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How to Treat AFib

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, 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™ device – Phase III clinical trials
    • AtriClip device – surgical option

Treatment of Supraventricular Tachycardia (SVT)

  • Medical management
  • Catheter ablation

Lifestyle

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