Electrophysiology

It is estimated that one out of every four individuals will develop AF in their lifetime. Certain risk factors are associated with a greater likelihood of developing AF including:

• Advancing age
• Congenital Heart Disease
• Coronary Artery Disease
• Diabetes
• Excessive alcohol or stimulant use
• Heart Failure
• High Blood Pressure
• Lung disease
• Obesity
• Serious illness or infection
• Sleep apnea
• Surgery (particularly open-heart surgery)
• Thyroid disease
• Valvular Heart Disease

Symptoms of AF can range from almost non-existent to disabling.

Mild symptoms include:

• Unpleasant palpitations or irregularity of the heart beat
• Mild chest discomfort (sensation of tightness) or pain
• A sense of the heart racing
• Lightheadedness
• Mild shortness of breath and fatigue that limits the ability to exercise

Severe symptoms include:

• Difficulty breathing
• Fainting or near fainting
• Chest discomfort
• Any symptom associated with stroke – weakness, slurred speech, numbness, confusion

Some of the consequences of AF include heart failure and stroke.

AF is usually diagnosed with an electrocardiogram (ECG or EKG), which records the heart’s electrical activity.

Other tests that may be performed:

• Ultrasounds to look for heart failure or heart valve problems
• Blood tests to screen for thyroid disorders
• Sleep studies to look for sleep apnea
• Lung function tests to detect underlying lung disease

Fortunately, there are many treatment options for AF, focused around two strategies:

• A “rate control” strategy focuses on reducing the symptoms of AF by controlling a patient’s heart rate.
• A “rhythm control” strategy focuses on keeping patients in a normal sinus rhythm.

You should discuss with your doctor which treatment plan makes sense for you.

The goals of AF treatment may include:

• Returning the heart to a normal rhythm, often via a procedure known as AF ablation, through the use of medications, or a combination of the two options.
• Reducing symptoms related to AF and improving quality of life.
• Controlling the heart rate.
• Preventing blood clots from forming in the heart.

Patients with AF are 5 to 7 times more likely to have a stroke.

Strokes in AF patients occur when a blood clot, caused by blood pooling when the top chambers of the heart (atria) beat rapidly, is dislodged from the heart and travels to the brain. Approximately 90% of these clots are formed within the area of the heart known as the left atrial appendage.

An individual’s risk of stroke due to AF is dependent on many factors, such as:

• Age
• Coronary Artery Disease
• Diabetes
• Heart Failure
• High Blood Pressure
• Prior History of Stroke

To assist with stroke prevention in AF patients for medium- to high-risk individuals: 

Medium-risk patients may be required to take blood thinners to help prevent blood clots from forming in the heart
High-risk patients who cannot tolerate anticoagulants may be eligible to have a non-surgical procedure, called a Left Atrial Appendage Occlusion, designed to reduce the risk of stroke related to AF.