Atrial fibrillation is the most common irregular heart rhythm, according to the Cleveland Clinic. During atrial fibrillation, many different impulses rapidly fire at once, causing a very fast, chaotic rhythm in the atria. The treatment goals consist of restoring the heart to normal rhythm, slowing the heart rate and preventing blood clots. Treatment options include cardioversion, catheter radiofrequency ablation, pacemakers and open-heart maze procedure.
Cardioversion
Resetting the heart to its regular rhythm, known as cardioversion, can correct atrial fibrillation. Cardioversion can be performed electrically or with medication.
During an electrically performed cardioversion procedure, an electrical shock is delivered to the heart to convert atrial fibrillation to a normal rhythm. A cardioverter machine sends an electrical shock to the heart through paddles or patches on the patient's chest. The shock stops the hearts electrical activity for a split second. A normal rhythm typically resumes when the hearts electrical activity re-starts.
A cardioversion performed with medication stops the arrhythmia and restore a normal rhythm. The medications used include anti-arrhythmics, which effectively maintain a normal rhythm for at least one in 50 to 65 percent of people, according to the Mayo Clinic. Anti-arrhythmic medication can cause unwanted side effects and typically involves long-term risks.
Cardioversion performed either electrically or with drugs successfully stores a regular heart rhythm in more than 95 percent of patients, but more than half of patients eventually go back into atrial fibrillation.
Catheter Radiofrequency Ablation
Atrial fibrillation can develop due to abnormal heart tissue. A treatment option known as catheter radiofrequency ablation can destroy the abnormal heart tissue. Threaded through the patient's blood vessel, multiple thin flexible tubes (catheters) reach the abnormal heart tissue.
Catheter radiofrequency ablation procedure involves two techniques either pulmonary vein isolation ablation or AV node ablation. Pulmonary vein isolation ablation (PVI) electrically isolates areas within the pulmonary veins which trigger atrial fibrillation. The Mayo Clinic states that pulmonary vein isolation eliminates atrial fibrillation in 60 to 80 percent of patients treated.
In AV node ablation, a catheter is placed near the atrioventricular (AV) node. Radiofrequency, applied through the catheter, destroys a small area of tissue, preventing the atria from sending too many electrical impulses to the ventricles. In 98 percent of patients who have AV ablation performed, the procedure completely block's electrical impulses and eliminates atrial fibrillation.
Pacemaker
A medical device known as a pacemaker helps regulate the heartbeat. Placed under the skin near the collarbone, the pacemaker can detect an abnormally slow heart rate or no heartbeat. The pacemaker emits electrical impulses that stimulate the heart to speed up or start beating again.
Open-Heart Maze Procedure
An open-heart maze procedure involves creating multiple cuts into the muscle of the atria then stitching them together, according to the Mayo Clinic. These incisions interfere with extra electrical pathways and circuits that cause atrial fibrillation to develop. Therefore, the incision lines reduce the size of atrial muscle tissue and the occurrence of atrial fibrillation. Only a few medical centers in the United States perform the surgical maze procedure due to its complexity.
