What you Need to Know About Atrial Fibrillation 
Approximately 2.5 million Americans experience atrial fibrillation each year. This common heart disorder occurs when electrical signals in the heart become irregular, causing the heart’s upper chamber to beat out of rhythm. Atrial fibrillation requires immediate medical attention because it could lead to a life-threatening stroke.

The Atrial Fibrillation Clinic at Saint Louis University Hospital, led by Dr. Ali Mehdirad, is a new, comprehensive outpatient evaluation and treatment center for patients to be examined for optimal rhythm and rate control. Our team of arrhythmia specialists works with patients to determine the best anticoagulation strategy and suitable candidates will be offered potentially-curative ablation procedures.

Our approach when treating atrial fibrillation is to first prevent stroke, secondly prevent the symptoms of atrial fibrillation, and finally to thoughtfully recommend ablation procedures for those patients whose symptoms cannot be controlled using medication.

Atrial fibrillation may or may not cause symptoms. Some people with the disorder can have palpitations, chest pain, fatigue, shortness of breath, dizziness, or confusion. The condition is diagnosed through an electrocardiogram, which measures the heart’s electrical impulses. In some cases, atrial fibrillation resolves on its own. Other times, an underlying condition such as an over-active thyroid, hypertension, diabetes, chronic lung disease, or heart valve disease must be treated. Medications may be prescribed to prevent blood clots or control heart rate. Cardioversion, another treatment option, can be recommended to shock the heart back to a normal rhythm by delivering a jolt of electricity to the heart. However, if these efforts are not successful, doctors could recommend atrial fibrillation ablation.

Atrial fibrillation ablation involves threading a long, thin, flexible tube called a catheter into the heart through a blood vessel in the arm, upper thigh, or neck. Live X-ray images are used to carefully guide the catheter into the heart. Several flexible tubes with electrodes on the tips are run through the catheter and placed in different small blood vessels in the heart. Sections of the heart are then mapped to locate abnormal tissue. Radiofrequency energy is applied to destroy targeted tissue that has been identified as causing the irregular heartbeat. The resulting scar line then acts as a barrier between affected tissue and the rest of the healthy heart, stopping abnormal electrical signals that cause an irregular heartbeat.

Patients may not eat or drink anything after midnight the night before going to the hospital. They are sedated during the procedure, but may still feel some lightheadedness, rapid heartbeat, burning when any medications are injected, or chest discomfort when energy is applied. An atrial fibrillation ablation procedure can last anywhere from four to nine hours. Following the procedure, pressure is applied to the site where the catheter was inserted, and patients must lie still for four to six hours. Their heart rate is closely monitored during this time. A chest X-ray, electrocardiogram, or transesophageal echocardiogram may be ordered to check the heart and prevent complications. Some patients are discharged the same day, while others need to stay in the hospital overnight. Most people resume normal activities in a few days.

Atrial fibrillation ablation may be a more effective treatment than medications. However, as with any procedure, there are risks associated with atrial fibrillation ablation. For more information, or to make an appointment with a physician in our clinic, call 314.977-4440.

Dr. Ali Mehdirad is a professor of internal medicine and director of electrophysiology.  Dr. Mehdirad is board certified in internal medicine, cardiovascular diseases and clinical cardiac electrophysiology.  He received his medical degree from the National University of Iran and his internal medicine residency and cardiology fellowship at Saint Louis University. He then completed additional training in the field of electrophysiology and arrhythmia management at Saint Louis University.