temperatures to freeze them. Both have an 80% overall success rate.
Device therapy includes a range of devices that can be implanted in the body to regulate a normal heartbeat and reduce frequency/severity of arrhythmias. These include:
- Pacemakers, small electrical devices, implanted under the skin close to the collarbone, that transmit an electrical signal to control proper contracting of the heart’s rhythm.
- Baptist Health offers the latest MRI-compatible pacemakers and is one of only 25 research centers in the nation, and one of only two in Florida, to offer the new leadless pacemaker. This advancement allows the world’s smallest pacemaker — the size of a vitamin — to be placed directly into the heart without any attached wires and offers numerous benefits.
- ICDs (implantable cardioverter-defibrillators) are implanted devices used to perform cardioversions and restore and correct pacing of the heart. Unlike pacemakers, they are also able to treat unexpected, life-threatening arrhythmias such as Ventricular Tachycardia and Ventricular Fibrillation. Baptist Health offers the most advanced defibrillator technologies. The new subcutaneous defibrillator has wires placed under the skin instead of directly into the heart to decrease chances of infection. The new ICD Mini is the world’s smallest heart defibrillator. New biventricular defibrillator implants now utilize the latest biventricular leads for patients whose hearts are both weak and out of sync to improve symptoms and quality of life.
- We also provide Left atrial appendage repair WATCHMAN™
Causes and Risk Factors
Some common causes of palpitations include abnormal levels of potassium; heart attack, or a damaged heart muscle from a past heart attack; or a congenital heart condition (present since birth, but not necessarily known). Arrhythmias also may be caused by caffeine, or stimulant drugs; heart or blood pressure medicines; tobacco use (nicotine); and other medicines such as those used for depression.
The most common risks that can lead to Afib include:
- Increasing age (60 and greater)
- Coronary artery disease
- Congestive heart failure
- Heart valve disease
- Thyroid problems
- Obstructive sleep apnea
- Excessive alcohol intake
Even people who do not have or show any of the above factors can be candidates for Afib. It is important to consult your physician for routine checkups to monitor your heart health.
12 reasons to choose Baptist Heart Specialists
- 1. Top-rated EP physicians using the latest research and minimally invasive treatment options
- 2. Full array of diagnostic tests, including tilt-table and EP studies
- 3. State-of-the-art EP lab in the region’s only dedicated heart hospital
- 4. Access to clinical trials such as the Left Ventricular Stability Lead
- 5. Hybrid treatments in which EP doctors work with cardiovascular surgeons to address persistent longstanding AFib
- 6. One of the first five centers in the U.S. to use the minimally invasive intracardiac ultrasound catheter for high quality images inside the heart
- 7. Latest 3-D electrical mapping systems for greater precision
- 8. Thermocool SmartTouch© and Cryoballoon catheter ablation options for improved safety and outcomes
- 9. Vitamin-sized pacemakers that are placed directly in the heart, eliminating wires
- 10. Baptist Heart Device Clinic, providing constant oversight of patients using home monitoring devices or an implantable heart device
- 11. Options for treating Afib with reduced radiation, and in some cases no radiation at all
- 12. Convenient Baptist Heart Specialists locations throughout the greater Jacksonville area
Meet Our Cardiac Electrophysiologists
Electrophysiologists are cardiologists who have completed specialized training of the electrical system of the heart. Our experienced EP specialists diagnose and treat all heart rhythm disorders and coordinate your care, ensuring communication is provided back to your referring physician.
“Been feeling fantastic. I’m relaxing now and getting on with my life and it feels good.”
Joy Seiler, Patient of new heart ablation procedure
Atrial Fibrillation is a disorder that affects the normal rhythm of the heart, and it can become progressively worse over time. Increasingly, heart experts are saying that "wait and see" approach may not be best.