Your heart works tirelessly, but silent threats can affect your health when you least expect it. Atrial fibrillation (Afib) can increase your risk of stroke, often without any noticeable symptoms. The good news is that understanding your options and acting early can help protect your health and give you peace of mind.
Yoaav Krauthammer, MD, a cardiac electrophysiology specialist with HonorHealth Heart Care, shares his insights on Afib treatments in this informative Q&A.
Q. What is Afib?
A. Normally, the electrical signals that make your heart beat move in a coordinated way. In Afib, the signals in your heart’s upper chambers (atria) are disorganized, causing a fast, irregular heartbeat.
Q. What are the symptoms of Afib?
A. Some people may not notice any symptoms, while others may experience:
- Palpitations (racing and irregular heartbeat)
- Fatigue
- Chest pain
- Shortness of breath
- Dizziness or fainting
Q. What are the risks of Afib?
A. Afib may not feel dangerous at first, but it can significantly increase your risk of stroke – about five times higher than someone without Afib. If untreated, a rapid heart rate can also weaken your heart’s function over time (cardiomyopathy).
Q. How is Afib commonly treated?
A. Blood thinners (anticoagulants) are often the first step. Afib can cause blood to pool in the atria, which may form clots that travel to the brain and cause a stroke. Blood thinners help prevent these clots.
Q. How do blood thinners work?
A. Blood thinners block key steps in the clotting process. Warfarin, for example, interferes with vitamin K, which helps your blood clot. Newer drugs, called direct oral anticoagulants (DOACs), work on different parts of the clotting process without affecting vitamin K.
Q. Are there risks to taking blood thinners long-term?
A. Yes, they increase the chance of bleeding, including serious events such as bleeding in the brain (intracranial hemorrhage).
Q. How effective are blood thinners at preventing stroke?
A. Blood thinners can reduce your risk by as much as 50-60%.
Q. Are there any alternatives for warfarin?
A. Yes, direct oral anticoagulants (DOACs) are now recommended over warfarin unless you have a prosthetic heart valve or moderate-to-severe narrowing of your mitral valve. These drugs include rivaroxaban, apixaban, dabigatran and edoxaban.
Q. Are any other treatments available?
A. Yes, the Watchman™ device is an implant about the size of a quarter that closes off your left atrial appendage where most clots form.
Q. What is the left atrial appendage?
A. It’s a small pouch off the main section of your left atrium. Its exact function isn’t fully understood, but it may act as a decompression chamber for your heart.
Q. How is the Watchman™ implanted?
A. A cardiologist places the device in your heart using a catheter through the femoral vein in your groin.
Q. What type of anesthesia is used?
A. General anesthesia is most commonly used, enabling the cardiologist to control your breathing and test the device once it’s placed.
Q. How do you know if you’re a candidate for the procedure?
A. If you have Afib not caused by valve disease, have experienced significant bleeding on blood thinners or have other intolerance to these medications, you may qualify. Conditions that increase bleeding risk, like frequent falls, can also make you eligible. Always consult your primary care doctor or cardiologist.
Q. Is the Watchman™ device FDA approved?
A. Yes, the FDA approved it for commercial use in 2015.
Q. What are the benefits of the Watchman™ implant?
A. It can reduce your risk of Afib-related stroke. Blood thinners are needed for 45 days after implantation until your doctor confirms the appendage is fully closed, after which you may stop the medication.
Q. How do I know which treatment is right for me?
A. Everyone is different. Talk with your doctor about your options, your lifestyle and your risk factors to determine the best approach for you.
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