New Treatment for Patients with Atrial Fibrillation, or Afib

It is estimated that in 2030, more than 12 million people in the United States will be diagnosed with atrial fibrillation, or Afib, which in 2019 was the underlying cause of death for 26,535 people, according to the U.S. Centers for Disease Control & Prevention (CDC). Afib can result from any type of problem that changes the way the heart handles electricity, the CDC says, and sometimes the cause is unknown.

Experts at Baptist Health Miami Cardiac & Vascular Institute say Afib is the most common type of abnormal heart rhythm, or arrhythmia. During Afib, the heart receives electrical signals causing the heart’s upper chambers, or atria, to contract in a disorganized fashion. This causes the atria to fibrillate or quiver.

“The disorganized signals are then transmitted to the heart’s lower chambers, or ventricles, causing them to contract irregularly and oftentimes quickly, and the contraction of the atria and the ventricles is no longer coordinated,” explains Mario Pascual, M.D., an electrophysiologist with the Institute who specializes in diagnosing and treating heart rhythm disorders, or arrhythmias. “As a result, the amount of blood pumped out to the body will vary with each heartbeat and the ventricles may not be able to pump blood efficiently to the body.”

Mario Pascual, M.D., an electrophysiologist with Baptist Health Miami Cardiac & Vascular Institute

Many Afib patients have experienced successful outcomes with catheter ablation, Dr. Pascual notes. Also known as radiofrequency ablation, the procedure uses radiofrequency energy similar to microwave heat to destroy a small area of heart tissue that is causing the rapid and irregular heartbeats.

“Destroying this tissue helps restore your heart’s regular rhythm,” says the American Heart Association (AHA), adding that “catheter ablation destroys the abnormal tissue without damaging the rest of the heart.” Both the American College of Cardiology and the Heart Rhythm Society consider catheter ablation to be a first-line therapy for patients with Afib. Dr. Pascual says that the best outcomes result if the time from diagnosis to ablation is less than one year.

Catheter ablations getting an upgrade

And, says Dr. Pascual, a new technology available soon in the U.S. promises to make the procedure even safer as well as more efficient and effective. “Within the next few months, we’ll be able to start using a new type of energy source – pulse field ablation, or PFA – for catheter ablations.”

With PFA, high-frequency electrical impulses (“neither hot nor cold,” says Dr. Pascual) are delivered to the heart. “These impulses specifically target atrial tissue, which means there is minimal risk of damage to other structures that are near the heart.”

According to Dr. Pascual, the enhanced procedure should not only correlate with improved outcomes for patients but also even greater efficiency and safety. “The technology has been used successfully in Europe for the past several years,” he says. Also, the procedure time will be reduced by at least half with the new technology.

What are the symptoms of Afib?

Afib can cause different symptoms, says Dr. Pascual, who notes that 10 to 20 percent of people with the condition have no symptoms whatsoever and don’t even know they have it. It can be gradual and subtle, too, he adds. “Things that used to be easy to do become more difficult, and many patients think to themselves, ‘Oh, I’m just getting older,’ or ‘It’s because I’m out of shape.’”

For Afib patients who do experience symptoms, they commonly include one or more of the following:

• Irregular heartbeat
• Heart palpitations (rapid, fluttering or pounding)
• Lightheadedness
• Fatigue
• Shortness of breath
• Chest pain

Who’s at risk for Afib and what if it’s left untreated?

The CDC says Afib is more common in people who are older than 65, and more common in men than women. People of European descent are more likely to have Afib than African Americans. “Underlying heart disease, high blood pressure, thyroid problems, excessive alcohol use, sleep apnea, and certain lung disease put people at risk for atrial fibrillation,” it says.

“If left untreated, patients with Afib are more prone to developing blood clots that can possibly dislodge and shoot off to the brain, causing a stroke,” Dr. Pascual cautions. “There are several medications that do an excellent job at preventing these clots but they also increase the risk of bleeding so some patients aren’t candidates.”

Dr. Pascual stresses the importance of seeing your doctor or specialist if you experience any symptoms of Afib. “Don’t write off your symptoms to advancing age or not being in shape. See your primary care provider or cardiologist for an evaluation,” he advises. “If it is Afib, then we can talk about how to treat it.”

Catheter ablations for treating Afib are a common procedure performed at Miami Cardiac & Vascular Institute, according to Dr. Pascual, who, as one of three electrophysiologists on staff, has helped thousands of patients with Afib over the past 11 years. “We’re extremely proud of our results and outcomes,” he says.

The Institute last year opened the Atrial Fibrillation Clinic where patients with Afib and other heart rhythm disorders can receive comprehensive, multidisciplinary care for their condition. “Catheter ablations and medications are just a part of the process,” Dr. Pascual says. “We take a broader view and look at lifestyle issues that can be risk factors for Afib – obesity, hypertension, congestive heart failure and obstructive sleep apnea. We evaluate patient for risk factors that are increasing their risk for Afib.”