Top five treatment options for Atrial fibrillation

ST. LOUIS, Mo. _September is Atrial fibrillation Awareness Month. If you have a-fib, consult your doctor and create a plan. Be proactive about it. There is reasonable data that says the longer you have a-fib, the harder it is to treat.

Washington University and Barnes-Jewish Heart & Vascular Center's Dr. Mitchell Faddis joins us with information on symptoms and treatment.

The top five treatment options for the disorder:

1. Reduce the risk of stroke: To reduce the risk of stroke, the use of blood thinners is a time-proven way to prevent a blood clot from developing in the left atrium due to a-fib. The blood thinner prescribed could be aspirin or a more potent drug, such as warfarin (Coumadin), dabigatran (Pradaxa), apixaban (Eliquis), or rivaraoxaban (Xarelto). Patients at high risk for stroke who cannot tolerate anticoagulation medication may also be candidates for a new minimally invasive procedure. In this procedure, a device is used to close the left atrial appendage where clots routinely develop.

2. Antiarrhythmic drugs: In addition to blood thinners, antiarrhythmic drugs may be given for long-term treatment. These drugs depress the transmission of impulses in tissues that either conduct too rapidly or participate in reentry. Daily medications, and the possible side effects associated with them, lead some patients to look for alternative or more permanent treatment methods.

3. Catheter ablation: Catheter ablation is a non-surgical option for the treatment of cardiac arrhythmias. Washington University electrophysiologists and their colleagues use advanced ablation techniques to create ablation lines (scar tissue) within the atria that work as barriers to surround and disrupt the abnormal heart rhythms. After treatment, nearly 70-80 percent of patients are symptom free.

4. Surgical options: The Washington University and Barnes-Jewish Heart & Vascular Center is celebrating the 30th anniversary of the Cox-Maze procedure this month. September marks the 30th anniversary of the Cox-Maze procedure, a treatment for atrial fibrillation, known as an irregular heartbeat.

It was developed here in 1987 by James Cox, MD. Since then, the treatment was refined by our chief of cardiothoracic surgery, Ralph Damiano, Jr., MD. The refined approach has led to excellent patient outcomes with a 20 percent better survival rate at 10 years following the Cox-Maze procedure. Additionally, one-year cure rates for patients having the procedure are more than 90 percent.
In this procedure, surgeons make incisions and ablations in the heart, creating a planned 'maze' of scar tissue.

This scar tissue serves as barriers, guiding irregular cardiac electrical signals back to more normal pathways. In doing so, the Cox-Maze procedure restores a regular heartbeat again.

After undergoing the Cox-Maze, the majority of patients no longer need blood thinners or heart rhythm medications and can enjoy a normal life.

5. Lifestyle changes: There are a lot of things people can do for their own health outside of what medications or treatments can do for them. Lifestyle changes can greatly improve your quality of life. Get regular physical activity; eat a heart-healthy diet low in saturated fats, trans fats, and cholesterol; manage high blood pressure; avoid excessive amounts of alcohol and caffeine; don`t smoke; control cholesterol; and maintain a healthy weight.

The link between obesity and a-fib is strong, so aiming for an ideal body weight is important. A 20-lb weight loss could be the difference between having and not having a-fib.

If you have a-fib, consult your doctor and create a plan. Be proactive about it. There is reasonable data that says the longer you have a-fib, the harder it is to treat.

There is no need to suffer from a-fib when there are treatments available that work.