Atrial Fibrillation

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If you have a type of irregular heartbeat called atrial fibrillation, or Afib, it’s important to seek specialized care.

Without proper treatment, Afib can reduce your heart’s ability to pump blood. This causes symptoms like fatigue and lightheadedness and may lead to heart failure. Afib also greatly increases your risk of stroke.

University of Iowa Heart and Vascular Center cardiac electrophysiologists offer tests that distinguish Afib from other, less serious types of irregular heartbeats. We also provide the treatments you need to improve challenging symptoms and prevent life-threatening complications. We’ve helped many people with hard-to-treat Afib who didn’t find relief with standard medications or procedures.

Atrial fibrillation symptoms

Atrial fibrillation is a type of arrhythmia, or irregular heartbeat. It occurs when the top two chambers of your heart don’t beat in sync with the bottom two chambers. This causes episodes of irregular and often rapid heart rhythms. You may have these episodes occasionally or frequently.

Some people with Afib don’t have any symptoms. Others experience one or more of the following:

A quivering or fluttering sensation in the chest
A rapid, pounding heartbeat
Chest pain
Dizziness
Fatigue
Lightheadedness
Shortness of breath
Weakness

Even if you don’t have symptoms—or your symptoms come and go—your risk of stroke is still high. That’s because the chaotic heart rhythm associated with Afib can also cause blood to pool in the heart, leading to blood clots.

If part of a clot breaks off, it may get stuck in an artery leading to the brain, resulting in a stroke.

Atrial fibrillation diagnosis

The UI Heart and Vascular Center offers the full range of tests used to diagnose Afib. These include:

Electrocardiograms

If you have a persistent irregular heart rhythm, the only test you might need is an electrocardiogram, also called an EKG or ECG.

During this test, we attach sticky metal discs called electrodes to your chest. These electrodes are attached by wires to a machine that measures your heart’s electrical activity.

If your heart was beating abnormally during your EKG, your results will confirm whether you have Afib or another type of arrhythmia.

Portable devices

If your EKG results were inconclusive—or your arrhythmia only happens occasionally—we may need to monitor your heart rhythm for a longer period of time. We can do this with wearable or implantable devices that keep track of your heart rhythm while you go about your day. These devices include:

Holter monitor: This is a small, portable EKG that continuously records your heart rhythm for at least 24 hours. You can carry it in your pocket or wear it on a belt.
Event recorder: This device is similar to a Holter monitor, but it’s usually worn for 30 days. With most event recorders, you push a button to record your heart rhythm every time you feel symptoms.
Implantable loop recorder: This is a small device implanted just under the skin on your chest. It can continuously record your heart rhythm for up to three years. It’s often used to monitor people who have an irregular heartbeat and fainting spells known as syncope.

Depending on your pattern of symptoms, your provider may also try to provoke an Afib episode. For example, if you have fainting spells or experience symptoms while exercising, you might need to have a tilt table test or a stress test.

Atrial fibrillation treatment from UI Health Care

We offer all the treatments you might need to get your Afib under control. Our goal is to restore your normal heart rhythm and heart rate and lower your risk of stroke.

Nonsurgical treatments

Many people with Afib can improve their symptoms with prescription medicine and other nonsurgical therapies, such as:

Lifestyle changes

Your risk of Afib increases if you’re overweight or have other cardiovascular problems like high blood pressure. You can improve your heart health and lower your risk of Afib by losing weight, quitting smoking, and improving your diet and exercise. If your Afib gets worse when you drink alcohol or take part in physical activities, you can help prevent future episodes by avoiding these triggers

Medication

Beta blockers and calcium channel blockers can slow or restore your heart rate during rest or activity. Anti-arrhythmic medications help your heart maintain a normal rhythm. Blood thinners help prevent blood clots.

Minimally invasive procedures

If medication isn’t enough to get your heart rate and rhythm under control, or if your medication causes serious side effects, you may need more advanced care.

The UI Heart and Vascular Center offers several minimally invasive treatment options for Afib. Compared to traditional surgery, these procedures can help you recover more quickly and with less pain.

Cardioversion: During this procedure, we reset your heart rhythm back to normal. We’ll either use special medication or send an electrical shock to your heart.
Pacemaker implantation: If you have Afib and an abnormally slow heart rate, you may need a pacemaker. We implant this small, battery-powered device under the skin in your chest. Once in place, the pacemaker controls your heart rate.
Cardiac ablation: We guide flexible, hollow tubes called catheters through your blood vessels to your heart. The catheters apply extreme heat or cold to the part of the heart that’s sending abnormal electrical signals. This creates scar tissue that blocks those signals. Many people with Afib have a type of cardiac ablation called AV node ablation. It permanently damages the part of the heart that lets electrical signals travel from the top two chambers to the bottom two chambers. If you have AV node ablation, you will also need a pacemaker.
Left atrial appendage closure: We use catheters to place a small device inside the part of your heart where blood clots are most likely to form. This device prevents any clots from escaping.
Convergent procedure: Combines minimally invasive heart surgery with cardiac ablation to effectively treat Afib. This is one of the least invasive and most successful methods to surgically treat long standing, persistent Afib that hasn’t responded to other treatments.

Pulse field ablation for Afib

University of Iowa Health Care now uses the Farapulse™ Pulse Field Ablation (PFA) System for atrial fibrillation (Afib) ablations. This new technology uses electrical signals that isolate and ablate specific heart cells in a precise pattern, resulting in a quicker and safer procedure.

This new technology has proven to be effective and minimizes the risks associated with thermal ablations (radiofrequency and cryo), like damaging structures surrounding the heart.

Surgery

If your Afib doesn’t improve after trying various medications and procedures, you may need a type of heart surgery called maze surgery. In this case, your electrophysiologist will refer you to a heart surgeon.

During maze surgery, we create a unique maze pattern of scar tissue in the heart. Because scar tissue can’t transmit electrical signals, the abnormal signals that cause Afib can no longer travel between the heart’s top and bottom chambers.

If you have other serious heart conditions in addition to Afib, we may combine your maze surgery with other treatments. For example, if you need open heart surgery such as heart valve repair or coronary artery bypass grafting, we’ll perform maze surgery at the same time.

A team approach to Afib care

Certain heart conditions, including coronary artery disease and heart valve problems, increase your risk of Afib. And if you have Afib, you have a higher risk of conditions such as heart failure.

To help make sure you get complete cardiovascular care, our electrophysiologists work closely with many other UI Heart and Vascular Center experts.

Together we’ll provide the care and support you need to improve your Afib symptoms and overall heart health.

A life-changing alternative to blood thinners

Many people with Afib take blood thinners to reduce their risk of stroke. But for some patients, blood thinners cause serious side effects.

If you have Afib and you’re unable to tolerate blood thinners, you may be eligible for a procedure called left atrial appendage closure.

During this minimally invasive procedure, we place a tiny device called Watchman into the part of the heart where blood clots usually form. This permanently seals the area so blood clots can’t escape and travel to the brain.