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    AFib Care Network

    Improving access to specialty care for patients with atrial fibrillation in North Carolina

  • Older couple fishing

    AFib Care Network

    A novel system wide pathway to streamline care delivery and improve overall quality of care for patients with atrial fibrillation

AFib Care Network 

The AFib Care Network aims to teach patients about atrial fibrillation. One of our primary goals is to get you involved in your care and help you learn how to manage your atrial fibrillation. We also will work with other members of your care team to develop treatment strategies in order to give you the best chance at long-term success.  Patients seen at an AFib Transitions of Care location receive short-term care and an individualized treatment plan in partnership with your primary care provider. Our AFib Integrated Care option is available if you are in need of ongoing specialty care for atrial fibrillation.  Talk to your provider if you are interested in participating in our AFib Care Network. 

About Atrial Fibrillation

What is atrial fibrillation (AF, A-fib, AFib)?

Atrial fibrillation is an irregular heart rhythm in which the top chambers of the heart (atria) fibrillate (quiver or twitch quickly) instead of fully contracting. This causes the bottom chambers of the heart to beat irregularly. A normal heart rate is around 60 to 100 beats per minute. When someone is in A-fib, the atria may beat as often as 300 times per minute. Atrial fibrillation is the most common heart rhythm disorder in the world. Some people with A-fib feel no symptoms at all, while others are aware as soon as an episode happens. 

Common symptoms of atrial fibrillation include:

  • Fatigue or lack of energy
  • Dizziness, lightheadedness, or fainting 
  • Chest pain, pressure, or tightness
  • Shortness of breath
  • Heart pounding/racing
  • Increased urination
  • Trouble completing daily activities

What are the dangers of atrial fibrillation?

  • Stroke: Because the top chambers of the heart do not fully squeeze when in atrial fibrillation, blood can pool and allow clots to form. Blood clots from the heart can travel to the brain and cause stroke.
  • Heart failure (weakening of the heart muscle): very fast heart rates over time can cause the heart muscle to weaken
  • Lower quality of life: Many patients with atrial fibrillation experience fatigue, lower energy, shortness of breath, or other symptoms that interfere with daily life

Ask your Doctor

Patients with atrial fibrillation are at increased risk for stroke and developing heart failure. Therefore, it is important for patients to see a provider for proper care and treatment. Ask your doctor today about your options. 

Treatment

Treatment of atrial fibrillation aims to make people feel better and improve quality of life. Treatment focuses on the following:

Preventing AFib

Anyone can develop atrial fibrillation, although there are common risk factors. These include high blood pressure, sleep apnea, thyroid disease, obesity, coronary artery disease, heart failure, heart valve disease, excessive alcohol or stimulant use, prior open-heart surgery, chronic lung disease, diabetes, and age >60 years. An important part of treatment for AFib is controlling these risk factors as much as possible. 

Preventing stroke

Blood can pool in the atria during AFib, which can allow a clot to form. If a blood clot dislodges from the atria, it can cause a stroke. Patients with atrial fibrillation are almost always prescribed a blood thinner medication such as warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), or edoxaban (Savaysa.)

Patients who are at risk for stroke but unable to take a blood thinner may benefit from a Watchman™ left atrial appendage closure device. The left atrial appendage (LAA) is a small pouch in the left atrium of the heart and is the source of most stroke-causing blood clots. The device works as a plug to close the LAA, which prevents the clots from escaping the heart and travelling to the brain and cause a stroke.

Keeping the heart rate from going too fast

If left untreated, AFib can cause a fast, irregular pulse for long periods of time. This can cause the heart muscle to weaken leading to heart failure. Because of the potential for weakening of the heart muscle, it is important to keep the heart from beating too fast when in AFib. 

Medications are used to slow down the heart rate. Examples of types of medications that slow down the heart rate are beta-blockers (metoprolol, atenolol, carvedilol), calcium channel blockers (diltiazem, verapamil), or digoxin.

Keeping the heart in normal rhythm

Patients who have symptoms and feel poorly when in atrial fibrillation may need more aggressive treatment to put them back into normal rhythm and keep them in normal rhythm. This can be done with medications, cardioversion (external shock to the heart), or catheter ablation (radiofrequency lesions made on the inside of the heart to destroy AF triggers).

    How to handle an AFib Episode

    One of the biggest questions is what to do during an AFib episode. 

    When to manage AFib at home

    If you are feeling okay and it is your typical AFib episode, it is okay to wait it out at home and or go about your normal day if you feel up to it. You can try some relaxation exercises (deep breathing, imagining a peaceful place). Make notes about how long the episode lasted and how you felt to share with your provider at your next visit. 

