Atrial Fibrillation and Heart Disease
Lifestyle Changes for Atrial Fibrillation
In addition to taking medications, there are some changes you can make to improve your heart health.
- If you notice that your irregular heart rhythm occurs more often with certain activities, you should avoid them.
- Limit your intake of alcohol. Moderation is the key. Ask your doctor for specific alcohol guidelines.
- Some people are sensitive to caffeine and may notice more symptoms when using caffeinated products (such as tea, coffee, colas, and some over-the-counter medications). Consider limiting your caffeine intake if you feel that it increases your symptoms.
- Beware of stimulants used in cough and cold medications. Some of these types of drugs contain ingredients that promote irregular heart rhythms. Read the label and ask your doctor or pharmacist what type of cold medication is best for you.
Procedures for Atrial Fibrillation
When drugs do not work to correct or control atrial fibrillation, or when medications are not tolerated, a procedure may be necessary, such as: electrical cardioversion, pulmonary vein isolation, catheter ablation of the AV node, or device therapy.
What Is Electrical Cardioversion?
Electrical cardioversion frequently restores a normal rhythm, although its effect may not be permanent. After a short-acting anesthesia is given, a machine is used to deliver an electric shock through electrode patches placed on the chest to synchronize the heartbeat and restore a normal rhythm. Although this procedure only takes a few seconds, several attempts may be needed to restore a normal rhythm. A patient may need to be on Coumadin for at least three weeks before this procedure is performed. This decreases the risk of a stroke that can occur with the cardioversion.
What Is Ablation Therapy?
Catheter ablation therapy is an option for people who cannot tolerate medications or when drugs fail to maintain the normal heart rhythm.
Pulmonary vein isolation: During this procedure, special catheters are inserted into the heart. Research has shown that most atrial fibrillation signals come from the four pulmonary veins as they enter the left atrium.
A specialized viewing device called intracardiac echocardiography is used to visualize the left atrium during the procedure. One catheter in the left atrium is used to map or locate the abnormal impulses coming from the pulmonary veins. The other catheter is used to deliver the radiofrequency energy to create lesions outside the pulmonary veins. The procedure is repeated for all four pulmonary veins.
The lesions heal within four to eight weeks and form a circular scar around the pulmonary veins. The scar blocks any impulses firing from within the pulmonary veins, thereby "disconnecting" the pathway of the abnormal rhythm and curing atrial fibrillation.
Ablation of the AV node: During this procedure, the doctor applies radiofrequency energy to injure the AV node. The end result is a permanent, very slow heart rate, since the electrical impulses from the top chamber of the heart cannot travel down to the lower chamber. Therefore, the patient needs a permanent pacemaker to maintain an adequate heart rate.