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More than 2 million men and women in the United States have atrial fibrillation (AF), making it the most common cardiac dysrhythmia. AF causes an irregular heartbeat due to disorganized impulses in the heart's electrical system. Because AF puts people at risk for stroke and congestive heart failure, it's imperative for people to understand the symptoms and to get routine physicals.

"AF is more common in older populations," says
Peter R. Maggs, M.D., Cardiothoracic Surgeon at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School. "It's also more common in people who have coronary artery disease, heart failure, or mitral valve disease, and in the first few weeks following cardiac surgery."

Understanding AF
As a result of AF the two upper chambers of the heart, called the atria, contract inefficiently. This reduces blood flow to the two lower chambers of the heart, called the ventricles, causing blood to pool in the atria. Some patients have no symptoms from AF, and don't realize they have it until they have a physical exam or electrocardiogram (EKG). However, when symptoms are present, they include

· Heart palpitations

· Shortness of breath

· Fatigue

· Chest pain

"AF can be easily diagnosed by checking a patient's heart rate and pulse," says Dr. Maggs. "Then, it can be confirmed with an EKG." With electrodes attached to the skin, this simple test measures electrical impulses given off by the heart.

Treating AF
Treatment for AF has become more effective with the availability of new medications and advances in interventional techniques. "Some medications can prevent AF, and sometimes even correct it, especially if the onset was recent," says Dr. Maggs. "Catheter ablation and surgical interventions are also effective therapies."

Cardiac ablation uses catheters to deliver radiofrequency energy to small areas of tissue in the wall of the atria, which prevents erratic electrical impulses. The procedure can eliminate the dysrhythmia and the need for medication or implantable devices.

Surgical interventions for treating AF have also evolved, and may relieve patients from the need to take certain medications. "Surgical intervention for AF has been developed over the past 20 or so years," says Dr. Maggs. "This landmark work has led to the current maze procedure." The initial maze procedure consisted of incisions that incised the wall of the atrium, thus blocking the passage of abnormal electrical impulses. Today, these incisions have been largely replaced by cryotherapy, which freezes the tissue or radiofrequency, which heats the tissue. Like incisions, these energy sources create scar tissue to block abnormal electrical impulses.

Although the maze procedure can be performed on patients who only have AF, it is more commonly done in patients who are also undergoing other cardiac surgery, such as valve repair. "For a relatively new therapy, the maze procedure has quite a high success rate," says Dr. Maggs.

Today, patients with AF have more treatment options than ever before. Mount Auburn Hospital provides all these top-notch AF treatments. "Not only do we have a great program, but we also have a friendly atmosphere, with highly personalized care," says Dr. Maggs.

For a free Mount Auburn Hospital physician directory, please call us at 617-499-5094.