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When you are diagnosed with atrial fibrillation, a lot of uncertain will be swirling around your head. With advancements in medicine, atrial fibrillation is a disease that can be treated either by a cardiologist or cardiac surgeon, but in a different way.

Atrial fibrillation is the global disease of modern society and has been increasing in frequency in the last few decades. Studies show that atrial fibrillation can be found in: 

  • 0.1 percent of the population less than 50 years old,
  • 4 percent of patients between 50 and 60, and
  • up to 17 percent of patients older than 80 [1].

In medicine, there are two branches of thought to that help you find treatment for atrial fibrillation and your treatment will depend vastly whether you're treated by a cardiologist or a cardiac surgeon. These methods both have their positive and negative aspects and can greatly influence a patient is able to deal with daily living or exertion like an exercise in which a patient should follow exercise tips when suffering from atrial fibrillation.

Theory of Treatment from a Cardiologist's Perspective  

Generally speaking, the first line of treatment for any cardiologist will be any type of pharmacology to alter the fast pace of your heart. The medications that are associated with treating atrial fibrillation can be dividing into one of four classes of medications that act on ion channels in your heart [2]. They target the balance of essential elements like sodium, potassium, and calcium and regulate the electrical activity that flows through the heart and causes it to beat [3]. These medications can be very effective and patients can regain a normal life.

In a study done to determine the effectiveness of these medications, drugs blocking sodium channels and potassium channels were found to have a 60 to 80 percent resolution of symptoms [4]. 

Unfortunately, these medications cannot be considered a long-term viable solution because there is a small therapeutic window between treating the patients effectively and potentially lethal side effects [5]. Patients that elect to follow their cardiologists will require having control visits to ensure that the reward of the medications outweighs the risks. One such medication that is commonly used for this atrial fibrillation therapy is amiodarone. Compared to a placebo, amiodarone is found to be almost three times more effective at restoring a normal heart rhythm. During this same period, patients were also ten times more likely to have to stop their amiodarone therapy because of the adverse side effects of this medication [6]. This medication is linked with adverse side effects like problems with vision, thyroid, nerves and cardiac problems in up to 20 percent of patients [7]. 

Theory of Treatment from a Cardiac Surgeon's Perspective 

In most patients, the short-term use of medications will fail and patients will need to seek another alternative their atrial fibrillation treatment. With the expertise of the cardiac surgeon, a person is more likely to solve the difficulties associated with the failing heart.

Electric cardioversion is a common procedure that can be used in extreme cases of atrial fibrillation [8]. One study found that the success rate of electric cardioversion after therapy reached over 80 percent of cases. This same test found that there was a higher level of improvement of symptoms if the patients were female and were on maintenance anti-arrhythmic drug therapy afterward. Although this therapy can improve symptoms, factors such as weight, duration of symptoms and age can all influence the effectiveness of the surgery. A study conducted to determine the frequency of resolution of symptoms in patients with persistent atrial fibrillation were free of their fibrillation episodes only in about a third of surgeries within one month of their procedure [9]. 

Another option for patients to consider when venturing to a cardio surgeons office is a procedure called cardiac catheter ablation. This is becoming a population option in medicine and the effects are more promising in a long-term outlook. Compared to anti-arrhythmic medications and electric cardioversion, a cardiac ablation procedure will improve symptoms more consistently [10]. What is more, cardiac ablation is indicated for patients with cardiomyopathies, an end-stage condition that is the natural conclusion of most heart diseases. If a patient falls into this category, they will only partially respond to medications or electric cardioversion [11].  

Cardiac ablation is a surgery performed by a cardiac surgeon that targets problematic cardiac muscles that could be causing your arrhythmia. With the help of a sensitive electrical probe, a surgeon is able to pinpoint over-active muscle fibers that could be the pathophysiology of your symptoms and burn the fibers in order to reduce the signal throughout the muscle tissue. This therapy is effective in over 40 percent of patients to stop atrial fibrillation a year after surgery and grows to over 70 percent of cases after an additional operation [12]. This surgery is also performed in less than an hour in most cases and patients are discharged home within 24 hours so you can resume a normal life without anti-arrhythmic medications in the majority of cases. 

Regardless of your final destination, it is important that after the first signs of an irregular heartbeat, visit your cardiologist. The longer you hold off on managing the symptoms, the more probable that therapies will be only partially successful and your quality of life will be greatly reduced. 

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