Early Stage Afib. What This Means, and How to Treat It

As with virtually any disease or condition, especially those involving the cardiovascular system, early diagnosis, and treatment, if necessary, are critical. This is also true for atrial fibrillation or Afib, which affects upwards of 5 million Americans. Let’s explore why we preach early intervention.

Afib is a progressive disorder and is likely to get worse over time. Afib episodes almost always start as paroxysmal, meaning they come and go rapidly without any discernible pattern. While paroxysmal cases are harder to diagnose because patients are not consistently in Afib, it’s also easier to treat either with medical therapy or, for the 50% of patients for whom medicines don’t work, cardiac catheter ablation.

What We Want to Avoid

Once left untreated for long enough, this paroxysmal form of Afib can eventually become persistent. This means that an episode continues for more than seven days and may not end on its own. It is much more consistent in its presentation – steady and often easy to diagnose. Unfortunately, persistent Afib also typically comes with more damage to the heart, including the dilation of the atria, as well as the even greater potential for the pooling of blood in the left atrial appendage that can increase the risk of stroke by five times.

Once the blood has pooled and clotted in the left atrial appendage, most patients will require a blood thinning medication, known as an anticoagulant, to reduce the risk of a blood clot breaking off and causing a stroke. This is the easiest and most reliable way to address stroke risk. However, here too, some patients do not receive the benefit of medication or experience unacceptable side effects. Fortunately, we offer a minimally invasive catheter-based procedure known as a left atrial appendage occlusion, which uses a small plug-like medical device to seal off the LAA for good.

Well-qualified patients may still be able to address their persistent Afib with cardiac catheter ablation. However, the complexity of the procedure is greater, and the results are less predictable, potentially requiring follow-up strategies to address the problem.

Long-Standing Persistent and Permanent Afib

If persistent, Afib is left untreated, patients may enter a state of long-standing persistent Afib where the episode lasts more than a year without stopping, and significant structural damage to the heart is usually found.

Lastly, there is permanent Afib which often means that there is no medical or surgical intervention that can reliably address the condition. Patients at this point will have to live with and manage the condition and the significantly higher risk of a cardiovascular event.

The Prognosis

As you can see, the progression of untreated Afib is not ideal, and patients begin to close the door to practical and accessible treatment options as they delay their diagnosis and treatment plan. Fortunately, the treatment of Afib and most other cardiac arrhythmias are very safe, minimally invasive, and unintrusive to one’s lifestyle. With modern technology and technique, most of our catheter-based interventions are performed on an outpatient basis. Patients are home the same day to recover in their environment and can return to regular activity within days rather than weeks.

If you have the signs and symptoms of an arrhythmia, including, but not limited to, pounding of the chest, palpitations, the feeling of your heart beating out of your chest, constant fatigue, and more, we encourage you to visit a qualified electrophysiologist like those at The Heart House. And, of course, if you believe you’re having a medical emergency, such as a heart attack, do not delay dialing 911 or having someone get you to the ER as soon as possible.