Atrial Fibrillation Treatment Guide

Transcription

1 Atrial Fibrillatio Treatmet Guide

2 Uderstadig Atrial Fibrillatio The most importat step you ca take toward maagig your Afib is to be iformed about your coditio ad proactive about seekig the right treatmet at the right time. Baptist Health welcomes the opportuity to parter with you to provide the highest quality, most advaced approaches available to help you fid your freedom from Afib. What is Atrial Fibrillatio? Atrial fibrillatio (Afib) is the most commo type of heart rhythm disorder (arrhythmia), impactig about 2.7 millio people i the Uited States. Normal Heart The heart has a electrical system, which provides sigals to the chambers of the heart idicatig whe they should cotract (squeeze) or relax. Afib is caused by chaotic electrical sigals, which make the upper chambers of the heart (the atria) quiver, istead of fully cotractig. For someoe with Afib, the atria may beat as ofte as 300 times a miute, about four times faster tha ormal. Afib is a progressive coditio, meaig that if it is ot treated, it ca worse. Whe this occurs, episodes ted to become more frequet ad last loger. It is importat to see a doctor if you have symptoms, because treatig Afib early o improves log-term success rates. 2 Afib Treatmet Guide Afib Heart

3 Risk Factors Eve people committed to healthy lifestyles, who have o other medical problems, ca develop Afib. There are a umber of factors, however, that ca icrease a perso s risk for developig Atrial fibrillatio: Icreasig age (60 ad greater) Coroary artery disease Prior heart attacks Cogestive heart failure Prior ope-heart surgery Utreated atrial flutter (aother type of abormal heart rhythm) Heart valve disease Afib Risk Chroic lug disease High blood pressure Diabetes Obesity Smokig Thyroid disease Sleep apea Excessive alcohol or stimulat use Icrease Age 60 ad greater Afib Treatmet Guide 3

4 Symptoms Some people with Afib do ot feel ay symptoms at all. Others otice a differece as soo as a Afib episode happes. Symptoms ca be differet for each idividual, depedig o age, the cause of the Afib, ad how much Afib affects the pumpig efficiecy of the heart. Symptoms iclude: Feelig overtired or havig little to o eergy A faster-tha-ormal or irregular pulse Shortess of breath Palpitatios (poudig, racig, or flutterig heart) Trouble with everyday exercises or activities Pai, pressure, tightess, or discomfort i your chest Lightheadedess, dizziess, or feelig like you could pass out If you are experiecig ay of these symptoms, please schedule a appoitmet with your doctor. If you do t have a regular doctor, we ca help you fid the right oe for you. If you are experiecig chest pai, emergecy medical actio should be take immediately, as it could be a sig of a heart attack. 4 Afib Treatmet Guide

5 Risks of Leavig Afib Utreated While Afib itself is ot usually life threateig, if left utreated, the effects of Afib ca be potetially life threateig. Afib makes it more difficult for the heart to pump blood efficietly. With the blood movig more slowly throughout the body, it icreases the chaces for a blood clot to form. If a clot is pumped out of the heart ad travels to the brai, it ca cause a stroke. Afib is actually the leadig cause of stroke i the U.S. ad people with Afib are five times more likely to have a stroke tha someoe without Afib. Without treatmet, Afib ca also make the heart beat too fast for log periods of time, causig the heart muscle to weake. This coditio is called cardiomyopathy ad ca lead to cogestive heart failure ad result i log-term disability or death. If treated early ad properly, however, people with Atrial fibrillatio ca live ormal, healthy ad log lives. The key is beig proactive about your care. Progressio of Afib There are four stages of Afib progressio. The sooer you receive appropriate treatmet, the higher the likelihood that it ca be successfully treated. Paroxysmal Afib Sigs or symptoms occur spotaeously ad heart restores to ormal rhythm withi seve days of oset Persistet Afib Irregular rhythm lasts cosistetly for loger tha seve days Did You Kow? Afib is the leadig cause of strokes i the Uited States People with Afib are likelier to have a stroke 5x Logstadig Persistet Afib Irregular rhythm lasts cosistetly for loger tha 12 moths Permaet Afib Irregular rhythm lasts idefiitely Afib Treatmet Guide 5

