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Atrial Fibrillation

About Atrial Fibrillation

About Atrial Fibrillation

Atrial fibrillation is the most common type of abnormal heart rhythm. During atrial fibrillation, erratic electrical impulses start in the upper chambers of the heart (atria), which affect the normal electrical pathway through the rest of the heart. The heart beats too fast, resulting in a lower blood flow to the body and a higher risk for clots, stroke or heart failure. Proper treatment reduces the risk for serious problems.

The University of Chicago Approach

At the University of Chicago Medicine, our team of electrophysiologists, cardiac surgeons, cardiac nurses and other heart care specialists provide the full spectrum of diagnostic and treatment options for people with atrial fibrillation. Our heart experts regularly care for people who have complex arrhythmias or co-existing heart or medical conditions.

We offer solutions that can cure or greatly reduce the occurrence of atrial fibrillation. If a procedure or surgery is required, it can typically be performed through using a minimally invasive approach in our state-of-the art electrophysiology lab or through the use of robotic surgical techniques.

Comprehensive Treatment for Atrial Fibrillation

The goal of atrial fibrillation treatment is to return the heart to a normal rhythm and to reduce the risk for complications associated with the arrhythmia, such as blood clots or stroke.

Our physicians assess each patient's case individually to determine the optimal treatment, taking into account several factors, such as the onset of atrial fibrillation, the severity of the condition and symptoms, the existence of other medical conditions, and the patient's medical history. Treatment options include:

Medications

University of Chicago electrophysiologists have years of experience determining the right medicines and dosages for people with atrial fibrillation. Medications are typically the first-line treatment for the condition. Antiarrhythmic medicines can be used to restore and maintain a normal rhythm and to slow the fast heart rate commonly associated with atrial fibrillation. Blood thinners (also called anticoagulants) are often prescribed to prevent blood clots, therefore reducing the risk for stroke.

For some people with atrial fibrillation, antiarrhythmic drugs are ineffective, can lose effectiveness over time or are not ideal due to negative side effects. In those cases, other treatment options are considered, such as ablation therapy, cardioversion or a pacemaker.

Electrical Cardioversion

Electrical cardioversion is a treatment that involves delivering a short electrical shock to the chest which helps reset the heart to a normal heart rhythm. A special external defibrillation machine is used. This treatment is performed while the patient is under sedation in our electrophysiology lab and patients can often go home the same day.

Radiofrequency Catheter Ablation

3D CT scan of ablation map Three-dimensional CT scan. This CT scan provides a view from within the heart to help the physician guide placement of ablation lesions during a catheter ablation procedure. The red dots depict the ablation sites around the opening of a pulmonary vein in the left atrium.

Radiofrequency catheter ablation is a treatment that uses high frequency radio waves to destroy the tissue source of atrial fibrillation. Catheter ablation can cure atrial fibrillation--especially in patients with paroxysmal atrial fibrillation (occasional episodes of atrial fibrillation) -- with success rates reaching 70-80 percent.

The procedure involves the use of a specially designed catheter that is threaded through the leg into the heart. The catheter is used to locate the arrhythmia source, and a device attached to the tip of catheter delivers high-frequency radio waves to heat the tissue and eliminate the source. «Learn more about our expertise with catheter ablation therapies.

Surgical Ablation Treatment

Some people with atrial fibrillation may have other heart conditions, such as mitral valve disease that requires valve repair/replacement or atherosclerosis that necessitates coronary bypass surgery. In select cases, physicians may determine that a surgical approach is the best method to treat the arrhythmia because of the patient's anatomy, prior unsuccessful catheter treatments or other concerns.

At the University of Chicago Medicine, our cardiac surgeons perform the modified Maze procedure that delivers radiofrequency energy to heart tissue to redirect the electrical pathways through the heart. This treatment is performed during open-heart surgery or using minimally invasive techniques done through small incisions in the chest. »Learn more about surgical treatment of atrial fibrillation.

Pacemakers

A pacemaker is a small device that monitors heartbeats and emits electrical impulses to regulate heart rhythm. For people with atrial fibrillation, a pacemaker will be used in conjunction with another treatment for the condition, but does not actually treat atrial fibrillation. You may need a pacemaker after having certain types of ablation therapy, or when heart medicines may cause the heart to beat too slowly.