Atrial Fibrillation & Heart Rhythm Disorders

Atrial fibrillation is the most common arrhythmia that affects people over the age of 60. The prevalence may be as high as 15% of all patients over the age of 60, and is predicted to increase. Atrial fibrillation can increase the risk of stroke depending on underlying risk factors. Those include age (over 65), female gender, history of prior stroke, diabetes, hypertension, and presence of vascular disease.

Another type of arrhythmia, supraventricular tachycardia (SVT), is an abnormal electrical pathway that causes the heart to beat rapidly.

What to Watch For

Symptoms that you may experience if you have atrial fibrillation:

• Palpitations
• Shortness of breath
• Chest discomfort
• Feeling of a rapid or irregular heartbeat
• Trouble breathing during physical exertion

Symptoms of supraventricular tachycardia (SVT)

Patients who experience SVT suffer from palpitations, episodes of rapid heart rates. This may prompt an emergency department evaluation.

How to Diagnose Heart Rhythm Disorders

Our practice is equipped to provide Holter monitor and event monitor testing. A Holter monitor or event monitor is a painless exam that aims to diagnose possible arrhythmias. It involves wearing a small device that monitors your heart rhythm over a period of time. You simply come into our office to be fitted and given detailed information about wearing the monitor.

A Holter monitor may be worn for 24 hours or 48 hours and is triggered when symptoms occur. You will return to our office to have the monitor taken off. The recorded tracings will be taken from the monitor and can then be read by a physician.

How to Treat Atrial Fibrillation

Classification of Atrial Fibrillation

• Paroxysmal
  • Episodes lasting from minutes up to 7 days in duration
• Persistent
  • Episodes lasting more than 7 days in duration, requiring chemical or electrical cardioversion for restoration of sinus rhythm
• Long Standing Persistent
  • Episodes lasting more than 7 days, and typically longer than 30 days in duration. Cardioversion has never been offered, or rate control approach has been used.

Management of Atrial Fibrillation

• Rhythm control strategy to help manage symptoms
• Catheter ablation using either radiofrequency energy or cryoablation to destroy the cells responsible for triggering atrial fibrillation
• Ablation is not curative, but improves control of atrial fibrillation, with fewer arrhythmia episodes
• Surgical approaches if inadequate control with catheter-based ablation

Stroke Risk Reduction in Atrial Fibrillation

• Oral anticoagulation medications (blood thinners)
  • Physician determines need based on patient’s risk for stroke
  • Risk score includes age, gender, vascular disease, hypertension, diabetes and history of stroke
• Devices for patients who cannot take oral anticoagulation medications (recurrent bleeding or in professions with high risk for bleeding)
  • Watchman™ – left atrial appendage occlusion (blockage) device
  • Amulet™ – left atrial appendage occlusion (blockage) device
  • AtriClip device – surgical option

How to Treat SVT

Treatment options for supraventricular tachycardia (SVT) include medical management and catheter ablation.

Lifestyle

These lifestyle factors are important to help manage atrial fibrillation and other heart rhythm disorders:

• Weight loss/maintain healthy weight
• Moderate exercise
• Avoid alcohol
• Control blood pressure
• Treat sleep apnea, if present