Treatment of atrial fibrillation aims to make people feel better and improve quality of life. Treatment focuses on the following:
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 A-fib is controlling these risk factors as much as possible.
Blood can pool in the atria during A-fib, 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.
If left untreated, A-fib 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 A-fib.
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.
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).
One of the biggest questions is what to do during an A-fib episode.
If you are feeling okay and it is your typical A-fib 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.
A-fib Transitions of Care at Meadowmont
300 Meadowmont Village Circle
Chapel Hill, NC 27517
8:00 AM to 5:00 PM
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.
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.
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.
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.
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.