What treatments are available for atrial fibrillation?
1. Atrial fibrillation can be treated with medication. In some people these medicines can be very effective. In others however, the medications are ineffective and may produce side effects. If you elect to take medication, your doctor will discuss the different options and the possible side effects of these medications.
2. DC Shock. When the heart is in fibrillation it can be reverted to the normal rhythm with a “shock on the chest”. You receive a short general anaesthetic and the shock reverts the rhythm to normal in the majority of cases. With this approach the possibility of the fibrillation returning remains present (approximately 50% of patients will have another episode of atrial fibrillation over the next year). In addition, most patients will also require medication to try to prevent the fibrillation coming back.
3. Blood Thinning medication. Because of the risk that atrial fibrillation may cause blood clots in the heart most patients with this heart rhythm disturbance will require blood-thinning medication to prevent blood clots forming. At your doctors discretion this may either be with aspirin or warfarin.
Can Atrial Fibrillation Be Cured?
At the present time only very few patients with atrial fibrillation can be cured. Unfortunately, for the majority of patients with atrial fibrillation this is not possible at the present time.
What is AV node ablation and how will a pacemaker help?
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AV node ablation and pacemaker implantation is usually reserved for patients in whom all other treatments of atrial fibrillation have been ineffective.
The first step is to implant the pacemaker. By itself the pacemaker will not improve the way you feel. However, following this a special procedure called AV Node ablation (sometimes also called His bundle ablation) will be performed. This procedure is a simple procedure which effectively “knocks out” the AV node. This will prevent any of the electrical short-circuits in the atria from reaching the ventricles. The pacemaker will now have complete control of your heart rhythm. The heart rhythm will be regular and will no longer race rapidly.
What are the advantages of having an AV Node Ablation and Pacemaker Inserted?
- Your heart will no longer race rapidly but will be appropriately controlled by the pacemaker.
- Your heart rhythm will be regular. 3. You will no longer require many of your medications to control the heart rhythm (you should check with your doctor as to which ones you may stop taking).
- There is a very high probability that you will feel very much better.
What are the disadvantages of having an AV Node Ablation and Pacemaker Inserted?
- This procedure will control the heart rhythm but the multiple short circuits in the atria will still be present. You will simply no longer be aware of them. Thus, the procedure does not cure the condition. It only treats the symptoms.
- YOU WILL STILL NEED WARFARIN.
- You will be dependent on the pacemaker.
- The procedure cannot be reversed.