6 Diagosig Afib To diagose Afib, your physicia will review your symptoms ad risk factors ad perform a physical examiatio. He or she may also order oe or more of the followig diagostic tests: Electrocardiogram (EKG) A EKG is a sapshot of your heart s electrical activity. Stickers (electrode sesors) are attached to your chest, arms ad legs to pailessly measure your heart s rate ad rhythm. A EKG is commoly used to diagose Afib. Holter moitor A Holter moitor is a small, portable EKG device, usually placed i a pocket or wor o a belt. It records the heart s activity for 24 to 48 hours i order to provide your physicia with a more i-depth look at your heart s rhythms ad rates. Evet recorder A evet recorder is a small, portable device, much like a Holter moitor, used for patiets who have a irregular heart rhythm every oce i a while. You will carry it with you ad activate it whe you feel symptoms. Echocardiogram This test uses soud waves to produce images of your heart, eablig your doctor to assess ay potetial structural issues. The stadard type is called trasthoracic echocardiagram (TTE), which is o-ivasive ad coducted by a traied techicia. With the secod type, a trasesophageal echocardiogram (TEE), you are give a small amout of sedatio through a itraveous (IV) lie ad a trasducer is iserted through your mouth ad esophagus to give a better picture of your heart s atria. Cardiac computerized tomography (CT) A cardiac CT uses a X-ray machie ad a computer to take clear, detailed pictures of the heart. This test creates a threedimesioal (3D) picture of your heart ad chest. Magetic resoace imagig (MRI) A cardiac MRI uses radio waves, magets, ad a computer to create images of your heart ad videos of it beatig. Doctors use a cardiac MRI to see the beatig heart, the parts of the heart, ad how it is workig. 6 Afib Treatmet Guide

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8 Treatig Afib The goals of treatmet for Atrial fibrillatio iclude regaiig a ormal heart rhythm (sius rhythm), cotrollig your heart rate, prevetig blood clots ad reducig the risk of stroke. May optios are available to treat Afib, icludig lifestyle chages, medicatios, catheter-based procedures ad surgery. The type of treatmet that is recommeded for you is based o your particular heart rhythm ad symptoms. Medicatios There are, geerally, three types of medicatios to help maage Afib: Aticoagulats are used to reduce blood clottig ad prevet stroke i Afib patiets. They ca rage from aspiri, which causes platelets to become less adhesive, to prescriptio medicatios like warfari, which this the blood to prevet coagulatio. Rate cotrol medicatios, such as beta blockers, calcium chael blockers ad cardiac glycosides, ca be used to brig the heart rate dow i order to reduce Afib symptoms. Atiarrhythmics are rhythm cotrol medicatios. From sodium chael blockers to potassium chael blockers, they ca impede the electrical sigals that cause Afib, thereby keepig it suppressed i order to maitai ormal rhythm. Procedures Whe medicatios do ot work to cotrol Afib, or whe they are ot well tolerated, a procedure may be eeded to treat your abormal rhythm. Cardioversio is a outpatiet procedure performed uder shortactig sedatio that electrically resets the heart. A low dose of eergy reactivates ormal rhythm, although its effect may ot be permaet. Catheter ablatio is a miimally ivasive procedure that typically applies radiofrequecy eergy to elimiate the small areas of heart tissue that are causig your Afib. Catheter ablatio is desiged to restore the heart s ormal rhythm o a log-term basis. A electrophysiologist (EP) performs the procedure, guidig catheters to the heart usually through a vei i the groi or eck. The procedure ca take up to several hours ad is performed uder sedatio with a aesthesiologist. Patiets typically go home the followig day ad retur to ormal life ad activities i oe to two weeks. Medicatios for cotrollig the arrhythmia may be reduced or eve elimiated followig successful catheter ablatio. See page 10 for more o the latest advaces i catheter ablatio techologies. 8 Afib Treatmet Guide

