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Arryhthmia Care

At Baton Rouge General, our doctors and team are trained in heart rhythm conditions, known as arryhthmias, and what it can mean for their patients. We take a collaborative approach to provide the most comprehensive care for this and other heart conditions.

ATRIAL FIBRILLATION

A normal heart pumps blood in a cyclical pattern, from the body to the heart, into the lungs, back to the heart, and then back throughout the body. When the heart is pumping correctly, the heart's two upper chambers (atria) beat in coordination with the two lower chambers (ventricles), maintaining proper blood flow. But if the heart beats irregularly, blood flow becomes out of sync and this can result in serious complications.

Atrial fibrillation, often referred to as AFib, is a condition in which the upper chambers of the heart beat irregularly, quickly and chaotically, resulting in an abnormal heart rhythm (arrhythmia). This can increase a person's risk of heart failure, stroke, and other heart-related issues. One of the biggest concerns with AFib is the development of blood clots, which can block blood flow to the brain or other organs in the body.

Symptoms of AFib may only occur occasionally (paroxysmal atrial fibrillation) or persistently, depending on the severity of the condition. If symptoms come and go, the patient does not always require treatment. If symptoms are persistent, there is an increased risk for developing complications and treatment is often necessary. AFib treatment may involve the use of prescription medications or procedures designed to restore normal heart rhythm.

Causes of AFib

Heart structure abnormalities or heart damage are the most common causes of atrial fibrillation. The condition may result from:

  • congenital heart defects
  • abnormal heart valves
  • coronary artery disease
  • high blood pressure
  • previous heart surgery or heart attack
  • a problem with the heart's natural pacemaker (sick sinus syndrome)
  • lung diseases
  • sleep apnea
  • a metabolic imbalance

A person's risk for developing AFib increases due to the factors above, as well as advanced age, family history, obesity, and alcohol consumption.

Symptoms of AFib

Symptoms of atrial fibrillation may include:

  • heart palpitations (the feeling of a racing or fluttery heartbeat)
  • shortness of breath
  • weakness or fatigue
  • feeling lightheaded or dizzy
  • chest pain

In some cases, a person with AFib does not experience any symptoms and the condition is only discovered during a physical examination.

Complications of AFib

Individuals with atrial fibrillation are at risk for serious complications including stroke and heart failure. Stroke can occur because the irregular heart rhythm causes blood to pool in the heart's chambers and this may result in the formation of clots. These clots can dislodge and block blood flow to the brain, causing a stroke, or they can block blood flow to other organs. Additionally, the presence of AFib weakens the heart which can lead to heart failure. When this occurs, it makes it difficult for the heart to circulate enough blood to meet the body's needs.

Prevention of AFib

The risk of developing atrial fibrillation and its associated complications may be reduced by adopting healthy lifestyle habits such as:

  • increasing physical activity
  • eating a healthy diet
  • maintaining a healthy weight
  • quitting smoking
  • limiting or avoiding alcohol and caffeine
  • reducing stress
  • using over-the-counter medications only as needed

Treatment of AFib

Atrial fibrillation may be treated with blood thinning medication to reduce the risk of blood clots and/or medication to control heart rate and rhythm. If medication is not working or cannot be used to treat a patient's AFib due to side effects or other reasons, surgery may be recommended.

AFib surgery may be done using an open heart method or through minimal access procedures that change the electrical pattern of the heart. Surgical ablation procedures, referred to as the maze procedure or the mini maze procedure, are known to offer the best long-term success in treating atrial fibrillation.

During the maze procedure, a surgeon creates lines of scar tissue in the upper chambers of the heart in order to prevent the transmission of abnormal impulses and to restore normal heart rhythm. The pattern of scar tissue (maze) may be created using radiofrequency (heat), cryotherapy (freezing), a laser, or a scalpel. By creating this scar tissue, electrical signals are redirected in the heart through a more controlled passageway because scar tissue cannot carry electrical signals, thus restoring normal rhythm.

The maze procedure may also include the removal of the left atrial appendage (LAA) in order to reduce the risk of stroke due to AFib. The LAA is a small sac located in the left atrium's muscle wall and serves no known purpose. In patients with AFib, the chaotic movement of blood can cause blood to fill the sac and form clots, leading to a stroke. Removing the LAA reduces this risk.

Risks of AFib Surgery

As with any heart surgery, there are risks associated with surgical procedures to treat AFib. Risks for minimal access procedures are less than those for open heart surgery methods but may include:

  • infection
  • bleeding
  • stroke
  • heart attack
  • pneumonia
  • new heart arrhythmias
  • need for a pacemaker

What to Expect After Surgery

As a general rule of thumb, patients spend a day or more in the intensive care unit (ICU) following surgery. While there, they’ll receive oxygen, fluids, nutrition, medication, and close medical supervision. After a few days, patients are moved out of ICU and into a general hospital room. During this time, medical staff will monitor for infection at the incision site(s), manage any post-surgery pain, and periodically check heart rate, breathing, and blood pressure. Patients will also engage in daily walking and breathing exercises to promote recovery.

Patients may experience pain in the shoulders, chest, or ribs following surgery, which can be treated with pain medications. Diuretic medications may be prescribed for several weeks post-surgery to control fluid build-up. In some cases, patients will also need to take blood thinners to prevent the formation of blood clots. Patients may still have a few episodes of AFib during the recovery process, but the procedure carries a high rate of success in halting symptoms.

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