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In this video Dr. Syed Ahsan, our Consultant Cardiologist, discusses atrial fibrillation (AF) management. Initially, blood thinners are prescribed to prevent stroke risk. Your medications are then tailored to either maintain a normal heart rhythm or control your heart rate. Catheter ablation, a modern minimally invasive procedure, corrects heart irregularities as a day case procedure. To understand which of these treatment options is most appropriate to your unique needs, contact us today.
Atrial Fibrillation Treatment

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If you have AF, the first thing we need to do is to stop you from having a stroke, and that’s with blood thinners, which prevent clots from forming. Secondly, we can use medications: medications which either keep your heart in a normal rhythm or medications which control your heart rate. Finally, we can nowadays use a treatment called ablation. This is a minimally invasive procedure, which is usually done as a day case, and essentially aims to correct the irregularity in your heart. The key thing to take away is there are lots of different treatments. They’re going to be bespoke to you and what’s most appropriate for you, and you have options.

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Dr Syed Ahsan advises that while there is no cure for atrial fibrillation, there are plenty of treatments, such as medications and ablation, that can treat the problem.
Atrial Fibrillation Treatment

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We can treat atrial fibrillation, using medications, but that simply suppresses the rhythm or prevents episodes. Ablation and radiofrequency ablation are techniques that we use to treat atrial fibrillation, which has a high success rate in a large proportion of patients depending on what type of AF you have.

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Dr Syed Ahsan, Consultant Cardiologist explains the different types of treatments available for atrial fibrillation. These include catheter ablation and convergent ablation. There is another hybrid procedure called the convergent procedure which is currently being trialled.
Atrial Fibrillation Treatment

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So, ablation has been around for some time now, and the success rates of catheter ablation, which is a minimally invasive procedure, are continuously improving. What we are able to offer is a new technique called the convergent AF ablation. And this is particularly for patients who’ve been turned down for ablation previously, or who’ve had ablation for a long time. In this group of patients, the success rates from a typical catheter ablation are actually very low. But we are now working in conjunction with our cardiac surgical colleagues to offer a hybrid procedure called the convergent procedure. This is a new technique and the data is still relatively new, but is very promising, and we are trying to conduct a randomized control trial to see whether this technique, actually delivers better success rates in a particular group of patients.

Video Description

Are you experiencing atrial fibrillation (AF) and concerned about what it means for your health? AF is totally manageable, but it is important that you keep taking your medications and contacting a healthcare provider if you’re worried about anything. The key is to stay calm, as there are many effective strategies to address and treat atrial fibrillation. Dr. Syed Ahsan is a world-leading expert in heart rhythm disorders, treating many people like you with AF every day. Contact us today to book your consultation with him.
Atrial Fibrillation Treatment

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If you are having an episode of atrial fibrillation, first thing to say is don’t worry. It’s not going to be life threatening, and almost always we can control this and manage this. The first thing to do is make sure you’re taking your medications regularly. If you’re worried about that, contact us and we can advise you further. It may be that we need to do some more tests or some more investigations to establish whether you are in AF, how fast it’s going, and then we can advise you further on changing your medications or doing other treatments to get your heart back into a normal rhythm. But the key thing is not to panic.

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Wondering when to seek a specialist’s help for atrial fibrillation? Dr. Syed Ahsan explains that anyone with this condition needs to seek medical treatment, even if they have no symptoms. Early intervention can prevent blood clots from forming.
Atrial Fibrillation Treatment

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Anyone with atrial fibrillation should seek medical advice, even if they’re having no symptoms. And the main reason is to assess your risk of stroke and see whether you need to be started on blood thinning medications to prevent blood clots from forming.

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Atrial Fibrillation Treatment

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During the ablation procedure, fine wires called catheters are passed from the vein in your leg called the femoral vein, which runs like a motorway straight into the heart. So we use this vein to access the heart. If you are having an atrial fibrillation ablation, we need to access the top left chamber of the heart, so the vein in the leg goes into the right chamber, and we make a tiny hole using a long needle so that we can pass the wires into the left chamber.

We then create a three dimensional computer, virtual geometry of the heart chamber, which allows us to see the heart in three dimensions, move it around, tilt it up so we know that we can deliver the treatment, to very specific areas and safely. During the catheter ablation, we also monitor your blood pressure, your breathing. We can see exactly how much force we’re applying inside the heart to make sure that we’re not pressing too hard and the procedure can be done efficiently and safely. It’s mostly done with a general anaesthetic, so you’ll be asleep and there will be an anaesthetist who will be controlling your breathing. We can do it with sedation and strong pain relief as well.

Occasionally you may also need to have a camera test called a transoesophageal echo at the start of the procedure to make sure that there are no blood clots in the heart. So with ablation, number one is your safety. That’s paramount. So we take all the measures to make sure that you are safe. Uh, we can deliver the treatment safely and effectively. There’ll be various staff members around in the theatre to make sure that you are doing well, and we can perform the procedure as we want. And after the procedure, you’ll go back to the ward, maybe to a recovery bay and a normally discharge home the same day or maybe the following morning.

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Atrial Fibrillation Treatment

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If you’ve had a successful ablation, we’re always keen to try and take you off the medications. Now, you may need to stay on the medications that prevent strokes, but certainly the medications that are controlling your heart rhythm, we, and I’m sure you are keen to come off them, and that’s often the way it happens. Occasionally, we may need to continue on some of those medications after your ablation, but we’ll discuss that with you and we can have a clear understanding of what needs to be done.

