Doylestown Hospital
595 West State Street, Doylestown, PA 18901 (215) 345-2200
V.I.A. Health System
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A-Plus Care for A-Fibrillation
What is AFib?
How is Atrial Fibrillation Diagnosed?
Treatment Options


Treatment Options


Have you been diagnosed with atrial fibrillation (AFib)?

You’ve come to the right place.

As the top cardiac hospital in the Bucks and Montgomery County area, Doylestown Hospital offers a wide range of AFib treatment options.

Atrial fibrillation, or AFib, is when the heart beats irregularly or too fast. AFib is commonly seen in patients with congestive heart failure.

AFib is a major risk factor for stroke and heart failure. According to the National Stroke Association, about 15 percent of all people who suffer a stroke have AFib, and people with AFib are five times more likely to have a stroke.

That’s why it is vital to treat AFib, often with a combination of lifestyle changes and medication. Some people may require a medical procedure as well.

Treatment Options include:

Lifestyles Changes and Medications

Lifestyle changes and medications can control less severe cases of AFib, but some patients may require additional treatment options to control their AFib.

Lifestyle changes may include quitting smoking, limiting your intake of alcohol, limiting use of caffeine as well as avoiding certain cough and cold medications that may increase your risk of an irregular heart rhythm.

Ablations and Other Procedures

Ablation removes a part of biological tissue (cells), usually by surgery. Ablation therapy using radio frequency waves on the heart is used to cure a variety of cardiac arrhythmias as noted below.

Cryoablation

Cryoablation is used to restore normal electrical conduction in the heart. A balloon-based technology is used to ablate, or destroy, cardiac tissue through the use of a coolant for freezing.

Radiofreqency Ablation or RF Ablation

RF Ablation is a minimally invasive procedure used to treat some types of rapid heart beating, such as atrial fibrillation, atrial flutter and atrial tachycardia. This procedure involves a guided catheter with an electrode at the tip directed at the damaged area of the heart muscle and then a mild, painless radiofrequency energy is transmitted to the site of the pathway. Cells in a very small area of the heart muscle die and the heart stops conducting the extra impulses that caused the rapid heartbeats.

Ablation of Ventricular Tachycardia (VT)

VT is a tachycardia, or fast heart rhythm, that originates in one of the ventricles of the heart.

Electrophysiologists perform ablations on patients who have severe weakening of the bottom chambers of the heart, called cardiomyopathy. Often these patients are prone to having life-threatening arrhythmias from the bottom chambers of the heart called ventricular tachycardia. Doylestown Hospital physicians have extensive expertise performing ablations of ventricular tachycardia.

Epicardial Ventricular Tachycardia (VT) Ablation

During percutaneous Epicardial VT ablation, electrophysiologists target the abnormal rhythms on the outside of the heart without open-heart surgery. They use a small needle placed through the chest wall and into the pericardium. Special catheters are then placed through the needle and burns are accomplished on the outside of the heart to eliminate the dangerous arrhythmias.

Atrioventricular Node (AVN) Ablation 

The atrioventricular node (AV node) is a part of the heart’s electrical control system that coordinates the top chambers. It electrically connects atrial and ventricular chambers.

During this procedure catheters are inserted through the veins and guided to the heart. The AV node is severed or altered by radiofrequency energy which is delivered through a catheter, which then prevents the electrical signals of the atrium from reaching the ventricle. The outcome is permanent which results in a patient needing a pacemaker to maintain an adequate heart rate.

Premature Ventricular Contraction Ablation (PVC)

Premature Ventricular Contraction are the most common of irregular heartbeats. You can control most cases of PVC with lifestyle changes such as reducing or eliminating your caffeine, tobacco and alcohol intake and reducing stress and anxiety. A beta blocker medication may also be prescribed for patients with PVCs. Ablation is another treatment option for some patients with frequent or prolonged PVCs.

