Atrial Fibrillation

Atrial fibrillation, also called arrhythmia, is a disorder found in about 2.2 million Americans. About 15 percent of strokes occur in people with atrial fibrillation. Atrial fibrillation can affect both men and women and becomes more common with increasing age. Three to five percent of people over 65 have atrial fibrillation.

Atrial fibrillation is caused by a disruption of the normal electrical system of the heart. Normally, the four chambers of the heart contract in a very specific, coordinated way. In atrial fibrillation, two of the chambers contract very quickly and differently from the normal pattern. This makes the other two chambers beat abnormally, leading to an irregular and usually fast pulse.

Signs and Symptoms

John Miller, MD, director of Electrophysiology Services, is among the Indiana University Health physicians developing new techniques to treat atrial fibrillation. If you are experiencing irregular heartbeats, contact your primary care physician or an IU Health cardiologist.

The inefficient pumping of blood caused by atrial fibrillation can cause signs and symptoms, such as:

• Palpitations (feelings that your heart is skipping a beat, fluttering, or beating too hard or fast)
• Shortness of breath
• Weakness or difficulty exercising
• Chest pain
• Dizziness or fainting
• Fatigue (tiredness)
• Confusion

If you are experiencing any of these symptoms contact your primary care physician or a cardiologist.

Treatment Options

Medication 

A primary care provider or cardiologist may prescribe medication to treat atrial fibrillation. Your doctor will consider your age and other medical problems to decide which drug is best, but some medications may include:

• Anti-arrhythmic medications to get the heart back into a normal rhythm
• Blood thinners to reduce the risk of a blood clot traveling in the body (such as a stroke)
• Antiplatelet drugs

Cardiac Ablation

Cardiac ablation is a procedure that can correct heart rhythm problems (arrhythmias). Ablation typically uses catheters - long flexible tubes inserted through a vein in the groin, arm or leg and threaded to the heart - to correct structural problems in the heart that cause an arrhythmia.

Cardiac ablation works by scarring or destroying tissue that blocks the electrical signal that travels through the heart to make it beat. By clearing the signal pathway of the abnormal tissue, the heart may beat normally again.

Ablation isn't usually a first treatment option. Ablation is a treatment option for people who:

• Have tried medications to treat an arrhythmia without success
• Have had serious side effects from medications to treat arrhythmias
• Have certain types of arrhythmias that respond well to ablation, such as Wolff-Parkinson-White syndrome
• Have a high risk of complications from their arrhythmia, such as sudden cardiac arrest

Maze Surgery 

Maze surgery consists of creating a number of incisions in the heart. Once the incisions are made, they are sewn together again causing the heart to no longer fibrillate, and the normal rhythm of the heart to be restored. 

The MAZE procedure is not necessary in most patients with atrial fibrillation. However, if the patient has experienced a stroke they are at significant risk for another stroke and the procedure would be highly recommended.

Advantages of the Maze Procedure

• Corrects atrial fibrillation; many patients require no further treatment
• Restores a regular, coordinated heartbeat
• For many patients, brings freedom from long-term use of blood-thinning medications
• Lowers risk of developing blood clots or strokes
• Decreases symptoms, such as fainting or near-fainting