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Atrial Fibrillation Clinic

The Roper St. Francis Heart & Vascular Center provides clinical expertise for diagnosis and treatment of the most common heart arrhythmia, atrial fibrillation. Atrial fibrillation, or AFib, is an irregular and often rapid heart rate resulting from uncoordinated or chaotic electrical activity, and is associated with aging. Currently some three million Americans have AFib, a number that is anticipated to rise as our population ages.

Patients with AFib may report symptoms that feel like the heart is racing, fluttering or pounding, or a fish is flopping in the chest. Some people with AFib are asymptomatic; however, this does not diminish concern or need for treatment.

Types of AFib 

Afib

  • Paroxysmal AFib occurs when faulty electrical signals and rapid heart rate begin suddenly and then stop on their own. Symptoms can be mild or severe, and duration is typically no more than a week but usually less than 24 hours.
  • Persistent AFib means the arrhythmia continues for more than a week. It may stop on its own, or it may require treatment to be stopped.
  • Longstanding Persistent AFib is a consistent state of irregular sinus rhythm that lasts for a year or longer.
  • Permanent AFib is a condition when the rapid irregular heart rhythm cannot be stopped with intervention and treatment. Both paroxysmal and persistent AFib can become more frequent and eventually permanent.


Symptoms of atrial fibrillation can include:

  • Palpitations or irregularly fast heart rate
  • Lightheadedness and/or muscular weakness
  • Confusion
  • Shortness of breath
  • Chest pain


Risk Factors

AFib is most closely associated with aging. While normally healthy people can get AFib for no apparent reason, there are some associated risk factors:

  • Older than 60 years of age
  • Diabetes
  • High blood pressure
  • Coronary artery disease
  • History of prior heart attacks or cardiac surgery
  • Congestive heart failure
  • Structural heart disease (valve problems or congenital defects)
  • Untreated atrial flutter (another type of abnormal heart rhythm)
  • Thyroid disease
  • Chronic lung disease
  • Sleep apnea
  • Excessive alcohol or stimulant use
  • Serious illness or infection

The primary concern related to AFib is that the irregular beat can result in blood not being pumped out fully, leaving some in the left atrial appendage where it could form a clot, thus increasing the risk of stroke. To help prevent stroke, anti-coagulation therapy (warfarin) is a common part of Afib treatment, but this also increases risk of bleeding or intracranial hemorrhage resulting from falls.


Diagnostic Testing

There are several tests that our Roper St. Francis doctors can do to determine if you have a fast or irregular heartbeat. Your doctor may order these tests if you are having signs or symptoms of a heart problem.

  • Electrocardiogram (ECG)
  • Holter monitor
  • Mobile cardiac monitoring
  • Event monitor
  • Echocardiogram
  • Transthoracic echocardiogram (TTE)
  • Transesophageal echocardiogram (TEE)
  • Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI)


Treatment Options

The Roper St. Francis Heart & Vascular Center has highly-trained cardiac electrophysiologists who specialize in treatments to improve and sometimes cure atrial fibrillation. These include surgical, non-surgical, ablation and medical management therapies designed to stop AFib and restore the heart’s normal sinus rhythm (NSR) or to control heart rate. 

  • Electrical Cardioversion
  • AV Node Ablation
  • Catheter Ablation Therapy which includes radiofrequency ablation and cryoablation
  • Stroke Prevention/Anticoagulation Therapies
  • Left Atrial Appendage (LAA)


Non-surgical Treatment

Watchman Mesh

The Watchman device, FDA approved in March 2015, is an umbrella-shaped device that is positioned via the femoral vein (non-invasively) to shut off blood from being trapped in the Left Atrial Appendage. The procedure takes approximately one hour to complete and has a very low procedural complication rate.

This device can be considered for patients who meet the following criteria:

  • Increased stroke rate
  • High risk for falls
  • History of GI bleeding
  • Head bleeds or other event
  • High risk occupation
  • Medical reason for seeking alternative therapy to blood thinning medications

Surgical Treatments
  • Thoracoscopic Clip of the Left Atrial Appendage (LAA): Patients who cannot tolerate short term anticoagulation for LAA occlusion may be good candidates for clipping of the appendage.
  • Mini-Maze: If a patient has atrial fibrillation with no heart valve issues, he/she may be a candidate for a minimally invasive version of the traditional Cox Maze III procedure (an open heart surgical ablation procedure). 

Meet Our Team

Electrophysiology
Brett Baker, MD
Brian Frain, MD

Interventional Cardiology
Matthew O’Steen, MD

Cardiothoracic Surgery
Scott Ross, MD
Matthew Toole, MD
John Spratt, MD

 

 

 

 

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