How is AFib treated?
The main goals of treatment are to prevent hemodynamic compromise and stroke. Medications are used to control the heart rate and rhythm, and anticoagulation (a blood thinner) is used to prevent a stroke.
To restore normal sinus rhythm, electrical (electric shock) or chemical (medications) cardioversion is often attempted first. If unsuccessful, an ablation may be attempted by the cardiologist in a specialized cath lab called an electrophysiology (EP) lab.
Another form of ablation, the surgical MAZE procedure, may be performed as either a stand-alone procedure or in conjunction with open heart surgery. If stand-alone, this may be performed in a minimally invasive fashion with a minithoracotomy or with video-assisted thoracoscopic surgery (VATS) using either radiofrequency ablation or cryoablation.
A benefit to the surgical approach is that the left atrial appendage is ligated or clipped at the same time to decrease stroke risk. A hybrid approach is also often used where the cardiologist and surgeon work together performing a combination of ablations to improve the chance of success in restoring a normal sinus rhythm.