Treating A-fib: Now and in the Future
When Dr. Rick Henderson sees patients for atrial fibrillation and discusses the electrophysiology procedure called cardiac ablation with them, he usually has to offer them caution.
"Most people have the goal of ‘I want to be cured of this,’" Henderson says. "That is not going to happen a lot."
The complicated procedure sends electrical energy through a catheter into the heart to create a small scar on the problem area, thus causing heart rhythm problems to stop.
"Our goal," Henderson says, "is to decrease the frequency and to decrease the duration" of atrial fibrillation, or fluttering, a problem that can lead, to stroke or more serious heart issues if untreated.
Henderson says the success rate of cardiac ablation of more than 75 percent makes it an effective procedure for people whose atrial fibrillation issues are not able to be controlled with medications.
And he is excited about new procedures on the horizon.
The Heart Center at Wake Forest Baptist Health may soon offer a hybrid procedure that can help treat the most difficult cases of atrial fibrillation. The hybrid procedure combines cardiothoracic surgery with cardiac ablation to treat both the inside and outside of the atrial wall.
In addition, Henderson has attended a clinic in Minneapolis to learn a new technique to help prevent blood clots, which can be created by atrial fibrillation and which can cause stroke. The technique involves implanting an occlusion device into the left atrial appendage with a catheter. In effect, this shuts down the flow of blood from that chamber.
Henderson is hopeful that Wake Forest Baptist Health will be the first in the region to offer such surgery, which typically is needed for patients unable to take anticoagulant medications.
Atrial fibrillation is a problem Henderson says is growing, and because its causes are not clearly known, it can be difficult to diagnose and treat. He says he believes new techniques to fight atrial fibrillation could bring about a reduction in the number of future patients.
High blood pressure and binge alcohol use — in particular heavy weekend or holiday use of alcohol, the problem known as “holiday heart” — can lead to atrial fibrillation. But Henderson says being healthy or even taking high blood pressure medication doesn’t mean you won’t develop atrial fibrillation.
Not all the news is bad.
The largest study shows that atrial fibrillation does not shorten your life, Henderson says. And people can lead normal lives with treatment.
"The goal on our end is … you continue your life just as you would before. All of our treatment options are aimed at improving quality-of-life issues. So someone who has been diagnosed and is being treated? I would expect them to enjoy all of the things they have done previously."
Then he pauses.
The only caveat is listening to your body.
"If you feel like you’re working too hard," he says smiling, "you’re probably working too hard."