Heart disease, heart attack and heart failure are common conditions of which most people are aware. While atrial fibrillation, or A-fib, might not get as much attention as the others, it’s a serious condition that can put patients at risk for stroke and decrease quality of life.
“Atrial fibrillation is an irregular heart rhythm,” explained John N. Catanzaro, MD, a cardiac electrophysiologist at the UF Health Cardiovascular Center. “Typical symptoms include feeling palpitations or skipping in the heart, shortness of breath and a decrease in exercise tolerance. This can make it difficult for patients to perform common tasks such as walking up flights of stairs or grocery shopping.”
This condition is often called the “gray hair of electrophysiology” due to the fact that it grows older with the patient. There is no cure for A-fib, but there are treatment options to improve quality of life and prevent stroke.
“It increases substantially with age,” Catanzaro said. “Patients are either diagnosed with A-fib incidentally — meaning it’s found on an electrocardiogram (EKG) — or it is found when a patient presents with flips, skips or palpitations.”
More than 160,000 new cases of A-fib are diagnosed each year, and it likely contributes to approximately 89,000 deaths annually. The cardiac rhythm disturbance increases in prevalence with advancing age. Catanzaro explained than approximately 1 percent of A-fib patients are under the age of 60, whereas up to 12 percent of patients are between 75 and 84. More than one-third of patients with A-fib are older than 80.
Atrial fibrillation has two common types: paroxysmal and persistent. Paroxysmal is when the patient’s heart rhythm goes in and out of a normal rhythm on its own, and persistent is when the heart can no longer go back to a normal rhythm. In persistent A-fib, patients are out of their normal rhythm all of the time.
The risk of developing A-fib is higher in patients with one or more of these conditions:
- High blood pressure
- Thyroid problems
- Atherosclerotic heart disease
- Congestive heart failure
- Heart valve disease
- Obstructive sleep apnea
“Untreated, A-fib can raise the risk of stroke more than five-fold and has also been shown to double the risk of mortality in a large population study,” Catanzaro explained. “At UF Health Jacksonville we have a comprehensive A-fib program. Our program includes a variety of medical and procedural options for A-fib including catheter ablation.”
A catheter ablation for atrial fibrillation is performed for symptomatic patients. A thin, flexible wire called a catheter is inserted into a vein in the leg and guided into the heart. Once there, an electrode at the tip of the catheter sends out radio waves that create heat, destroying the heart tissue that triggers the fast heart rate.
While radiofrequency ablation has been the standard treatment for A-fib, advancements in technology and techniques offer the potential for increasing success rates and shorter procedure times. This in turn is performed in an effort to extended quality of life.
“We partner with our cardiothoracic surgeon, Dr. John Pirris,” Catanzaro explained. “While working together we have the ability to perform a convergent ablation. This includes a minimally invasive surgical portion and a standard catheter ablation portion all performed on the same day in a specialized hybrid operating room.” This procedure enables physicians to better treat recurrent or persistent A-fib.
In addition to advanced radiofrequency techniques, the UF Health Atrial Fibrillation Center will begin using alternative energy sources such as cryothermal energy in 2017. Cryothermal energy will allow the electrophysiologist to freeze the areas around the pulmonary veins offering shorter procedure times.
Once this procedure is introduced into the program, UF Health Jacksonville will have a comprehensive multidisciplinary atrial fibrillation program. The combination of surgical techniques, different energy sources and a close partnership with cardiothoracic surgeons will offer patients a variety of options depending on the type of atrial fibrillation they have.
To learn more or schedule an appointment, please call 904-244-7214 or visit UFHealthJax.org/ atrial-fibrillation.
John N. Catanzaro, MD, FACC, FESC, FHRS
Associate Medical Director, Electrophysiology Program; Interim Program Director, Clinical Cardiac Electrophysiology Fellowship; Associate Program Director, Clinical Cardiac Electrophysiology Fellowship