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Atrial Fibrillation (A-fib) Treatment

Atrial fibrillation (A-fib), is a kind of abnormal heart rhythm or arrhythmia. Normally, a specific group of cells begin the signal to start your heartbeat. During A-fib, the signal to start the heartbeat is disorganized. This causes the atria (upper chambers of the heart) to quiver or “fibrillate."

The quivering atria can lead to blood pooling, which increases the risk of forming blood clots. These clots can then travel to the brain and cause a a stroke. This is why A-fib significantly increases the risk for stroke.

A-fib Treatment Options

Treatment initially may involve controlling the rapid heart rate associated with A-fib, either with medications that slow the ventricular rate down, or by converting the A-fib back to a normal rhythm with medications or an electrical shock (a procedure called cardioversion).

After conversion of AF to a normal rhythm, you may need to be treated indefinitely with antiarrhythmic medication(s) to maintain normal heart rhythm. If a patient prefers not to take medications long-term, or if medications fail to prevent recurrence of A-fib or cause intolerable side effects, we can perform a catheter ablation procedure to target the triggering beats of A-fib. This is called pulmonary vein isolation ablation procedure or “A-fib ablation.”

If medications and/or A-fib ablation fail to prevent recurrence of A-fib, and if the patient has A-fib symptoms or the heart rate cannot be controlled with medication, we may perform an ablation of the AV node connecting the upper and lower chambers of the heart.

AV node ablation (in contrast to an “A-fib ablation”) requires implantation of a pacemaker either before or immediately following the ablation.

Stroke Prevention for Patients with A-fib

Blood thinners such as Coumadin (warfarin) or the non-vitamin K antagonist oral anticoagulants (such as Xarelto, Eliquis, Pradaxa, or Savaysa) are usually the first treatments used to minimize the risk for stroke.

UC San Diego Health offers an Anticoagulation Clinic where physicians and pharmacists help patients monitor and manage their treatment with warfarin or other anticoagulants.

When blood thinners are not the ideal solution, we can reduce stroke risk by performing a left atrial appendage occlusion (LAAO).

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