    When to see or call your provider

    • If symptoms get worse or you start feeling worse
    • AFib lasts longer than 24 hours
    • AFib episodes become more frequent
    • To get an EKG to confirm that what you are feeling is AFib
    • Routine follow-up

    When to call 911 or go to the Emergency Room

    • Signs of stroke (sudden weakness, numbness, trouble seeing or speaking)
    • Passing out/nearly passing out
    • Severe lightheadedness
    • Chest pain
    • Trouble breathing
    • Feeling weak, cold sweats, or clamminess
    • Medication side-effects (bleeding, overdose)

      AFib Transitions of Care Locations

      AFib Transitions of Care 
      UNC Hospitals Heart and Vascular Center at Meadowmont 
      300 Meadowmont Village Circle
      Suite 104
      Chapel Hill, NC 27517
      (984) 974-7244

      AFib Transitions of Care at UNC Chatham (coming soon) 
      Chatham Medical Specialists
      163 Medical Park Drive
      Suite 220
      Siler City, NC 27344
      (919) 663-3360

      AFib Transitions of Care at UNC REX Healthcare
      North Carolina Heart & Vascular, Raleigh
      2800 Blue Ridge Road
      Suite 400
      Raleigh, NC 27607
      (919) 787-5380

      Hours: Monday-Friday
      8:00 AM to 5:00 PM

      AFib Integrated Care Locations


      AFib Integrated Care 
      UNC Hospitals Heart and Vascular Center at Meadowmont 
      300 Meadowmont Village Circle
      Suite 104
      Chapel Hill, NC 27517
      (984) 974-7244

      Hours: Monday, Tuesday, Thursday 
      8:00 AM to 5:00 PM
      Wednesday and Friday
      8:00 AM to 12:00 PM

      AFib Care Network Map

      AFib Care Network Operations & Planning Team

      Anil Gehi, MD
      Anil Gehi, MD
      Tiffany Armbruster, AGNP-C
      Tiffany Armbruster, AGNP-C
      Dr. Biese
      Kevin Biese, MD
      Zack Deyo, PharmD
      Zack Deyo, PharmD
      Anil Gehi, MD
      Jennifer Walker, AGNP-C

      Heather Tuttle, RN
      Heather Tuttle, RN

      Rachelle Alpern,
      Rachelle Alpern,
      UNC Center for Innovation

      Leah Hatfield, PharmD
      Leah Hatfield, PharmD

      Patient Education & Resources

      The AFib Care Network has created a Living with Atrial Fibrillation patient guide. Please download a complimentary copy here.

      AFib Transitions of Care

      If you have been referred by your physician to AFib Transitions of Care, you can download a patient information card here. Meet the AFib Transitions of Care team in our Meadowmont, Raleigh and Chatham locations.

      AFib Integrated Care

      This new clinic offers patients referred to the program unique opportunities to participate in our AF patient support group, access to the AF self-management mobile app, in addition to receiving personalized education, care plans, risk-factor management, and comprehensive care. Talk to you provider if you are interested in a referral to the AFib Integrated Care clinic at Meadowmont. If you have been referred by your physician to the AFib Integrated Care clinic, you can meet the team here.

      AF Patient Support Group
      Meets quarterly
      Next meeting: November 10, 2018, 10 am - noon 

      Click here to download the presentation from the last quarterly meeting.

      Research

      Based on pilot data, we believe that a model of care delivery which increases access to AF specialty clinics with an easy transition from multiple points of entry (emergency department (ED), urgent care and primary care clinics) can reduce unnecessary hospitalizations and improve quality of care. Increasing specialty care access, particularly in regions serving a large vulnerable patient population, helps to reduce disparities in care. Further research efforts are under way.

      Press Room

      UNC AFib Care Network Launches AFib Integrated Care Clinic
      Network also launches AFib support group and a smartphone app to help people with AFib manage their condition

      The UNC AFib Care Network has launched a new clinic that coordinates all of the services needed by patients with atrial fibrillation (AFib) in one convenient location. The new AFib Integrated Care Clinic is now open and seeing patients at 300 Meadowmont Village Circle in Chapel Hill.

      Read More

      Bristol-Myers Squibb Foundation Provides $1.7 million grant to UNC School of Medicine to fund program streamlining Afib care & education for underserved populations

      UNC School of Medicine cardiologist Anil Gehi, MD, will use a $1.7 million grant from the Bristol-Myers Squibb Foundation to further innovate a care model, launched in 2015, that reduced hospitalizations for patients with atrial fibrillation (A-fib) presenting in the emergency room by more than 30 percentage points in its first year.

      Read More

      UNC lands $1.7M grant from Bristol-Myers Squibb (TBJ)

      The UNC School of Medicine has landed a $1.7 million grant from the Bristol-Myers Squibb Foundation – aimed at improving care and education for patients with atrial fibrillation (A-fib), or an irregular heartbeat that can lead to stroke and heart failure, among other complications.

      Read More

      Bristol-Myers Squibb Foundation Provides $1.7 million grant to UNC School of Medicine (Business Wire)

      The three-year grant from the Bristol-Myers Squibb Foundation will enable Dr. Gehi to continue development of a new protocol he established at UNC Medical Center through a pilot grant from the UNC Center for Health Innovation and adapt and evaluate its application primary care and urgent care settings as well.

      Read More

      Improving Geriatric Emergency Medicine

      UNC Health Care recently held a Geriatric Emergency Medicine Boot Camp to generate ideas for improving emergency care for elderly adults. The boot camp was the result of UNC Health Care’s participation in the Geriatric Emergency Medicine Collaborative, a national collaborative of health-care systems seeking to produce better outcomes for these patients.

      Read More

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