A serious consequence of atrial fibrillation is stroke, which is five times more likely in patients with afib.

Afib can be caused by high blood pressure, obesity, sleep apnea, heart disease, stress and excess caffeine or alcohol intake.  Some people feel poorly when they are experiencing atrial fibrillation, while others may not feel any differently at all. Likewise, some people experience afib for just short periods of time, while others are always in a state of afib. 

The prevalence of this disease is increasing in epidemic proportions. Thankfully, available treatment options are also growing. UT Health Physicians offers patients the complete spectrum of atrial fibrillation care.

Treating Afib

The electrophysiology team at UT Health Physicians is dedicated to making our practice a site of excellence in treating atrial fibrillation and preventing the adverse effects of the disease.

Some patients with atrial fibrillation may be treated using a “rate control approach”, where afib is maintained while the heart rate is controlled. This is achieved using medication or through a minimally invasive technique, coined “ablate and pace,” which involves ablation of the atrioventricular (AV) node and implantation of a pacemaker. For many of these patients, an external monitor or a small implantable monitor is used to regularly assess the heart’s rhythm and rate over a prolonged period of time.

Other patients may be candidates for a “rhythm control approach” in which a normal heart rhythm is maintained using external cardioversion. Additionally, different medicines, including beta-blockers and anti-arrhythmic medications, are used to help maintain a normal heart rhythm. 

Patients who experience negative symptoms due to their atrial fibrillation may be candidates for surgical treatments. The electrophysiology program at UT Health Physicians offers advanced surgical procedures for treating atrial fibrillation.

Some of our patients are currently participating in the aMAZE trial to study a two-stage procedure for treating patients with atrial fibrillation. Patients who participate in this trial undergo minimally invasive surgery for a suture ligation of the left atrial appendage and subsequently undergo a catheter ablation procedure to isolate the pulmonary veins.

Catheter ablation is a minimally invasive surgical procedure in which 3-D mapping of the heart is performed and the pulmonary veins are electrically isolated using either radiofrequency energy or a cryoablation balloon. 

For patients with more long-standing, persistent afib, a treatment called hybrid ablation may be considered. This treatment involves minimally invasive surgery followed by a catheter ablation to achieve higher success rates in suppressing afib. 

UT Health Physicians is dedicated to discovering and offering our patients the most advanced care for atrial fibrillation. 

Reducing the Risk of Stroke in Patients with Afib

The physicians at UT Health insist that all patients with atrial fibrillation undergo a stroke risk assessment. Many patients are candidates for taking oral blood thinner medication to help decrease their risk of having a stroke. There are many options for blood thinners, but the decision about taking blood thinners should be made between the patient and their doctor with consideration given to the bleeding risks and other factors. 

For many patients, the stroke risk and bleeding risk may both be high. In cases where a blood thinner cannot be used long-term, UT Health offers patients a minimally-invasive procedure called WATCHMAN™. During this procedure, a device is implanted to close the left atrial appendage to prevent clots from forming in that area of the heart. If the procedure is successful, patients can ultimately be taken off of their oral blood thinners. 

UT Health Physicians offers excellent care for atrial fibrillation, including:

• Recognition as the only center in the region participating in the aMAZE trial for persistent afib
• Establishing the first program to perform left atrial appendage suture ligation in the region
• Expertise in both radiofrequency catheter ablation and cryoablation for afib
• Regional expertise in the use of novel oral anticoagulants
• A hybrid surgical and catheter ablation program
• An established, multidisciplinary team implanting left atrial appendage closure devices

This article was written by Manoj M. Panday, M.D., a board certified clinical cardiac electrophysiologist. Dr. Panday has led the cardiac electrophysiology program at UT Health Physicians for over 10 years. He specializes in non-invasive and invasive treatment of patients with heart rhythm disorders. 

If you or someone you know has afib and is interested in treatment options, call UT Health San Antonio at 210-450-4888.