Atrial fibrillation (or afib) is a common heart rhythm disorder. It can cause many symptoms, such as fatigue or palpitations, and also increase your risk of having a stroke.
There are many treatment options for patients with afib. Patients need to have treatment to reduce their risk of stroke and to decrease the symptoms.
2. Afib is a chronic condition, that may cause
problems if not properly treated
There are many treatment options available.
Stroke risk reduction
Improve quality of life
Education is an important part of your treatment.
www.theafcenter.com
3. The Normal Electrical System of the Heart
What is atrial fibrillation?
What are the problems caused by Afib?
Treatment Options
www.theafcenter.com
4. I. Sinus Node:
◦ Impulse originates
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I. Atrioventricular Node:
◦ After a short delay, it
transmits impulses to the
ventricle
I. His-Purkinje System:
◦ Electrical impulses transmitted
to Right and Left Ventricle via
the Right and Left Bundles
◦ Triggering cardiac contraction
◦ It is then transmitted across
Atria
5. Abnormal Rhythm in the top chambers of
your heart – The atria
It causes the top chamber to beat at very fast
rates:
◦ Causing the symptoms of afib
◦ Increasing the risk of stroke
www.theafcenter.com
6. 1 Fast and chaotic impulses
everywhere in the atria
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2 No meaningful contraction in
the atria, increasing risk of
blood clots Stroke risk
3 Many electrical signals will
reach the AV node:
• Causing fast heart beats
• Fast pulse
• Symptoms
7. •In most patients afib is caused by
abnormal areas in the pulmonary
veins – large veins that bring blood
from lungs to the heart
•Inside the veins, a group of cells
start firing electrical signals very
rapidly
•Signals will go into the
atria, triggering afib
www.theafcenter.com
8. Afib is very common and many studies show that the
number of patients affected will only increase.
0
2
4
6
8
10
12
14
16
1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050
Mayo Clinic data (assuming a
continued increase in AF incidence)
Mayo Clinic data (assuming further
increase in AF incidence)
ATRIA study data (50% >80 yo)
Patients
with atrial
fibrillation
(millions)
Year
2.08 2.26 2.44 2.66 2.94
3.33
3.8 4.34
4.78 5.16 5.42 5.61
5.1 5.6
6.1
6.8
7.5
8.4
9.4
10.3
11.1
11.7 12.1
5.1
5.9
6.7
7.7
8.9
10.2
11.7
13.1
14.3
15.2
15.9
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9. What Problems does it cause?
Fast Heart Beat
Decreased Blood
Flow
• Lack of contraction
in the atria
• Stagnant blood
Symptoms
Stroke Risk
www.theafcenter.com
10. • Fatigue
• Palpitations
• Chest pain
• Shortness of breath
• Dizziness
• Increase risk of
Congestive Heart Failure
• Other symptoms
www.theafcenter.com
11. Afib and Stroke
•Afib Inadequate blood
flow in some areas of the
heart specially the left
atrial appendage blood
clots can form
www.theafcenter.com
•Blod clots can dislodge and
travel to the brain
•In the brain they cut off
circulation, causing strokes
12. ◦ 5-fold increase in the risk of strokes
◦ Compare the number of strokes in patient with and without afib
Wolf PA, et al. Stroke (1991) 22: 983
Go AS, et al. JAMA (2001) 285: 2370
Friberg J, et al. Am J Cardiol (2004) 94: 889
12
0
2
8
4
41 53 2 41 53
Cumulativestrokeincidence(%)
Women AFib+
Women AFib-
Men AFib+
Men AFib-
Years of follow-up
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13. What are the risk factors for stroke?
www.theafcenter.com
•Some conditions put you at an even higher risk of stroke if you have afib
15. 1. Reduce the Risk of
Stroke
a) Use of blood thinners
b) Atrial Appendage occlusion
2. Improve Quality of Life
a) Medications to decrease
number of episodes or to
slow down the heart
b) Procedures to eliminate Afib
www.theafcenter.com
16. Many options are available to
prevent stroke. The treatment
choice is individualized and
based on your other risk factors
and preference.
◦ Blood thinners
Warfarin
Novel Anticoagulants
Pradaxa
Xarelto
Eliquis
◦ Atrial Appendage occlusion
www.theafcenter.com
17. In patients with afib, the vast
majority of strokes are
caused by blood clots that
form in the left atrial
appendage.
There are procedures that
can be performed to close
the appendage, to prevent
blood clots from forming and
causing strokes.
www.theafcenter.com
18. Umbrella like device
positioned in the Left
Atrial Appendage.
With time the heart
tissue grows over
it, completely
shutting off the
appendage.
Large research
studies have shown
it to be safer than
taking coumadin.
www.theafcenter.com
19. In order to decrease or
eliminate the symptoms
of afib, doctors can use
medications or
procedures.
Improve Quality of Life
a) Medications to decrease
number of episodes or to
slow down the heart
b) Procedures to eliminate
Afib
www.theafcenter.com
20. 1. If Afib is triggered by
abnormal electrical
impulses firing from
the pulmonary
veins, why not
eliminate it?
2. Afib ablation consists
of eliminating (or
isolating) the abnormal
impulses that trigger
afib. www.theafcenter.com
21. 1. Goal of procedure is to
electrically isolate the
pulmonary vein
a. Ablation is performed at
the mouth of the vein,
which causes scar tissue
b. Scar tissue does not
conduct electricity
c. Electrical firing from the
vein won’t get into the
atria
www.theafcenter.com
26. Afib ablation is
performed either with
Radiofrequency (which
heats the tissue) or
with cryoballoon
(which freezes tissue).
3D Mapping systems
are used to minimize
fluoroscopy (radiation)
www.theafcenter.com
27. • Improved Quality of Life
• Reduction of symptoms and
increase in energy
• Decreased risk of Stroke
• In some patients we are able to
stop some of the medications
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28. Atrial fibrillation ablation
is typically conducted
using a combination
of fluoroscopy (X-ray)
and 3D mapping
Exposure to X-ray can
increase the risk of
malignancies (cancer
and blood disorders)
www.theafcenter.com
29. At St Vincent’s Hospital in
Birmingham, Afib ablation is
performed using minimal or no
fluoroscopy
◦ Carto Mapping System
There are many benefits:
◦ reduced or no radiation to the
patient
◦ reduced or no radiation to the
physician and staff members
Carto 3 Image
www.theafcenter.com
31. To learn more about atrial fibrillation, please
check our website:
www.theafcenter.com
To schedule a consultation please call:
205-939-0073
www.theafcenter.com
