Atrial Fibrillation
Atrial fibrillation (AFib) is the most common abnormal heart rhythm (cardiac arrhythmia) and the second most common cardiac condition in the United States. Yale New Haven Health’s comprehensive Atrial Fibrillation Program provides expert care and management of this and related conditions.
Our team of nationally recognized cardiac arrhythmia specialists (electrophysiologists) is skilled in using the latest technology and groundbreaking scientific advancements to provide patients with the best treatment strategies for each patient. These include medical and procedural approaches to treating atrial fibrillation, atrial flutter and related heart abnormalities. Our physicians are experts in dealing with the complexities of cardiac rhythm disturbances.
Advanced technology for heart rhythm monitoring includes a very small monitor that is injected under the chest skin and, over an extended period, monitors every heartbeat 24/7. Information received from the monitor, including arrhythmias that may be sporadic and intermittent, is automatically and wirelessly transmitted to the patient’s physician. This type of device vs. a wearable monitor, may be an option.
Our physicians participate in clinical trials, national registries and conduct cutting-edge laboratory research to advance treatment of cardiac arrhythmias and ensure our patients receive the best possible care.
Treatments
Among our comprehensive treatments for atrial fibrillation:
- Atrial fibrillation rhythm control medications to prevent atrial fibrillation and stop the associated symptoms
- Anticoagulation (blood thinning) medications to prevent stroke in patients with atrial fibrillation
- Catheter-based ablation of atrial fibrillation and atrial flutter to prevent recurrence and stop related symptoms when rhythm medications are ineffective or cause side effects
- Catheter-based left atrial appendage closure for prevention of stroke and systemic thromboembolism in atrial fibrillation. Many patients cannot tolerate blood thinners (anticoagulants) due to bleeding, falls or other concerns. Bridgeport Hospital offers a minimally invasive procedure to implant a small, umbrella-like metal device (WATCHMAN FLX™) in the left atrial appendage (top of heart’s left atrium chamber) that prevents blood clots from forming in the heart and causing stroke.
- Comprehensive risk factor testing and management for associated conditions like obstructive sleep apnea, high blood pressure, diabetes, and congestive heart failure
- Genetic testing, as appropriate, for heart conditions that may be associated with atrial fibrillation
- Pulsed field ablation, an advanced technology that uses short electrical pulses to treat AFib
- Surgical procedures (convergent hybrid ablation, maze)
Pulsed Field Ablation for AFib
Among our advanced treatments for atrial fibrillation is pulsed field ablation. This new technology uses short electrical pulses to ablate cells that are triggering the AFib, without damaging surrounding structures. Studies suggest this new, highly precise technique safely and effectively treats atrial fibrillation with faster procedure times than traditional methods and with low complication rates.
Surgery for Atrial Fibrillation
Sometimes treatment for atrial fibrillation includes cardiac ablation performed by an electrophysiologist and surgery performed by a cardiac surgeon. There are two types of procedures that include surgery to treat this arrhythmia:
Hybrid atrial ablation (convergent) procedure: This procedure involves an electrophysiologist and cardiac surgeon to treat atrial fibrillation. During the procedure, an electrophysiologist will treat the inside of the atrium (two of the heart’s four chambers) using either radiofrequency to burn (scar) the tissue or cryoablation to freeze it. The surgeon will perform a series of ablations on the outside of the left atrium via a very small incision in the lower part of the chest. This dual approach is used to help reduce or prevent recurrent atrial fibrillation and eventually maintain a normal heart rhythm without the need for medications. The hybrid ablation procedure, first offered at Bridgeport Hospital in 2011, provides excellent results with most patients free of atrial fibrillation and without the need for heart-rate medications.
Maze procedure: An ablation is performed during open heart surgery usually in conjunction with coronary bypass surgery or valve repair surgery. The surgeon will use either radiofrequency or cryoablation to treat the atrial fibrillation by performing a series of scar lines (the “maze”) in the atrium to promote a normal heart rhythm. In addition, the surgeon will place a clip across a portion of the left atrium (the “appendage”) which significantly reduces the risk of stroke.
