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Atrial Fibrillation Patients Should Be Treated Surgically, Study Suggests

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Researchers found that patients with atrial fibrillation have a better prognosis when their atrial fibrillation is treated surgically during cardiac surgery. The study was led by Northwestern Medicine and was published in the Journal of Thoracic and Cardiovascular Surgery.

Atrial Fibrillation

Atrial fibrillation is a heart rhythm disorder characterized by absence of the atrial systole (the atria no longer contract as it should). Atrial fibrillation on an electrocardiogram is defined by the complete absence of P waves and irregular rhythm. This condition should not be confused with atrial flutter, which looks similar but shows a regular rhythm. Atrial fibrillation involves the rapid and irregular contraction of atria with a very high rate of 300 beats per minute. However, the ventricles will take fewer pulses due to the atrioventricular node. Installation is completely asymptomatic or patients feel palpitations. Also, an important sign is the pulse deficit. Sometimes, patients complain of dyspnea or pain. Once installed fibrillation can be maintained or the patient can return to normal rhythm spontaneously. There are cases in which the atrial fibrilation fails to resolve spontaneously and then we  speak about permanent atrial fibirlation. There are several conditions that predispose to atrial fibrillation such as mitral stenosis, a valvular heart disease characterized by narrowing of the orifice of mitral valve . Due to a very narrow hole the left atrium can not send the required blood in the left ventricle , therefore the left atrium is dilated, which predisposes to arrhythmias. If the patient reaches the hospital shortly after the onset atrial fibrillation, it can be converted to sinus rhythm by electrical defibrillation. It should be noted that electrical defibrillation is performed only in patients who have no thrombus in the left atrium. Another method is the pharmacological cardioversion using antiarrhythmic drugs.

heart surgery

Heart surgery

Richard Lee, MD, surgical director of the Center for Heart Rhythm Disorders at Northwestern Memorial’s Bluhm Cardiovascular Institute, said that patients with atrial fibrillation should be converted to normal rhythm by surgery. Currently only 38% of patients with atrial fibrillation are treated simultaneously during surgery. “By fixing two issues at once, we can improve Patient outcomes.” Dr. Lee said.

Atrial fibrillation requires chronic treatment with oral anticoagulants. These drugs are necessary for lysis of blood clots formed in the atria. If treatment is not followed, the risk of stroke is very high. Therefore, returning to a normal heart rythm is very important for patients. Brad Knight, MD, medical director for the Center for Heart Rhythm Disorders, notes that since all patients are operated, they should be treated of atrial fibrillation during surgery.