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In most patients, we do this procedure under a general anesthetic.
It’s more comfortable for you. We can use a camera during the procedure to help monitoring,
but we do do the procedure with just local anesthetic and sedation in some cases.

Atrial Fibrillation Treatment

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An ECG, or electrocardiogram, is a 12-lead test that records your heart’s electrical activity from different angles. It provides insight into how your heart is functioning electrically. When your heart is in a normal rhythm, the ECG will show a regular pattern.

In atrial fibrillation, however, the rhythm is chaotic, and the spikes representing heartbeats appear at irregular intervals. This causes the ECG to look uneven. Additionally, we don’t see the typical P waves, which are signals from the top chambers of the heart (the atria) during normal rhythm. In atrial fibrillation, this absence of P waves further indicates the irregularity.

Atrial Fibrillation Treatment

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What is an ECG? An ECG is a 12-lead recording of your heart. It looks at your heart from different angles and tells us about the electrical activity within the heart. If you are in a normal rhythm, your ECG will look very regular, so each spike on the ECG, which represents a heartbeat, occurs at regular intervals. In atrial fibrillation, the rhythm is chaotic and irregular, and these spikes occur at varying intervals. So on the ECG, atrial fibrillation will give an irregular appearance, but we can also see that there is no activity from the top of the heart. This activity is shown by P waves, which represent the normal, regular beating of the top of the heart.

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Atrial Fibrillation Treatment

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A pacemaker doesn’t control atrial fibrillation. It is used primarily for slow heart rhythms. Some patients with atrial fibrillation may find that their heart rate is going very fast and at the same time going very slow. So using a pacemaker allows us to prevent the heart rate from dropping too low, and we can therefore control the faster heart rhythms with medications.

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Dr Syed Ahsan lists some of the medications available for atrial fibrillation, including blood thinners and anti-coagulants, as well as rate control medications. The most effective treatment is a catheter ablation.
Atrial Fibrillation Treatment

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If you want to learn more about your heart rhythm, there are tools available to help you monitor it home. For example, the Kardia device is a home monitoring tool for heart rhythm that is available on smartphone or smartwatches. Dr. Syed Ahsan, a specialist expert in heart rhythm disorders, recommends it for accurate and non-invasive at-home heart rhythm monitoring. Recordings can be stored as PDFs and easily shared with your medical team to confirm your diagnosis.
Atrial Fibrillation Treatment

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You may have heard of the Kardia device, and that’s a way of monitoring your heart rhythm at home, either through your iPhone or through a smartwatch. It’s accurate and it’s a very useful way, a non-invasive way, of you monitoring your own heart rhythm at home. The recordings from the Kardia can be stored as A PDF and emailed over to us for a clinician or cardiologist to review and confirm the diagnosis.

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Dr. Syed Ahsan, a Consultant Cardiologist, explains the convergent procedure, a novel approach to treat atrial fibrillation. It combines internal and external heart treatments in two separate procedures, which take place across a few weeks. Research has shown that you can have better outcomes in maintaining a regular heart rhythm with this combined approach. If standard catheter ablations have failed, or your heart is too large or has been in AF for a long time, the convergent procedure may be more suitable for you. Contact us today to book your appointment with Dr. Ahsan.
Atrial Fibrillation Treatment

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So, the convergent procedure is a new way of treating atrial fibrillation, which involves not only treating the inside of the heart as we do conventionally, but also doing treatment on the outside of the heart. And it involves two separate procedures, which is separated by a few weeks. If you’ve had an ablation or several ablations that haven’t worked, or if you’ve been told that your heart is too large or you’ve been in AF for too long, then the convergent procedure may be suitable for you. And this is because patients in those groups, we know that they don’t do very well with just doing a catheter ablation alone. So, by combining treatment on the outside and the inside of the heart, the large trials have shown that the outcomes i.e keeping you in a regular heart rhythm is more likely and the procedure is more successful.

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If your watch or phone alerts you about potential atrial fibrillation (AF), it’s crucial to consult with a doctor or a specialist like Dr. Syed Ahsan, a specialist expert in heart rhythm disorders. Further tests and investigations may be necessary, as these modern devices are accurate in detecting AF. Take any alerts seriously and seek professional advice promptly.
Atrial Fibrillation Treatment

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If your watch or your phone has given you an alert that you may have atrial fibrillation or AF that needs further investigation and you should consult with your doctor or a specialist to look into this further, that will involve further tests and further investigations. But the devices nowadays are really quite good and quite accurate in determining if you have AF. So, if you have an alert, you should take it seriously.

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After you’ve had an ablation procedure, you will still need to keep an eye on your atrial fibrillation (AF). Our expert Cardiologist, Dr. Syed Ahsan, may request you to use a smart device, like a phone or watch, to monitor your heart rhythm. This will help you stay informed and on top of your condition, and, if concerned, you can share the data with him to get a professional assessment. The devices are very accurate and will help you feel reassured about your AF.
Atrial Fibrillation Treatment

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After ablation. More and more commonly, we may ask you to use your smart device, such as a phone or a watch to monitor your heart rhythm. These are really useful techniques because it’s something you have with you all the time, and it allows you to keep on top of what’s going on. If you are worried about what you see, you can always send this over to us, but often the devices will say your heart rhythm is normal, which is really reassuring because they’re very accurate and give you and me the reassurance of what’s going on.