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Vital Signs

Winter 2014

More Options Available to Treat Atrial Fibrillation


More options to treat atrial fibrillationAtrial fibrillation (AF) is the most common arrhythmia (abnormal heart rhythm) in the United States, with more than 150,000 new cases diagnosed each year. Although AF may produce a fast, irregular heartbeat that leads to palpitations, fatigue or shortness of breath, many people are unaware they have the condition until faced with serious health problems.

“Unfortunately, some patients only find out they have AF when they suffer a stroke, which is five times more likely in patients with AF,” says Eric Buch, MD, director of the Specialized Program for Atrial Fibrillation in the Cardiac Arrhythmia Center at UCLA. “Just as people should know if their blood pressure or cholesterol is high, they should know if they have AF so they can be treated for it.”

A new program at UCLA serves as a single point-of-contact to coordinate treatment for AF patients. The key goals of treatment for AF are to prevent stroke, control heart rate and control heart rhythm. The program offers a hotline for referring physicians, expedited evaluation and treatment for newly diagnosed AF patients and access to the newest therapeutic options.

“Less than five years ago, we had only a medication choices to prevent stroke in AF patients. In the last three years, several new options have become available,” Dr. Buch explains. “Minimally invasive procedures can also wall off the left atrial appendage, the part of the heart where blood clots form to cause strokes in AF patients.” UCLA began offering the lariat procedure in 2013, in which a needle is used to enter the sac surrounding the heart and guide a loop of suture around the base of the left atrial appendage to permanently seal it off. “An advantage of this approach is that we don’t leave hardware within the heart, which is important for patients who can’t take blood thinners,” says Dr. Buch. He adds that several ongoing clinical trials may provide still more options for AF treatment.

More Options Available to Treat Atrial FibrillationTo reduce symptoms of palpitations, fatigue and shortness of breath in AF patients, various medications are available to slow the heart rate during AF episodes, or prevent episodes from occurring. In patients for whom drugs are not effective, catheter ablation is a minimally invasive procedure that uses radiofrequency energy to destroy the tissue that triggers AF. It is more effective than medications and offers many patients the chance to avoid lifelong drug therapy while remaining free of AF symptoms.

“We’ve designed an AF program that makes it a lot easier for patients to get the help they need,” Dr. Buch says. “We are able to see new AF patients quickly and, in some cases, help them avoid a trip to the emergency room.”

The program coordinates care across multiple disciplines involved in treating AF, such as neurology, cardiac imaging and cardiac surgery, and helps primary-care physicians sort through the growing number of options now available to treat AF patients.

For more information about the Cardiac Arrhythmia Center at UCLA, go to: arrhythmia.ucla.edu

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