Supraventricular Tachycardia Ablation (SVT) 

A rapid heart rhythm originating at or above the atrioventricular node is known as a supraventricular tachycardia (SVT).

Catheter ablation of SVT is an option for patients who have significant side effects from medication.

Cardioversion

An electrical shock is delivered to the heart to convert, or change, an abnormal heart rhythm back to normal sinus rhythm in this corrective procedure.

Device Therapy: Pacemakers & Defibrillators

Pacemakers

A pacemaker is a small electrical device implanted in the body with wires going to the heart to regulate the heartbeat. It is implanted under the skin near the collarbone and sends out an electrical signal to keep a steady contracting rhythm in the heart. Some pacemakers sense when the heartbeat is too fast, too slow or irregular and fire impulses that help the heart return to the proper rhythm and speed. (AHA)

Implantable Cardioverter Defibrillators (ICDs)

An implantable device that regulates the rate and rhythm of the heart. The device is implanted in patients who are at risk of sudden cardiac death due to recurrent, sustained ventricular fibrillation (abnormal heart rate). The ICD is implanted under the skin and programmed to send an electrical shock when it detects that the heart's ventricles are pumping at a faster than normal rate. This shock restores the heart rate to normal.

Bi-Ventricular Implantable Cardioverter Defibrillator (ICD)

A biventricular ICD may be used for patients with severe left ventricular heart failure. This allows for a more balanced method of controlling a rapid heartbeat. The biventricular ICD leads are attached in the right atrium, right ventricle and left ventricle, which then detects when the heart is beating at a faster than normal rate and shocks it back to normal.

Surgical Treatment

Maze Surgery

For this procedure, the surgeon makes small cuts or burns in the atria. These cuts or burns prevent the spread of disorganized electrical signals. This procedure requires open-heart surgery, so it is usually performed at the time of surgery for other problems such as coronary artery disease or heart valve disease, which can increase the risk of AFib.

Convergent Maze Procedure

Sometimes, advanced forms of AFib do not respond to other therapies, and treatment requires a “convergent maze” procedure. For this procedure, a cardiothoracic surgeon reaches the heart via a 1-inch incision in the upper abdomen using a video-assisted scope. The surgeon is able to ablate, or destroy, arrhythmia-generating areas by applying radiofrequency energy on the outer surface of the heart.

What is The Convergent approach?

A truly minimally invasive approach that combines the best of electrophysiology (EP) and cardiac surgery treatments to help restore normal heart rhythm for longtime arrhythmia sufferers, including patients with structural heart disease who may have previously failed one or more other treatments.

Which patients are not candidates for The Convergent approach?

Patients who have had previous open chest surgical ablation procedures are not eligible for The Convergent Approach. Please consult with your physician to explore your treatment options.

A Comprehensive, Heart Team Approach For Arrhythmia Patients

Combines Best Techniques of EP and Surgeon

  • Single Setting
  • No Chest Incisions or Ports
  • Minimal Pain
  • Short Hospital Stay
  • Intraoperative Diagnostics
  • Confirm Success

How is the procedure performed?

The procedure uses radiofrequency (focused heat) to produce lesions (scar tissue) on the heart to block abnormal electrical signals. During the procedure, a cardiac surgeon and an EP work as a team, in a single setting. The surgeon is able to create comprehensive, linear lesions on the outside surface of a beating heart through a small incision (2cm) made in the patient’s abdomen, instead of through invasive chest incisions and/or ports, as in other surgical procedures. The EP then threads a catheter through the patient’s femoral vein, in the groin, to reach the heart and fill in any gaps in the completed ablation pattern and utilizes diagnostic techniques to confirm all abnormal electrical signals have been interrupted.

What is recovery like?

Most patients who’ve undergone The Convergent Approach experience restored normal heart rhythm and have been able to stop taking daily heart rate and rhythm medications shortly following treatment. Typical hospital stays have lasted two to three days.

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