9 Devices Pacemakers are small electrical devices, implated uder the ski close to the collarboe, that trasmit a electrical sigal to cotrol proper cotractig of the heart s rhythm. Baptist Health offers the latest MRI-compatible pacemakers ad was oe of the first research ceters i the atio to offer the ew leadless pacemaker. This advacemet allows the world s smallest pacemaker the size of a vitami to be placed directly ito the heart without ay attached wires ad offers umerous beefits. Implatable cardioverter-defibrillators (ICDs) are implated devices used to perform cardioversios ad restore ad correct pacig of the heart. Ulike pacemakers, they are also able to treat uexpected, lifethreateig arrhythmias such as Vetricular Tachycardia ad Vetricular Fibrillatio. Baptist Health offers the most advaced defibrillator techologies. The ew subcutaeous defibrillator has wires placed uder the ski istead of directly ito the heart to decrease chaces of ifectio. The ew ICD Mii is the world s smallest heart defibrillator. New bivetricular defibrillator implats ow utilize the latest bivetricular leads for patiets whose hearts are both weak ad out of syc to improve symptoms ad quality of life. Fid the right physicia. Your primary care doctor or cardiologist will typically prescribe medicatios for early stages of Afib, but it is importat to meet with a board certified cardiac electrophysiologist (EP) for a comprehesive evaluatio. A electrophysiologist, as a subspecialist i cardiology, will help you uderstad the advatages ad disadvatages of differet treatmets for symptomatic Afib, alog with the optimal timig of treatmet for best results. At Baptist Health, a coordiated team of cardiac experts, deliverig comprehesive care ad services, will address all of your medical issues. For help i fidig the right physicia to assess your symptoms, call Baptist Heart Specialists at AFIB (2342). Maze Surgery Maze surgery is a advaced procedure for those with persistet Afib, coducted by cardiac surgeos i collaboratio with cardiac electrophysiologists. Afib Treatmet Guide 9

10 Improvemets i Catheter Ablatio Treatmet Sigificat advaces have bee made i recet years i catheter ablatio treatmets for Afib. Baptist Health offers a full array of catheter ablatios for all abormal heart rhythms. We treat simple ad complex Afib cases utilizig the latest equipmet ad techiques. ThermoCool SmartTouch Catheter Cotact force therapy has emerged as the most sigificat recet advacemet i Afib treatmet, demostratig dramatically improved outcomes. Baptist Health is the first medical ceter i the regio to use the ew SmartTouch pressure-sesig catheter, which allows precise measuremet of cotact with the heart for more effective radiofrequecy ablatios ad improved safety. The ew techology also cools the tip of the catheter with salie to allow higher trasferece of eergy, eablig more effective ablatios. The procedure has a 80 percet overall success rate for patiets with Paroxysmal Atrial fibrillatio. Cryoballoo Catheter Baptist Health was oe of the first ceters i Jacksoville to offer the Cryoballoo ablatio. This balloo tipped catheter freezes the heart tissue istead of cauterizig it to produce similar success rates for patiets with Paroxysmal Afib compared with stadard radiofrequecy eergy. The Cryoballoo has a quicker procedure time, while the radiofrequecy catheter offers more flexibility to create complex lesios, if ecessary, to target all the ivolved areas i the heart. Itracardiac Ultrasoud Catheter Baptist Health was oe of the first ceters i the coutry to use the latest itracardiac ultrasoud catheter, which gives the same high quality ultrasoud images iside the heart as the stadard ultrasoud catheter but with a sigificatly smaller catheter. 10 Afib Treatmet Guide

11 Baptist Health was the first medical ceter i the regio to offer the safer, more effective ThermoCool SmartTouch Catheter Ablatio. Visit BaptistAfib.com to lear more. Advaced 3-D Mappig System We use the latest 3-D cardiac mappig systems, actig like GPS avigatio, to create virtual images of the heart s aatomy ad electrical system i real time. This allows our EP specialists to pipoit the source of abormal electrical sigals for improved success i eradicatig them. [ ] Did You Kow? More tha 50 percet of patiets with Afib either do t respod to, or caot tolerate, drug therapy. The America College of Cardiology ad the America Heart Associatio recommed catheter ablatio for patiets whe medicatio proves usuccessful. Afib Treatmet Guide 11

