- The heart maintains blood circulation
- The heart has two sides (right and left)
- Each side has two chambers, one top chamber (atrium) and one bottom chamber (ventricle)
Blood circulation through the heart
- Blood flows from the veins into the top chambers (atria) and passes into the bottom chambers (ventricles)
- Ventricles pump blood out into the arteries
- The right side receives blood from the body and pumps it to the lungs
- The left side receives oxygenated blood from the lungs and pumps it to the rest of the body
- The lungs and the left atrium are connected via pulmonary veins which are located adjacent to the left atrium
Normal heart rhythm
The heart’s natural pacemaker, the sinoatrial (SA) node, sets the regular heart beat rhythm
- SA node initiates the heart beat by sending out electrical signals
- Electrical signals stimulate the top chambers (atria) to contract and pump blood into the bottom chambers (ventricles)
- AV node sends out electrical signals to the ventricles
- Electrical signals stimulate the ventricles to contract and pump blood out to the lungs and the rest of the body
Abnormal heart rhythm / atrial fibrillation
This most common cardiac arrhythmia is caused by abnormal pacemaker activity in the pulmonary veins.
- Electrical signals from the pulmonary veins disturb the normal electrical signals in the heart
- The pulmonary vein signals trigger atrial fibrillation
- Electrical signals spread as erratic circular waves stimulating the top chambers (atria) to fibrillate (contract irregularly and rapidly)
- Ventricles also receive abnormal electrical stimulation and may contract quickly
- Atria and ventricles are uncoordinated causing an irregular heart rhythm
- Blood is inefficiently pumped and can pool, forming clots in the atria
About the condition
Clinical impactAtrial fibrillation (Afib/Af) tends to progress from paroxysmal (occasional, short and self-terminating), through persistent to chronic (long term). People with Afib are 5 to 7 times more likely to suffer a stroke and are at an increased risk of heart failure, but may also suffer only minor effects.
Signs and symptoms
- Palpitations (heart fluttering or racing)
- Shortness of breath
- Weakness or problems exercising/exhaustion
- Chest pain, pressure, discomfort
- Dizziness, fainting, lightheadedness
- Tiredness, lack of energy
- Many patients are asymptomatic (do not suffer symptoms)
DiagnosisThere are a variety of methods, including electrocardiography (ECG), echocardiography, several monitoring devices and stress tests, that check for atrial fibrillation and if an atrial fibrillation treatment is needed.
2% of the developed world population, including 20 million Europeans and Americans, suffer from Afib
Underlying factorsCardiac arrhythmia may occur due to a heart abnormality or chronic high blood pressure. It is often associated with aging, obesity, hyperthyroidism, smoking or excess alcohol. Family history can play a genetic role.
Atrial fibrillation treatment options
Afib medications, antithrombotics/antiarrhythmics, are one of several atrial fibrillation treatment options and are used to prevent the formation of thrombi (clots) and reduce the risk of strokes, but carry a risk of bleeding. Atrial fibrillation medication is used to maintain a normal heart rhythm.
Cardioversion is where, under brief anesthesia, an electric shock is applied to the heart to normalize its rhythm. This technique necessitates antithrombotic treatment due to the increased risk of thromboembolism (blockage of blood vessels by clot).
Catheter ablation for atrial fibrillation is currently for patients who are suffering paroxysmal (occasional) abnormal heart rhythm despite medication. It is a minimally invasive treatment designed to block the abnormal pacemaker activity in Afib. A catheter (a thin, flexible tube) is directed, via entry into the body from the groin, through the veins, into the left atrium and pulmonary veins. Energy is delivered from the catheter to ablate (damage) the small area of heart tissue where the abnormal electrical activity occurs. This stops dysfunctional electrical stimulation, treats Afib and restores normal heart rhythm. The energy source required for ablation can be ultrasound, heat (radiofrequency ablation), cold (cryoablation) or laser. We believe, our simplified technique using laser light is the most precise and best ablation method for atrial fibrillation treatment. Please read about our method of cardiac ablation for Afib.