Atrial Fibrillation What is it? Atrial fibrillation (AF) is an irregular heart rhythm that originates in the top chambers of the heart called the atria. During AF, the electrical impulses of the heart do not start in the normal area. Instead, the electrical impulse starts from many different areas of the atria and spreads out in a chaotic manner, which causes the heartbeat to be irregular and disorganized. What are the symptoms? Symptoms of atrial fibrillation present differently in different people. Some people have little or no symptoms with AF, others are aware the exact moment they go into AF. Many patients report feeling heart pounding, dizziness, shortness of breath and chest discomfort. Inability to exercise to pre-AF levels and fatigue are also common symptoms. Many people may find it quite stressful to have AF because episodes can be very unpredictable and can occur at almost anytime. Patients may be afraid to travel and attend social events for fear of having AF. How is it treated? In general there are two treatment approaches for managing AF: • Rate controlling strategy – several different medications can be used to help control the heart rate. This is important because very fast, uncontrolled heart rates can weaken the heart muscle and cause heart failure. • Rhythm controlling strategy - attempting to maintain the heart in a normal beating pattern can be done by either chemical or electrical cardioversion, and possibly antiarrhythmic drug therapy. Medications can control AF, similarly to how high blood pressure can be controlled with medications, however, medications cannot be expected to cure AF. In other words, treating AF with medications requires continuation of the medications indefinitely. Some forms of AF can also be treated with ablation therapy. Ablation therapy is the only treatment that offers a potential cure for this arrhythmia. The other therapies are temporary ways to control AF over the short term. Anticoagulation, or preventing blood clots from forming in the left atrium, is important to prevent strokes in the setting of AF regardless of which treatment strategy is implemented (rate vs. rhythm controlling strategy). This is best achieved by taking medicine, typically either aspirin or warfarin, depending on the risk factors of the patient. What is URMC’s approach? URMC is a world leader in heart rhythm disorders. Doctors here lead research that has changed the way heart rhythm disorders are treated around the world. We offer the most advanced and effective arrhythmia treatments to our patients. We perform more treatments for atrial fibrillation than any other hospital in the area. In many cases, the treatments we provide are not available anywhere else in the region. URMC Cardiology has three fully equipped labs for ablation and device implants. These labs are staffed by nurses and technicians who work exclusively on heart rhythm disorders. Our newest lab provides robotic navigation for radiofrequency ablation, giving our patients even greater precision, safety and versatility. Who should I contact? If you have symptoms of atrial fibrillation or believe you may have a heart rhythm disorder, call us at (585) 275-4775. Learn more about Atrial Fibrillation. Learn more about the Atrial Fibrillation Center at URMC. Learn more about Electrophysiology at URMC.