Treatments

Atrial Fibrillation Treatments

Medications

Medications are often the first line of defense in treating atrial fibrillation. Drugs are not a cure for atrial fibrillation, but in many cases they help to make the symptoms less bothersome.

• Heart rate control: Slowing down and controlling the heart rate during episodes of atrial fibrillation can significantly improve symptoms. To control heart rate during episodes of atrial fibrillation, we use medications, including beta-blockers, calcium blockers and digoxin.
• Stroke prevention: We may prescribe oral blood thinners to patients with a significant risk for stroke. In patients with less risk, aspirin or heparin may be effective. For some patients, devices or surgery that may eliminate the source of stroke might be considered.
• Heart rhythm control: By maintaining the heart rhythm in its normal state, sinus rhythm, we can prevent episodes of atrial fibrillation. Medications called anti-arrhythmic drugs help control heart rhythm for low-risk patients.

Catheter ablation

Catheter ablation is a nonsurgical treatment for irregular heartbeats, including atrial fibrillation that locates and destroys abnormal electrical pathways in the heart that cause the irregular heartbeat. Each year, at Northwestern Medicine, the Center for Heart Rhythm Disorders performs thousands of catheter ablations with a high rate of success. Although cardiac ablation can be successful, some people may need a repeat cardiac ablation in the future. After cardiac ablation, you may also need to take medication related to the atrial fibrillation diagnosis.

Surgical options

While medical management and catheter ablation are used to treat atrial fibrillation, some patients benefit from surgery. The “classic” or “cut and sew” Maze procedure is a surgical option for patients with:

• Atrial fibrillation despite medical management
• Severe symptoms
• Need for valve surgery or coronary artery bypass graft surgery
• Heart failure

The “classic” or “cut and sew” Maze procedure creates electrical blocks or barriers in the upper heart chambers (atria) that redirect the abnormal electrical signals of the heart that cause atrial fibrillation, restoring the heart rhythm. This Maze procedure is an open-heart surgery, performed through a chest (sternotomy) incision with the use of a heart-lung bypass machine.

Minimally invasive surgical options

Total thoracoscopic modified MAZE (TTm MAZE) and Convergent are two minimally invasive surgical options for the treatment of chronic, long standing, or persistent atrial fibrillation. TTm Maze may be offered to patients with atrial fibrillation that remain symptomatic after multiple catheter ablations procedures. Convergent may be offered to patients early in their treatment for atrial fibrillation.