Atrial Fibrillation (AFib) Treatment

Many heart diseases are preventable if detected early. Be more proactive with your heart health through routine check-ups at Hilton Head Hospital in Hilton Head Island, SC. Have our cardiologists listen to your heart for irregular rhythms such as atrial fibrillation or AFib, one of the most common arrhythmia types. AFib causes your heart to beat faster than normal. While some AFib cases go away on their own, others may lead to complications.

Getting Your Heart Back on Beat

Abnormal heartbeats or rhythms are not enough to make a diagnosis, so we may recommend further tests to pinpoint the real problem. We have board-certified heart specialists who can provide you with AFib treatment options, so rest assured that your heart is in good hands with us.

What Is Atrial Fibrillation?

AFib is a kind of abnormal heart rhythm. The sinoatrial (SA) node group of cells initiates the heartbeat in a normal heart by sending signals. This node is in your heart’s upper right chamber (right atrium). The SA node signal quickly travels down the heart’s conducting system to the heart’s two lower chambers (left and right ventricles).

As the signal travels, it prompts the heart chambers to contract. The atria contract with each heartbeat to move blood into the ventricles. With AFib, the signal to start the heartbeat is disorganized, causing the atria to quiver and the ventricles to contract irregularly.

When this happens, you may feel dizzy and tired or that your heart is skipping a beat or pounding too fast. With the lack of coordination with the ventricle and atria contractions, the heart may not be pumping blood efficiently to your body. Blood may collect in your heart, increasing your risk of developing clots, stroke or other complications.

What Does AFib Feel Like?

You may or may not notice atrial fibrillation symptoms. Some people have no symptoms, while others might not be bothered by their symptoms. Therefore, it is important to undergo heart screenings to determine your heart condition. AFib that is left untreated or undetected can lead to life-threatening complications such as heart failure and stroke.

Here are some AFib symptoms:

• Chest pain
• Difficulty breathing
• Fainting or dizziness
• Fatigue (most common)
• Heart palpitations
• Increased urination
• Low blood pressure
• Shortness of breath

Note when and how frequently you feel any of these symptoms. This information can help your heart care providers diagnose AFib.

AFib Diagnosis

Here’s what an AFib diagnosis may look like:

Medical History

Share with your cardiologist the following:

• Your eating habits
• Your physical activity habits
• Your medical history, such as previous surgeries, medications and so on
• Your family’s medical history
• Symptoms (if any)

Physical Examination

Your doctor may check your body for the following signs:

• High levels of thyroid hormones
• Swelling in your feet or legs
• Pulse that is faster than normal
• Abnormality in the heartbeat rhythm
• Unusual sounds from the lungs
• Blood pressure changes

Diagnostic Tests

You may need to undergo further diagnostic tests as recommended by your doctor, such as:

• Blood tests
• Echocardiography
• Chest X-rays
• Electrophysiology study
• Holter and event monitors
• Implantable loop recorder
• Magnetic resonance imaging (MRI)
• Sleep study
• Stress test
• Transesophageal echocardiography
• Transthoracic echocardiogram (TTE)
• Walking test

An AFib diagnosis and treatment plan at Hilton Head Hospital can help you manage your condition. Contact 833-383-3744 to inquire.

What Causes AFib?

Factors such as aging, infection, heart disease and more can change heart tissue, keeping the cardiac cells from coordinating in the same rhythm. Cardiac electrical signaling changes can also cause AFib, resulting in fast, irregular heartbeats. As you age, you are at an increased risk for AFib. Here are some AFib risk factors:

• Advancing age
• Diabetes
• Chronic kidney disease
• Enlargement of the heart’s left chambers
• European ancestry
• Heart failure
• High blood pressure
• Hyperthyroidism
• Ischemic heart disease
• Moderate to heavy alcohol use
• Obesity
• Smoking

AFib Treatments

Atrial fibrillation treatment options may vary depending on your symptoms, medical history and preferences. Some people with no symptoms may not need treatment, while others with symptoms may require more intensive AFib treatment. Our cardiovascular doctors may categorize your AFib under one of these three types:

• Paroxysmal AFib comes and goes, lasting for a few seconds, minutes, hours or even days before the heart returns to its normal rhythm. People with paroxysmal AFib have more symptoms than those under other AFib types.
• Persistent AFib does not stop on its own and lasts for more than a week. A person with persistent AFib needs to take medications or undergo cardioversion to help their heart return to a normal rhythm. Without these interventions, AFib will not go away. Long-standing persistent AFib is a persistent AFib that lasts for more than a year.
• Permanent AFib happens when the normal heart rhythm cannot be restored even with interventions such as medications, controlled electrical shocks and other procedures.

AFib Medication Treatment

If you have AFib, you may need to take certain medications for the rest of your life, such as:

• Heart rhythm medicine (anti-arrhythmic drugs)
  • Amiodarone
  • Dofetilide
  • Flecainide
  • Propafenone
  • Quinidine
  • Sotalol
• Blood thinners (anticoagulants)
  • Apixaban
  • Aspirin
  • Dabigatran
  • Enoxaparin
  • Heparin
  • Rivaroxaban
  • Warfarin
• Heart rate medicine
  • Atenolol
  • Bisoprolol
  • Carvedilol
  • Metoprolol
  • Propranolol
  • Timolol

Take your medications as prescribed, as discontinuing them can be very dangerous to your health.

Nonsurgical Procedures

• Electrical cardioversion is an AFib heart shock treatment that aims to reset the heart into its normal rhythm.
• Radiofrequency ablation or catheter ablation may be recommended for people with arrhythmias that cannot be regulated by medications or electrical cardioversion. Before ablation surgery, the electrical map of the heart will be drawn to spot areas that create problematic electric signals. This procedure may last up to 4 hours.

Surgical Procedures

• A pacemaker implant can send out an electrical signal to maintain normal heart rhythm. It is placed near the collarbone and under the skin. Some pacemakers can detect whether the heart is beating too slow or fast and thus release impulses to regulate heart rhythm.
• In an open-heart maze procedure, the surgeon will make small cuts in your heart’s upper part. When they are stitched together, scar tissue develops and disrupts the problematic signals that cause AFib. Normal heart rhythm is then restored.
• WATCHMAN is a permanent treatment option for reducing stroke in patients with non-valvular atrial fibrillation. It is a one-time procedure that permanently closes off the left atrial appendage (LAA). This minimally-invasive procedure typically takes one hour or less to implant. Patients usually stay in the hospital overnight and return home the next day.