What is Atrial Fibrillation or AFib?

Atrial fibrillation is one of the most common abnormal heart rhythms, impacting between 3 million and 6 million people in the U.S. alone. Left untreated, atrial fibrillation can lead to blood clots, heart failure and stroke.

Normally the heart contracts and relaxes to a regular beat. In patients with atrial fibrillation, the upper chamber of the heart is irregular. Therefore, it does not effectively move blood to the bottom chambers of the heart. This irregular heart rhythm can result in symptoms including:

• Palpitations or skipped beats
• Lightheadedness
• Shortness of breath
• Chest pain
• Fatigue

Some patients may confuse their symptoms with a heart attack, while others may not have any symptoms at all. Unfortunately, there are some patients who only discover their atrial fibrillation only after experiencing a stroke.

“Atrial fibrillation is associated with approximately five-fold increased risk of stroke and atrial fibrillation causes about one in seven strokes,” said Greenwich Hospital Heart and Vascular Center electrophysiologist Ilir Maraj, MD, assistant professor of Clinical Medicine at Yale School of Medicine.

Treatments for atrial fibrillation

Atrial fibrillation can be easily diagnosed through an EKG or use of heart monitors. Common treatments can include medications such as blood thinners, or ablation. Ablation is a procedure that does not require surgery and there are different types of ablation.

Using the veins at the crease of the thigh, a catheter can enter the heart, and then an energy source freezes or burns tissue in specific areas of the heart responsible for the atrial fibrillation. Pulsed field ablation is an advanced technology that uses a non-thermal approach to treat atrial fibrillation. Short electrical pulses ablate cells that trigger atrial fibrillation without damaging surrounding areas; it’s associated with a shorter procedure time and low complication rates.

“Ablation of atrial fibrillation has become a mainstay in the management of this disease. The advent of pulsed field ablation technology further enhances the safety profile of this procedure and significantly shortens the duration so that it can be easily performed on a same-day basis without overnight hospital stay,” said Joseph Akar, MD, PhD, director, Cardiac Electrophysiology Program and Complex Ablation Program, Yale New Haven Health Heart and Vascular Center; and professor, Cardiovascular Medicine, Yale School of Medicine. 

Even with advancements in treatment, patients need to be vigilant about their heart health. Obesity, high blood pressure, thyroid disease, smoking and increased alcohol use all put patients at risk of atrial fibrillation.

“We can be very effective in minimizing or eliminating the atrial fibrillation but there’s always a risk that atrial fibrillation comes back, which is why it’s very important to keep thinking about how to prevent the possibility of stroke and also to manage the other conditions that put stress on the heart,” said Northeast Medical Group electrophysiologist Robert Winslow, MD, of Heart and Vascular Center at Bridgeport and Yale New Haven hospitals.

Dr. Winslow and Dr. Maraj recommend patients who are risk of atrial fibrillation to take their blood pressure seriously. Those with elevated blood pressure higher than 120 should check their numbers regularly and stick to any prescribed medications. Patients should eat a heart healthy diet, reduce their salt intake and exercise regularly.

In addition, the moment a patient starts to experience symptoms, they should reach out to their doctor. Interventions such as medication can help reduce symptoms and keep people out of the hospital.