What are the latest treatments for atrial fibrillation?

Answer 1

Thank you to Linny for providing a decent answer!! I was astonished by the ignorance of the previous posters who claimed to be medical professionals. Burning the SA node is an absolute last resort these days, as you'd be pacemaker-dependant & on meds for the rest of your life, with no chance of being helped by any new technologies/procedures that may come up. Plus, you may find that you are in permanent AFIB with a pacemaker, which will only pace the ventricles, NOT the atria. As well, though the medical profession seems to like amiodarone, the drug is highly toxic and cannot be used long term. It may be OK for conversion in hospital, but the risks tolong term health if you start taking the pills are far more dangerous than atrial fib.

The Maze is not the newst procedure. I would sincerely hate to be in Soaringjeff's hospital if it's so woefully behind the times. Unfortunately, most AFIB meds lose effectiveness over time, and there are many who are looking to a procedure for help. The RF Ablation is becoming more & more common as it's fairly new, but the risks outweigh the potential benefit, which, at about 60% success rate dependant on the doctor who does the procedure, is not quite there yet. There is also no long term data on this procedure to see how effective it is. This technology needs a few years yet before I'd try it. One of the latest technologies is Cryoablation which looks promising, where they use cold to create lesions on the heart instead of heat, which is less risky. This is still in the testing stage though I believe some centres in Europe are now using it. Also, there is a microwave version of the ablation, pioneered by Dr Adam Saltman which has only been performed a couple hundred times in North America, but so far the results have been impressive. There is also a procedure commonly known as the "mini-maze", also quite new. It was pioneered by Dr Wolf and many people have had great results. They do not crack the chest open for this but go in through your ribs on the side, yet perform almost all the same lesions as the full maze procedure (known as the Cox Maze III, pioneered by Dr. Cox). However, it is apparently far more painful than having the sternum cracked! The advantage of these surgical options versus the ablation options, is that they remove something called the Left Atrial Appendage, which is responsible for 90% of the clots in afibbers (ear-like appendage in the atria thatblood forms behind when your heart is not pumping effectively) so the removal of this can help lower your stroke risk of the procedure fails to cure your AF. There is also a brand new procedure called the HIFU Maze (High Intensity Frequency Ultrasound) which is still in the testing stage but looks promising.

Bottom line, as AF is starting to reach epidemic proportions (see recent news articles, search the web), there'll be more & more procedures coming up in the next decade or so, so hang in there with your meds & see what happens. Eventually they'll find the procedure that really works! Do a search on any of the info I've given here, and tons of info will come up.

Answer 2

There are some good answers above,but, I want to clarify some of the information. An implantable defibrillator is used only for Ventricular fibrillation, not Atrial fibrillation. And with a catheter ablation, we do everything possible NOT to burn out the SA node (the natural pacemaker of the heart). A catheter ablation for Atrial fibrillation usually involves "burning" circles around the pulmonary veins (four vessels that bring blood back to the heart from the lungs). Much of atrial fibrillation starts in the area above these veins. When they are isolated from the rest of the heart by "burning", it allows the SA node to take over again and allow the heart to beat in a normal rhythm.
It is a safe procedure, but relatively new, so long term effects are not well known.
It is invasive, but not as invasive as the MAZE which involves open heart surgery.
As stated in above answers, sometimes, medical management is the best option.
This was a very general answer. More information can be found at the Heart Rhythm Society webpage.

Answer 3

AFIB can be treated in many different ways. If it is uncontrolled and the heart is running high (160-190 bpm) then there is a medication called amiodarone that is given IV to try to get the heart to convert back to a Normal Sinus Rhythm. This medication can be given in pill form also for people who are newly diagnosed with Afib to try to get the heart to convert. If the heart does not convert on its own, or by amiodarone, and is still uncontrolled, then the person may be put on IV heparin (which thins the blood) as the person is susceptible to a stroke with they're heart going so quickly. If the Afib is controlled (under 100bpm) and not able to convert back to normal, the person may go home on a daily treatment of coumadin (blood thinner) and have their blood checked every week with their doctors so the INR level is within 2-3 range.

There are other surgical interventions that can be done, pacemaker insertion (which now come with defibrillators) and the other is called Catheter Ablation, where the doctor cauterizes the SA node (pacemaker of the heart) and this hopefully stops the atrium from fibrillating as another part of the atrium may take over pacing the heart in a normal rhythm. These are the last straws as they are very invasive and most people can live with controlled afib by medications and proper follow ups with a cardiologist at home.

Answer 4

Wow, what a variety of answers here! The MAZE procedure is the newest and pretty darn impressive. It is invasive and should only be considered in someone that is seriously compromised and not responding to other treatments. One of the cardio-thoracic surgeons I work with (who also happens to be a really life rocket scientist too) is doing them and is one of a very few doing it here in the mid-south region. I've never heard of a pacemaker or defibrillator (AICD) being used for atrial fib. Must be something I don't know about. Amiodarone (Pacerone, Cordarone) is a great drug. We start folks on it IV in the hospital and hope to get them weaned off it and on to the pill form to go home on. I do consider it a dangerous condition because the risk for showering blood clots through the system is too great. There is a preventive measure that is also employed called an IVC filter or Greenfield Filter. It's a cage like device that is put in the inferior vena cava (bottom great vessel feeding the heart) and traps any small clots that may be drifting back toward the heart and lungs. They sit in there long enough to be absorbed by the system and no longer become a threat. I hope this helps. Jeff the nurse in Nashville.

Answer 5

Most patients that have a-fib take a beta blocker, such as toporol, or atenolol. And some DEPENDING ON AGE take a blood thinner such as aspirin, or coumadin ( to be sure they don't pass a clot and have a stroke. This arrhythmia's origin is the atrium so when many ectopic foci's try to pace the heart the heart rate is normally faster. The atrium is not letting the blood go to the ventricles as effectively. So it lingers in the atrium and that is what may cause a clot. BUT IN MOST cases a-fib is generally a benign arrhythmia. and what the gentleman discibed in the last answer cauterization is not likely because the arrhythmia is produced by many foci's

Answer 6

My mother in law had a MAZE procedure done. It is where they cauterized pathways of the natural electrical signal to the heart coming from the nodes to keep them from stimulating areas of the heart that isn't supposed to be stimulated. There is also the old pacemaker which has been around for years. Hope this helps.

Answer 7

Pretty much the same as before. Sorry.

Answer 8

implantable defibrilators.
D.
pacemakers are NOT capable of defibrillation.