Innovative Treatments for Afib That Are Already Saving Lives

Find out about the standard—and the cutting edge—options for treating atrial fibrillation.

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By Patrick Sullivan

Your heart is a muscle, but it’s also a complex piece of electronics. Electrical impulses shoot through your heart, causing it to fill up with blood and squeeze it out into the rest of the body. Normally that electricity creates a nice, steady rhythm, but what happens when something goes out of whack? Then you have arrhythmia and atrial fibrillation, or Afib, is the most common type, affecting between 2.7 and 6.1 million people in the US each year.

What is Afib?

2 / 8 What is Afib?

Afib happens when the electrical impulse doesn’t move through the heart correctly, causing the top chambers of the heart—the atria—to flutter or quiver. All the blood doesn’t leave the upper chambers, causing it to pool. When blood pools it can form a clot, and a clot can leave the heart and block blood flow to the brain, causing a potentially deadly stroke. But Afib is treatable. Click through to learn more about some of the most cutting-edge Afib treatments available.

Medication options

3 / 8 Medication options

People with early atrial fibrillation may turn to medication as an early treatment. Treating Afib with medication is a three-pronged approach: There are drugs to slow the heart rate, drugs to regulate the electrical rhythm, and drugs to stop the blood from clotting and potentially causing a stroke. “A lot of people can go years with just medication,” says David Affleck, MD, a cardiothoracic surgeon at Ogden Regional Medical Center in Ogden, Utah. “The downside to this is you’re not changing the triggers that cause the Afib. You will probably need medication for the rest of your life.”


4 / 8 Cardioversion

Cardioversion means resetting the heart back to its normal rhythm. Sometimes that’s done with drugs called anti-arrhythmics, and sometimes a cardiac electrophysiologist will use an electrical shock to resent the heart rhythm. In some cases the doctor may implant a device, called a pacemaker, which sends steady electrical signals to the heart to help it maintain a normal rhythm.

Catheter ablation

5 / 8 Catheter ablation

When Afib can’t be controlled by medication or cardioversion, there are a number of procedures available as next steps, such as catheter ablation. Ablation kills the cells that create the irregular heartbeat, usually by burning or freezing them. With a catheter ablation procedure, a cardiac electrophysiologist snakes a catheter from the groin through a blood vessel to reach the area inside the heart that’s causing the irregular heartbeats.

Surgical ablation

6 / 8 Surgical ablation

In a surgical ablation, instead of using a catheter, a cardiothoracic surgeon does a maze procedure, either by opening up the chest or making small incisions by the armpits. The open heart ablation is the gold standard in atrial fibrillation treatment, says Affleck. “It has the highest cure rate, the lowest recurrence rate and the lowest long-term stroke rate. But it’s a big operation: you’re opening the sternum and deflating the lungs, and there’s a long recovery.”

Hybrid ablation

7 / 8 Hybrid ablation

Hybrid isn’t so much a technique as it is an approach, says Affleck. A hybrid ablation is one in which the cardiac electrophysiologist and the surgeon work together. One problem with catheter ablation is it’s hard to burn the back wall of the heart from the inside without damaging the aorta and esophagus, which sit behind the heart, while a surgical ablation is a difficult operation with a long recovery time. A hybrid approach can solve both problems. “Catheter ablation is one technique, surgical ablation is one technique, hybrid ablation is both working together,” says Affleck. “I do what’s difficult for a catheter to do, and the electrophysiologist does the burns that I find difficult.”

Convergent ablation

8 / 8 Convergent ablation

Even minimally invasive ablation surgery requires the surgeon to deflate each lung in turn in order to get to both sides of the heart. That’s too intense for some patients, especially those who are obese or whose lungs already don’t work well. In these cases, Affleck and his team will perform a convergent ablation. Similar to a hybrid ablation where the surgeon and the electrophysiologist work together, during a convergent ablation the surgeon goes in through the abdomen, eliminating the need to deflate the lungs.

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