Atrial Fibrillation

click here

Four possible treatment modalities :

1. Most often and 99.9 % of the time initially with intravenous medication which ideally would be to try to 'chemically cardiovert' the heart rythm back to normal sinus rthyme. Having done that your doctor will dispense to you oral medication to be taken for a period of time to maintain this normal rythme.

In a situation when normal sinus rythm could not be achieved via medication, your doctor may aim for a compromise by accepting the ATRIAL FIBRILLATION, but at the same time focus on controlling the rate with a 'rate-limiting' oral medications such as a betablocker or a calcium antagonist [ atenolol, metoprolol, verapamil ]. Added to this , since your rythme is now in intermittent or perpetual AF [ short form for atrial fibrillation ], there is a finite and significant risk for stroke due to an increased tendency for minute blood clots to form in the left atrium. To circumvent this issue, your doctor will usually prescribe along with the 'rate-limiting'medication such atenolol, another drug to 'thin out' your blood, warfarin.

2. In an acute , life threathening situation when it is imperative that your doctor need to achieve normal sinus rythme as fast as possible for example in patient with bad heart function or acute coronary syndrome or when initial intravenous treatment fails to control AF or rate is too fast, your doctor may elect to use the technique of 'ELECTRICAL CARDIOVERSION'.
click here
click here

3. Increasingly now, in selected cases, persistent chronic AF can be converted to sustained and most time long term normal rythme by a technique called AF RADIOFREQUENCY ABLATION. This is done not by your usual cardiologist but rather by sub specialist in cardiology [ we bread and butter cardiologists, plumbing type of cardiologists, called them 'electricians' ]. They specialise in the electrophysiology of the heart.
click here
click here

4. If AF Radiofrequency ablation fail, very rarely one would proceed for a hybrid electrophysiological-surgical approach. This is only done limited to specialised cardiothoracic centres of excellence at present, centres that have the volume and numbers, to ascertain successful conversion of AF to normal rythme.
click here