How new technology is changing AFib treatment

A racing heartbeat. Shortness of breath. Feeling dizzy or unusually tired.

These can be signs of atrial fibrillation (AFib), the most common type of irregular heartbeat. While AFib affects millions of Americans and becomes more common with age, many people don't realize they have it until symptoms begin to interfere with daily lives.

"AFib is a progressive condition," says Dr. Charles Athill, a cardiac electrophysiologist with Sharp Community Medical Group who is affiliated with Sharp Memorial Hospital. "The longer the heart remains in an irregular rhythm, the more challenging it can become to restore a normal heartbeat. That's why early diagnosis and treatment are so important."

The heart relies on electrical signals to maintain a regular heartbeat. During AFib, abnormal signals disrupt this process, causing the heart's upper chambers, called the atria, to beat irregularly. Over time, episodes may become more frequent and last longer.

Recognizing the symptoms

Some people with AFib have no symptoms. Others notice changes that affect everyday activities.

Common symptoms include:

• A racing or irregular heartbeat

• Heart palpitations

• Dizziness

• Shortness of breath

• Fatigue, especially during physical activity

Some people also experience anxiety or sensations that feel like a panic attack. Because these symptoms can occur with other heart conditions, it's important not to ignore them.

Understanding your risk

AFib is most common in adults over age 65, but several factors can increase a person's risk. While age and family history can’t be changed, conditions such as high blood pressure, obesity, sleep apnea and diabetes can often be managed with lifestyle changes and medical care.

"Treating underlying conditions like sleep apnea can help reduce AFib episodes and improve treatment outcomes," says Dr. Athill.

One of the most serious complications of AFib is stroke. An irregular heartbeat can allow blood to collect in a small pouch of the heart called the left atrial appendage. When blood pools there, a clot can form and travel to the brain, causing a stroke.

AFib has also been linked to heart failure and cognitive decline, making early diagnosis and treatment especially important.

How AFib is diagnosed

Diagnosing AFib typically begins with a physical exam and review of a patient's medical history. Doctors may also use an electrocardiogram (EKG) or a wearable heart monitor to evaluate the heart's rhythm.

Additional testing may include blood work, an echocardiogram, chest X-rays, stress testing, or a specialized ultrasound called a transesophageal echocardiogram, which provides detailed images of the heart.

Treatment options for AFib

Treatment focuses on lowering stroke risk, relieving symptoms and helping the heart maintain a normal rhythm.

Many people begin with medication. Blood thinners can lower stroke risk, while other medications help control the heart's rhythm. Some people may also benefit from cardioversion, a procedure that uses a controlled electrical shock to restore a normal heartbeat.

For people who cannot take blood thinners long term, doctors may recommend left atrial appendage occlusion. This minimally invasive procedure places a device in the left atrial appendage to help prevent stroke-causing blood clots.

Advances in AFib care

For many people, catheter ablation offers a highly effective, minimally invasive treatment option. During the procedure, a doctor guides a thin catheter through a vein to the heart and uses energy to stop the abnormal electrical signals causing the irregular rhythm.

One of the newest advances in AFib treatment is pulse field ablation (PFA). Unlike traditional ablation methods that use heat or freezing, PFA uses short electrical pulses to target heart tissue while minimizing effects on nearby structures.

"PFA is an exciting advancement in AFib treatment," says Dr. Athill. "It allows us to precisely target the tissue causing abnormal electrical signals."

Sharp participated in the clinical trials that helped bring this technology to people and now offers FDA-approved systems from all major device manufacturers. For many people, ablation can be performed in under two hours with same-day discharge and may provide lasting symptom relief while helping slow the progression of the disease.

People with long-standing persistent AFib or those who have not responded to previous treatments may benefit from advanced procedures, such as the mini-maze or hybrid maze.

The hybrid maze combines the expertise of electrophysiologists and cardiac surgeons to treat complex AFib and reduce stroke risk. Sharp Memorial Hospital is one of only a few centers in California to offer this advanced procedure.

"The good news is that treatment options for AFib continue to improve," says Dr. Athill. "The sooner people seek care, the more opportunities we have to keep the heart in a normal rhythm and reduce the risk of serious complications."

Learn more about cardiovascular care at Sharp Memorial Hospital, which has earned certification from The Joint Commission as a Comprehensive Cardiac Center; get the latest health and wellness news, trends and patient stories from Sharp Health News; and subscribe to our weekly newsletter by clicking the "Sign up" link below.