Atrial fibrillation (AF) is caused by a malfunctioning atrioventricular (AV) node that disrupts the hearts electrical current and causes the atria to beat chaotically out of rhythm. This dysfunction with the AV node can be caused by various underlying problems. These can include previous or current heart conditions, congenital heart defects, sick sinus syndrome, lung disease, heart surgery, viral infections, sleep apnea, coronary artery disease, abnormal heart valves, high blood pressure and an overactive thyroid gland. However, in some cases the cause of AF is unknown.
Some behaviors can also contribute to AF, such stress, high intake of stimulant medication, caffeine, tobacco and/or alcohol use. People that are genetically predisposed to high blood pressure or have a family history of AF or other heart conditions are at a higher risk. Other risk factors that put people at an increased risk for atrial fibrillation are if the person is of older age, Caucasian and/or obese. A study published in the JAMA of Internal Medicine reported that 70% of people with AF are 65 – 85 years old, and 60% of people with AF over the age of 75 are women.
Mediation treatment is common protocol for treating AF. Specifically, flecainide is a commonly used medication that has proven to be successful. However, if that is unsuccessful, the doctor could prescribe other medications or perform catheter ablation. Catheter ablation is most commonly used on patients with paroxysmal AF with a success rate as high as 95%. Additionally, the success rate for medication treatment ranges from 40-90%, with higher success rates seen in those with paroxysmal AF.
Furthermore, medication treatment for AF has proven to be successful in other studies. A retrospective cohort study was conducted to compare the efficacy and safety of the medications flecainide and dronedarone in treating AF. The study was done on 123 patients with AF. They were treated with either flecainide or dronedarone and followed up 301 days later. It was found that only 36.6% of patients treated with flecainide and 21% treated with dronedarone had recurrences. It was concluded that both treatments are effective and safe in treating atrial fibrillation.
Lastly, the Cleveland Clinic reported high success rates with catheter ablation in people with paroxysmal AF. Between 75-80% of their AF patients treated with catheter ablation have been able to go off their medication and have had no AF episodes for a year. Approximately 20-30% of the patients had to undergo a second ablation. With the evidence from these studies, along with the patient’s healthy life style and compliance with successful medication, he is highly likely to live a full, active life.
References:
- Staff, Mayo Clinic. “Atrial Fibrillation.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 Dec. 2017.
- “What Are the Symptoms of Atrial Fibrillation (AFib or AF)?” American Heart Association, American Heart Association, Inc., 6 Feb. 2017.
- Cantillon, Daniel J. “Atrial Fibrillation.” Cleveland Clinic , The Cleveland Clinic Foundation, Jan. 2014
- “Division for Heart Disease and Stroke Prevention.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 22 Aug. 2017.
- Sánchez, R M, et al. “Comparison of the Efficacy and Safety of Dronedarone and Flecainide as Maintenance Antiarrhythmic Therapy for Sinus Rhythm in Atrial Fibrillation.” PubMed, U.S. National Library of Medicine, 30 Aug. 2017.
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