Barnes Jewish Hospital Washington University Magnet Recognition America's Best Hospitals 2009-10

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Heart & Vascular Center

Atrial Fibrillation

Atrial fibrillation is an abnormal heart rhythm caused by an irregular, disorganized heartbeat originating in the upper chambers of the heart, known as the right and left atria. Medical, catheter-based, and surgical treatments exist today to restore a normal heart rhythm, relieve symptoms and improve the quality of life of patients with atrial fibrillation. The choice of treatment depends on the severity of a person’s symptoms, the successfulness of prior treatments, and other related medical conditions.

The Barnes-Jewish & Washington University Heart & Vascular Center team of cardiologists, cardiac electrophysiologists, surgeons and clinical nurse specialists are world leaders in treating this condition. Working together, the goal is to restore normal rhythm or to slow down the heart rate and reduce symptoms. In addition, our clinical team actively leads research to develop and refine new treatments.

Atrial Fibrillation

The abnormal heart rhythm that underlies atrial fibrillation occurs in the top chambers of the heart, which is known as the atria. During atrial fibrillation, the steady rhythm of the normal heart beat is replaced by an irregular, and often rapid, rhythm. This electrical "storm" within the atria causes these chambers stop beating rhythmically and continuously quiver (fibrillate). Some of this irregular activity in the atria is transmitted to the lower chambers of the heart, known as the ventricles, causing the pulse to be irregular and often too fast.

Some people may not have any symptoms. Others may experience a sensation of an irregular or fast heartbeat, fatigue, lightheadedness, shortness of breath, inability to exercise, and chest discomfort or anxiety.

Although atrial fibrillation is often considered a harmless arrhythmia, it is associated with serious illness and death because of its effects:
  • palpitations, resulting in patient discomfort and anxiety
  • inefficient blood circulation, which may lead to cardiomyopathy (enlargement of the heart) and heart failure
  • lack of blood flow in the left atrium, which increases the risk of blood clot formation that can trigger a stroke
The goal of treating atrial fibrillation is to reduce symptoms as well as try and prevent stroke, pulmonary embolism, heart attack and heart failure.

Treating Atrial Fibrillation

Medical treatment is the “front line” of therapy. Commonly prescribed medications either control heart rate, attempt to restore and maintain a normal rhythm, or both. To prevent the risk of developing a blood clot within the left atrium due to atrial fibrillation, physicians commonly use aspirin or the more potent drug, warfarin, to block blood clot formation. Together, these treatments are often sufficient to adequately control the condition.

Other treatment options include electrical cardioversion, catheter ablation, or cardiac surgery. Cardiac electrophysiologists at the Heart & Vascular Center use advanced ablation techniques to create ablation lines (scar tissue) within the atria that work as barriers to surround and disrupt the abnormal heart rhythms.

When surgical treatment is needed, surgeons look to a procedure that was pioneered right here at Barnes-Jewish Hospital and Washington University School of Medicine. James Cox, MD, developed the Maze procedure to create “barriers” in the heart that block abnormal electrical signals. Recent technological advances have led to the minimally invasive Cox-Maze procedure, a less invasive treatment. 

To make an appointment with a Washington University heart or vascular specialist at Barnes-Jewish Hospital, call 314-TOP-DOCS (314-867-3627) or toll-free 866-867-3627.

Cardiac Surgery

Overview of cardiac surgery program at Barnes-Jewish Hospital