NYU Winthrop’s Atrial Fibrillation Treatment Center features today’s most advanced and innovative treatment approaches for atrial fibrillation and other heart rhythm conditions.
In 2012, NYU Winthrop Hospital physicians were the first on Long Island to offer a new therapy for patients with paroxysmal atrial fibrillation (PAF). With the ArcticFront(R) Cardiac CryoAblation Catheter system — the first and only cryo-balloon in the United States indicated to treat certain PAF cases — our cardiac specialists are offering renewed hope and the highest quality outcomes.
What is Atrial Fibrillation?
Atrial fibrillation (AF) is an abnormal heart rhythm originating in the atria. It is the most common irregular heart rhythm condition of cardiac patients in the United States.
During AF, electrical signals in the atria (the two smaller chambers of the heart) are fired in a quick and uncontrolled manner, causing the atria to quiver instead of contracting normally, and producing a rapid and disorganized heartbeat.
What Causes Atrial Fibrillation?
Most common causes
- Hypertension (high blood pressure)
- Coronary artery disease
- Heart valve disease
- Heart surgery
- Chronic lung disease
- Heart failure
Less common causes
- Viral infection
- Congenital heart disease
- Pulmonary embolism
In at least ten percent of atrial fibrillation cases, no underlying heart disease is found. In these cases, AF may be related to alcohol or excessive caffeine use, stress, certain drugs, electrolyte or metabolic imbalances, or severe infections. In some cases, no cause can be found.
The risk of AF increases with age, particularly after age 60.
Treatment of Atrial Fibrillation
At NYU Winthrop’s Atrial Fibrillation Treatment Center, treatment of AF is individualized to each patient’s needs. Lifestyle, age,symptoms and co-existing medical conditions are all taken into careful consideration, and treatment decisions also take into consideration how long a patient’s heart has been in AF.
Atrial fibrillation treatment typically involves attempts to restore (reset) the heart back to its normal rhythm (rhythm control) or to control the heart rate (rate control). Sometimes surgery or catheter ablation is used. Additionally, medications may be prescribed to prevent blood clots and reduce the risk of stroke.
Blood thinners — anticoagulation medications — are one of the most fundamental and important treatments for atrial fibrillation, as there is a strong association between stroke and AF. The medication called warfarin is used, and for patients with a contraindication to warfarin, aspirin therapy is an option. Your doctor will have a detailed discussion with you about which blood-thinning medications are best for you.
To help control heart rate, a rate control agent may be prescribed based on the needs of the individual patient. In general, beta-blocker therapy, calcium channel blockers or Digoxin are rate control medications used to achieve the goal of a more controlled heart rate.
Antiarrhythmic Medications: While part of the medical therapy for AF is targeted to control the rate of the heart, other medications may assist in getting the heart to convert to, or maintain, a normal and regular sinus rhythm. The selection of which drug(s) are used is based on the individual patient’s medical and cardiac assessment.
Electrical Cardioversion: If medications are not able to control atrial fibrillation, cardioversion may be required. Cardioversion frequently restores a normal rhythm, although its effect may not be permanent. After a short-acting anesthetic is given, a small electrical shock is delivered to the patient’s chest wall to “short circuit” the heart and have the heart’s normal rhythm take over.
Studies have shown that almost all atrial fibrillation signals come from the four pulmonary veins. During radiofrequency ablation, two catheters are inserted into the right atrium and two into the left atrium. One catheter in the left atrium is used to map or locate the abnormal impulses coming from the pulmonary veins. The other catheter is used to deliver the radiofrequency energy to ablate, or create lesions outside the pulmonary veins. The procedure is repeated for all four pulmonary veins. The lesions heal and within 4 to 8 weeks, form a circular scar around the pulmonary veins. The scar blocks any impulses firing from within the pulmonary veins, thereby “disconnecting” the pathway of the abnormal rhythm.