Atrial fibrillation (AFib) is a common heart rhythm disorder characterized by a rapid and irregular beating of the heart’s upper chambers, known as the atria. This irregular activity can lead to various symptoms, including heart palpitations, fatigue, shortness of breath, and dizziness. AFib can also increase the risk of serious complications, such as stroke and heart failure. Many individuals diagnosed with AFib often wonder if the condition can truly be “cured.”
Defining “Cure” in Atrial Fibrillation
The term “cure” for AFib often means achieving long-term remission or a sustained normal heart rhythm (sinus rhythm), rather than a complete eradication of the underlying predisposition. For many, AFib is a chronic condition requiring ongoing management. While some may achieve a state where AFib no longer manifests, it often involves managing contributing factors. Achieving a sustained normal rhythm and controlling symptoms is the primary goal, which can be considered a “functional cure” for many. The likelihood of maintaining rhythm control is influenced by factors including AFib duration and underlying structural heart disease. Early detection and management can improve the chances of restoring and maintaining a normal rhythm.
Treatment Options Aimed at Restoring Rhythm
Several medical and procedural interventions are used to restore and maintain a normal heart rhythm in individuals with AFib. Medications known as antiarrhythmics are often prescribed to prevent AFib episodes and help the heart stay in a normal rhythm by affecting its electrical signals. Rate-control drugs manage symptoms by slowing a rapid heart rate, though they do not aim for rhythm restoration.
Catheter ablation is a common interventional procedure that isolates or destroys abnormal electrical pathways in the heart. During this minimally invasive procedure, thin tubes (catheters) are guided to the heart, where radiofrequency energy (heat) or cryoablation (cold) creates small scars. These scars block faulty electrical signals, allowing the heart’s normal rhythm to prevail. Success rates for catheter ablation range from approximately 70-85% for paroxysmal AFib, though some individuals with persistent AFib may require multiple procedures for sustained rhythm control.
Surgical ablation, also known as the Maze procedure, is a more invasive option for complex cases or when other treatments have not been successful. This procedure involves creating a maze-like pattern of incisions or lesions in the heart’s upper chambers to block irregular electrical signals. The scar tissue formed redirects electrical impulses, allowing a normal heart rhythm to be maintained. The Maze procedure is sometimes performed alongside other heart surgeries, such as valve repair or coronary artery bypass grafting, and has success rates of 80-90%.
Electrical cardioversion delivers a controlled electrical shock to the chest to reset the heart’s rhythm. This intervention is typically used as a temporary measure to restore a normal rhythm in acute situations. While effective in immediately restoring sinus rhythm, electrical cardioversion is not a long-term “cure” on its own, as AFib can recur without ongoing management or other treatments.
Living with Atrial Fibrillation and Long-Term Outlook
Even after successful rhythm control interventions, ongoing monitoring and regular medical check-ups remain important for individuals with AFib. These appointments help detect any recurrence of AFib or the development of other complications.
A heart-healthy lifestyle plays a significant role in supporting rhythm control and overall heart health, regardless of whether a sustained normal rhythm is achieved. Lifestyle modifications include maintaining a healthy weight, engaging in regular physical activity, managing stress, and moderating alcohol intake. A balanced diet emphasizing fruits, vegetables, whole grains, and lean proteins, while limiting processed foods and excessive salt, contributes to better heart health. Addressing underlying conditions like high blood pressure, diabetes, and sleep apnea is also beneficial for AFib management and reducing recurrence.
Understanding the important role of blood thinners (anticoagulants) for stroke prevention is important when living with AFib. AFib can cause blood to pool in the atria, increasing the risk of clot formation, which can then travel to the brain and cause a stroke. Anticoagulation therapy mitigates this risk, irrespective of the heart’s rhythm status.
AFib can recur even after successful procedures or medication, and individuals may require continued treatment or different strategies over time. For many, AFib is a manageable chronic condition that benefits from a comprehensive approach to care.