The goals of Atrial Fibrillation (AF) treatment are to:
- Restore a normal heart rhythm
- Control heart rate
- Reduce stroke risk
- Help patients return to a healthy, active life
The treatment selected will depend on the severity of the AF, the symptoms and the patient's lifestyle. Treatment options can be placed into two categories: Suppressive therapies, which work to suppress or control symptoms; or Curative therapies, which are designed to eliminate the cause of the condition and have the potential to cure.
Several different types of medicine can be used to treat AF. Some anitarrhythmics medicines can be used to help restore and maintain a normal heart rhythm. Other medicines may be prescribed to control the heart rate. Anticoagulant medicines are often prescribed for people with AF to help reduce the risk of blood clots forming and causing a stroke.
Occasional episodes of AF can be treated electrically with a procedure called cardioversion. During the procedure, an electrical shock is delivered to the heart to stop AF, and restore a normal heart rhythm. This procedure is performed under temporary anesthesia.
The WATCHMAN Implant
McLeod Regional Medical Center is among the first hospitals in the region to offer patients with non-valvular atrial fibrillation an alternative to long-term blood thinning Warfarin medication with the newly approved WATCHMAN Left Atrial Appendage Closure (LAAC) Implant.
For patients with atrial fibrillation who are considered suitable for blood thinning medications by their physicians but who have reason to seek a non-drug alternative, the WATCHMAN LAAC Implant is an alternative to reduce their risk of atrial fibrillation-related stroke.
The WATCHMAN Implant closes off an area of the heart called the left atrial appendage to keep harmful blood clots from this area from entering the blood stream and potentially causing a stroke. By closing off the left atrial appendage, the risk of stroke may be reduced and, over time, patients may be able to stop taking blood thinning medications.
People with atrial fibrillation have a five times greater risk of stroke. Atrial Fibrillation can cause blood to pool and form clots in the left atrial appendage. For patients with non-valvular atrial fibrillation, the left atrial appendage is believed to be the source of the majority of stroke-causing blood clots. If a clot forms in the left atrial appendage, it can increase one’s risk of having a stroke. Blood clots can break loose and travel in the blood stream to the brain, lungs, and other parts of the body.
“The new WATCHMAN LAAC Implant provides physicians with a breakthrough stroke risk reduction option for patients with non-valvular atrial fibrillation,” said Rajesh Malik, M.D., Director of Electrophysiology Services for the McLeod Heart and Vascular Institute. “These patients who are seeking an alternative to blood thinning medications, the WATCHMAN Implant offers a potentially life-changing stroke risk treatment option which could free them from the challenges of long-term blood thinning medication therapy.”
Implanting the WATCHMAN device is a one-time procedure that usually takes about one hour. Following the procedure, patients typically need to stay in the hospital for 24 hours.
For some patients a catheter ablation is recommended. During the procedure, small wires or electrode catheters are threaded through a blood vessel into the heart to record electrical activity and help locate the problem areas responsible for AF. After locating these areas, an ablation catheter is used to apply high-frequency energy to the inside of the heart, creating a lesion or scar. As a result, this tissue is either electrically isolated from the rest of the heart or made incapable of sustaining AF.
Surgical ablation may be an option for people who can not tolerate drugs or for whom these and/or other therapies have been ineffective. With this procedure, energy is applied to the outside of the heart, creating a lesion or scar that blocks the abnormal electrical signals that causes AF. Patients, who undergo cardiac surgery such as valve replacement or coronary artery bypass, may be advised to receive surgical ablation at the same time.
The McLeod Heart and Vascular Institute has received full Atrial Fibrillation Certification from the Society of Cardiovascular Patient Care demonstrationg its expertise and commitment to quality care of atrial fibrillation patients.