DISEASE MANAGEMENT

Disease Management for Atrial Fibrillation (A.F.)

Learn about the treatment options for Atrial Fibrillation (A.F.):


Consult with your doctor to make the best decisions


When discussing with your doctor, you may want to use this document to help guide the conversation

When discussing with your doctor, you may want to use this document to help guide the conversation

1. Identify


An electrocardiogram records the electrical activity of the heart via electrodes that are placed on your chest and sometimes on your limbs. It is a noninvasive and painless method to help diagnose a heart problem.

A medical assessment can identify if you are at risk of malignant arrhythmias, i.e. those that originate from the ventricles, which are the chambers responsible for pumping blood from the heart to the whole body.

Continuous heart monitoring is useful for capturing irregular heartbeats that happen infrequently — in some cases, you may not even feel any symptoms.

Holter Monitor: This portable ECG device may be used for up to seven days to record the electrical activity of the heart while performing your daily routine. Performing a record of your ECG will allow your doctor to analyze your heart rate and identify any abnormalities that may be occurring.

Insertable Cardiac Monitor (ICM): The ICM is a small device that is implanted under the skin in the chest area. The ICM detects and stores abnormal heart rhythms for about three years.

  • Based on your treating doctor’s consideration, an echocardiogram may be performed to evaluate the size of your heart and its functioning.
  • Another diagnostic test is coronary angiography, which makes the blood flow through the arteries of your heart visible. Like the echocardiogram, this procedure will be requested by your doctor if considered necessary.
  • An electrophysiological study (EPS) may be performed to observe the functioning of the heart’s electrical system in more detail and confirm the presence or absence of electrical abnormalities.

You can determine how quickly your heart beats by taking your pulse. If you identify that your pulse is irregular or slow, consult a doctor.

Example on how to take the pulse in the wrist. Taking care of your heart.

Flip one hand, palm up. Gently place the index and middle finger of your opposite hand in the internal part of your wrist below the base of the thumb; the position is correct if you feel your heartbeat. Count the total number of heartbeats for 1 minute, or for 30 seconds, and multiply this number by two.

Example on how to take the pulse in the neck. Taking care of your heart.

The pulse can also be found in the neck, always using the same fingers and performing the process similarly to the previous one.

During the ECG test, electrodes (sensors) that can detect the electrical activity of the heart are located in your chest and sometimes in your limbs. An ECG measures the time and duration of the electrical phases of each heartbeat.

This portable ECG device may be used for a day or more to record the electrical activity of the heart while performing your daily routine. Performing a record of your ECG will allow your doctor to then analyze how your heart rate is, and identify any abnormalities that may be occurring.

En algunos casos, la F.A. es difícil de detectar. Por eso, a veces es necesario realizar una pequeña cirugía para implantar un sistema de monitoreo que permite medir momento exacto en el que se presenta la condición.

You can determine how quickly your heart beats by taking your pulse. If you identify that your pulse is irregular or slow, consult a doctor.

Example on how to take the pulse in the wrist. Taking care of your heart.

Flip one hand, palm up. Gently place the index and middle finger of your opposite hand in the internal part of your wrist below the base of the thumb; the position is correct if you feel your heartbeat. Count the total number of heartbeats for 1 minute, or for 30 seconds, and multiply this number by two.

Example on how to take the pulse in the neck. Taking care of your heart.

The pulse can also be found in the neck, always using the same fingers and performing the process similarly to the previous one.

2. Manage


There are implantable cardiac devices that can slow the progression of atrial fibrillation, through reactive anti-tachycardia technology that helps regulate the rhythm of the heartbeat.

Delivers therapies to treat irregular, interrupted or slow heart rhythms

Continuously monitors the heart and automatically delivers therapies to correct fast heart rhythms.

These devices deliver therapies to correct uncoordinated (or unsynchronized) and inefficient heartbeats and to provide treatment for fast, irregular or slow heart rates.

3. Treat


A Cardiac Resynchronization Therapy (CRT) device is implanted under the skin and delivers therapies to correct uncoordinated (or unsynchronized) and inefficient heartbeats and provides treatment to fast, irregular, interrupted or slow heart rates.

It serves 3 functions:

Upon detection, it delivers therapies to treat fast, irregular, interrupted or slow heart rhythms

Continuously monitors the heart and automatically delivers therapies to correct abnormal rhythms.

The device delivers therapies to correct uncoordinated (or unsynchronized) and inefficient heartbeat and provides treatment to fast, irregular, interrupted or slow heart rates.

The CRT implant procedure does not require open-heart surgery and most people return to their homes in less than 24 hours.

4. Maintain


Maintaining healthy habits can help prevent heart disease and improve your quality of life.

  • Maintain a healthy diet: Eat fruits and vegetables, high-fiber foods, lean meats, fish and unsaturated fats like olive oil. Reduce alcohol and caffeine-containing beverages.
  • Exercise regularly: Try to get physical activity every day for at least half an hour.
  • Avoid harmful habits like smoking.
  • Control your blood pressure regularly: If you have high blood pressure, follow your doctor’s orders and take all prescribed medications as directed.
  • Control your cholesterol: Have your cholesterol levels checked regularly. Eat fewer high-cholesterol foods, and if necessary, take cholesterol-lowering medication as prescribed by your doctor.
  • Manage your stress levels: Reduce stress as much as possible. Practice healthy techniques for managing stress such as muscle relaxation, deep breathing, and exercise.
  • Treat sleep apnea and thyroid disorders: If you have sleep apnea or thyroid disorder, it’s important to go to the doctor to treat them properly

Keep close communication with your doctor to monitor your condition and see if medications are working properly, or if you have new symptoms or side effects.

  • Antiarrhythmic medications
  • After electrical cardioversion (see Medical Procedures on the tab below), your doctor may prescribe antiarrhythmic medications to help prevent episodes of Atrial Fibrillation in the future.
  • Heart rate control medications
  • Medications help regain a normal heart rhythm.
  • Anticoagulation medications
  • Anticoagulation medications decrease the blood’s ability to clot, preventing thrombus formation and helping to prevent stroke.
  • Stroke can be very dangerous: it can cause permanent damage to your brain or even death.
  • Cardioversion
  • It is performed either with medications or with an electric shock delivered to your heart, when you are sedated, to reset an abnormal heart rhythm back to normal.
  • Catheter Ablation
  • In this procedure, scar tissue lines are created to block abnormal electrical circuits that cause Atrial Fibrillation (AF).
  • Catheter Ablation is a minimally invasive procedure that can be used before medication or when it fails to control the heart rhythm.
  • Catheter Ablation can improve your quality of life and eliminate or reduce unpleasant symptoms of AF such as shortness of breath, fatigue or weakness.
  • It is considered a safe and effective treatment for Paroxysmal Atrial Fibrillation (PAF).
    • There are two types of ablation procedures:
      • Cryoablation: The affected area is frozen, creating scar tissue.
      • Radiofrequency ablation: Uses heat to destroy the problem area.

Keep a close communication with your doctor and report to him/her when you are not satisfied with the treatment, if you have new symptoms or side effects.

Seek help in case of an emergency. Contact your doctor or ER right away if your heart rate is faster than usual, if you feel you’re going to faint, if you have chest pain or palpitations or if you notice shortness of breath.

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When discussing with your doctor, you may want to use this document to help guide the conversation

When discussing with your doctor, you may want to use this document to help guide the conversation