Atrial Fibrillation

Advanced technology for heart rhythm monitoring includes a very small monitor that is injected under the chest skin and, over an extended period, monitors every heartbeat 24/7. Information received from the monitor, including arrhythmias that may be sporadic and intermittent, is automatically and wirelessly transmitted to the patient’s physician. This type of device vs. a wearable monitor, may be an option.

Our physicians participate in clinical trials, national registries and conduct cutting-edge laboratory research to advance treatment of cardiac arrhythmias and ensure our patients receive the best possible care.

Treatments for atrial fibrillation can include:

• Atrial fibrillation rhythm control medications to prevent atrial fibrillation and stop the associated symptoms
• Anticoagulation (blood thinning) medications to prevent stroke in patients with atrial fibrillation
• Catheter-based ablation of atrial fibrillation and atrial flutter to prevent atrial fibrillation and stop related symptoms when rhythm medications are ineffective or cause side effects
• Catheter-based left atrial appendage closure for prevention of stroke and systemic thromboembolism in atrial fibrillation. Many patients cannot tolerate blood thinners (anticoagulants) due to bleeding, falls or other concerns. Yale New Haven Hospital offers a minimally invasive procedure to implant a small, umbrella-like metal device (WATCHMAN FLX™) in the left atrial appendage that prevents blood clots from forming in the heart and causing stroke. An alternative device (Lariat®) closes the left atrial appendage with a loop of suture. With either device most patients can come off blood thinners and remain only on aspirin.
• Comprehensive risk factor testing and management for associated conditions like obstructive sleep apnea, high blood pressure, diabetes, and congestive heart failure
• Genetic testing, as appropriate, for heart conditions that may be associated with atrial fibrillation
• Pulsed field ablation, an advanced technology that uses short electrical pulses to treat AFib
• Surgical procedures (Maze and left atrial appendage closure/excision, hybrid ablation)

Pulsed Field Ablation for AFib

Among our advanced treatments for atrial fibrillation is pulsed field ablation. This new technology uses short electrical pulses to ablate cells that are triggering the AFib, without damaging surrounding structures. Studies suggest this new, highly precise technique safely and effectively treats atrial fibrillation with faster procedure times than traditional methods and with low complication rates.

Sometimes treatment for atrial fibrillation includes cardiac ablation performed by an electrophysiologist and surgery performed by a cardiac surgeon. There are two types of procedures that include surgery to treat this arrhythmia:

Hybrid atrial ablation (convergent) procedure: This procedure involves an electrophysiologist and cardiac surgeon to treat atrial fibrillation. During the procedure, an electrophysiologist will treat the inside of the atrium (two of the heart’s four chambers) using either radiofrequency to burn (scar) the tissue or cryoablation to freeze it.

Maze Procedure Surgery: With the maze procedure, the surgeon can use small incisions in the heart tissue and burn or freeze the area, thereby creating scar tissue that does not conduct the electrical activity causing the atrial fibrillation. The scar tissue directs electric signals through a controlled path, or maze, to the lower heart chambers (ventricles) and can maintain a normal heart rhythm. Similar surgery can also be performed to treat ventricular arrhythmias.

Through our centralized program, we can provide a physician referral and initial appointment with one of several electrophysiologists on our medical staff. Physician offices are conveniently located in New Haven, Branford, North Haven, Bridgeport, Greenwich and New London. To learn more or to make an appointment, please call the Atrial Fibrillation Program at 203-785-4126.