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13 Baptist Health Electrophysiology Program Baptist Health offers the most advaced ad comprehesive electrophysiology program i the regio. Advaced Techology Complete diagostic testig, icludig tilt-table testig ad EP studies Experieced EP physicias who diagose ad treat all heart rhythm disorders with a full spectrum of electrophysiology services Latest 3-D electrical mappig systems for greater precisio i eradicatig arrhythmias The most advaced pacemakers, defibrillators, ad bivetricular device implats Comprehesive Patiet Care Comprehesive treatmet optios for simple ad complex Atrial fibrillatio, with a full array of catheter ablatios Ogoig cardiology care through multiple coveiet locatios across the regio Your medical problems will be addressed by a coordiated team of cardiac specialists to make sure all facets of your health are addressed, with commuicatio back to your primary care physicia Regioal Excellece First health system i the regio to offer ThermoCool SmartTouch Catheter Ablatio for improved safety ad outcomes, as well as Cryoballoo Catheter Ablatio therapy Oly dedicated Heart Hospital i the regio, featurig a state-of-the-art EP Lab Oe of the first five ceters i the U.S. to use the miimally ivasive itracardiac ultrasoud catheter for high quality images iside the heart Afib Treatmet Guide 13

14 Baptist Heart Specialists is made up of over 30 board-certified, experieced cardiologists i eight locatios across ortheast Florida. We provide our patiets with a umatched rage of services ad expertise i heart care. A multidiscipliary team approach is used to meet patiet eeds for prevetio, diagosis, i-office procedures ad testig, outpatiet procedures, surgery, ad cardiac rehabilitatio. State-of-the-art Expertise Left to right, Scott Lee, MD, Vekata Sagi, MD, Aaditya Vora, MD, Chris Ruisi, MD Scott Lee, MD Director of Electrophysiology I am committed to takig the time eeded to help you fully uderstad your medical coditio ad offer you the most advaced treatmet optios available. Vekata Sagi, MD Cardiac Electrophysiologist I derive professioal satisfactio whe I kow I did my best to help you achieve a better quality of life. Beig part of your healig process is my ultimate achievemet. Our philosophy is to offer comprehesive services to our patiets utilizig the latest equipmet ad techiques. By offerig all modalities, we ca use our extesive experiece to tailor your treatmet pla ad [maximize success. Aaditya Vora, MD Cardiac Electrophysiologist I am dedicated to helpig you uderstad your coditio as well as available treatmet optios so that together we ca make the best decisio to help improve your quality of life. Chris Ruisi, MD Cardiac Electrophysiologist Every patiet is uique ad, to that ed, I strive to provide you with a thoughtful treatmet strategy that ca provide a dramatic improvemet i your quality of life. [ 14 Afib Treatmet Guide

15 What to Ask Your Doctor If you have bee diagosed with Afib, or suspect that you may have the coditio, here are some questios that you may wat to ask your physicia: What is the cause of my Afib? How ca I be sure I have Afib ad ot aother heart rhythm problem? What are the risks that my coditio will become worse over time ad how ca I prevet it from becomig worse? Am I at icreased risk of stroke or heart attack? What are my treatmet optios? What are the risks ad side effects of medicatios to cotrol my coditio, or to reduce the risk of stroke? What are the risks ad beefits of other treatmet optios? Should I see a electrophysiologist (a specialist i heart rhythm disorders)? For More Iformatio Call Baptist Heart Specialists at AFIB (2342). We ca help you determie the type of physicia you should see, help you fid a coveietly located physicia, ad schedule your appoitmet. Afib Treatmet Guide 15

16 301 Hilliard NASSAU COUNTY Callaha Yulee 9A Feradia Beach A1A 1 2 Baptist Heart Specialists Baptist Health Jacksoville BAPTIST JACKSONVILLE - PAVILION 836 Prudetial Drive, Suite 1700 Jacksoville, FL FAX BAPTIST SOUTH Old St. Augustie Road, Suite 201 Jacksoville, FL FAX BAPTIST NASSAU 1340 S.18th Street, Suite 200, Bldg. B Feradia Beach, FL FAX BAPTIST CLAY 1747 Baptist Clay Drive, Suite 320 Flemig Islad, FL FAX Orage Park CLAY COUNTY Jacksoville DUVAL COUNTY Fruit Cove 9A Atlatic Beach Jacksoville Beach Pote Vedra Beach BAPTIST BEACHES th Aveue South, Suite 270 Jacksoville Beach, FL FAX UNIVERSITY 3599 Uiversity Blvd South, Suite 104 Jacksoville, FL FAX BAPTIST NORTH Baptist Health Drive, Suite 310 Jacksoville, FL FAX WORLD GOLF VILLAGE 533 Twicourt Trail, Suite 701 St. Augustie, FL FAX ST JOHNS COUNTY 95 8 A1A BaptistAfib.com 05/2018