Atrial fibrillation is one of the most common types of heart rhythm disorder (arrhythmia), affecting more than two million people nationwide. In atrial fibrillation, a problem with the heart's electrical system causes the two upper parts of the heart, the atria, to quiver, or fibrillate. The quivering upsets the normal rhythm of the heart.
Atrial Fibrillation Care at UVM Medical Center
We are proud to be among a select group of medical centers able to provide the highest level of care to patients with atrial fibrillation. We are fully committed to providing a caring, personal approach to every patient and family we see. We spend as much time with you as you need, answering all your questions and working together to develop a treatment plan that works for you.
Atrial Fibrillation Diagnosis
Atrial fibrillation is dangerous because if the heartbeat is irregular, blood can collect, or pool, in the two upper chambers of the heart. Pooled blood is more likely to form clots, which can travel to the brain and cause a stroke. Atrial fibrillation can also lead to congestive heart failure.
Atrial fibrillation may be occasional (paroxysmal atrial fibrillation) where your symptoms come and go, and then stop. Chronic atrial fibrillation is when your heart rhythm is always abnormal.
Symptoms of atrial fibrillation include:
- Heart palpitations, which feel like a fluttering or flopping in your chest, or a racing, pounding or uneven heartbeat
- Shortness of breath
- Decreased blood pressure
- Chest pain
Atrial Fibrillation: Managing Your Symptoms
Risk factors for atrial fibrillation include:
- Increased age
- Family history - parent, brother or sister with atrial fibrillation
- Heart disease, heart attack or heart surgery
- High blood pressure
- Chronic medical conditions such as thyroid problems or sleep apnea
- Drinking alcohol, especially a large amount at one time
Our cardiologists are specially trained in advanced technology to diagnose atrial fibrillation:
- An echocardiogram is a noninvasive test using ultrasound waves to evaluate your heart's structure and blood flow. A computer translates the ultrasound waves into an image of your heart. The image is shown on a screen, and it can be recorded on videotape or printed on paper. A transesophageal echocardiogram helps us see if you have any heart blood clots. In this procedure, you are sedated while a tube is passed down your esophagus to make detailed ultrasound images of your heart.
- An electrocardiogram (EKG or ECG) is a painless test using patches with wires (electrodes) attached to your chest to measure your heart's electrical impulses. The electrodes are hooked up to a machine that displays or prints your heart's electrical activity.
- An event recorder is a device used to record your heart rhythms, and is similar to an EKG.
- Holter monitoring uses a portable machine to record all of your heartbeats.
- Blood tests help your doctor determine if your atrial fibrillation is due to thyroid problems or other substances in your blood.
- A chest x-ray is a picture that shows your heart, lungs, airway, blood vessels and lymph nodes.
Treatments for Atrial Fibrillation
The results of your diagnostic testing and other factors determine our treatment approach. Options include:
- Cardioversion - this procedure attempts to reset your heartbeat back to normal. Cardioversion can be performed through anti-arrhythmic medications, which can be either intravenous or oral. If the intravenous medication resets your heart rhythm, then the same medication may be prescribed in oral form to prevent further atrial fibrillation. We may also perform electrical cardioversion. In this procedure, you are sedated while you're given a brief electric shock to try and get your heartbeat back to normal.
- Medications - anticoagulants such as warfarin (Coumadin) are blood-thinning medications recommended for most people with atrial fibrillation who are at average-to-high risk of stroke.
- Atrioventricular (AV) Node Ablation - this procedure destroys the AV node, which then blocks signals or impulses to the lower heart chambers (ventricles). After this procedure, you will need a permanent pacemaker to regulate your heart rhythm.
- Radiofrequency catheter ablation - this procedure destroys small areas of the heart to create scar tissue. The scar tissue blocks or destroys the areas that are causing the abnormal heart rhythm.
- Surgical Maze Procedure - this procedure is usually done during open heart surgery. It creates scar tissue that blocks extra electrical impulses from traveling through your heart.
A-Fib at UVM Medical Center: How We Compare
Our specially trained heart rhythm team includes internationally recognized experts, several of whom were recruited from the world-renowned Cardiac Arrhythmia Research Institute, a center on the frontiers of heart rhythm care.