Atrial fibrillation is the most common form of arrhythmia in which the heart rhythm is irregular. It is associated with the aging of the population and hypertension and affects one in four people over 80 years of age. It can cause blood clots and embolisms, as well as cardiovascular complications. There are cases of atrial fibrillation that “come and go” spontaneously (paroxysmal) and other cases in which the arrhythmia is persistent and requires some type of intervention to reverse it. The symptoms are very varied, from palpitations to dizziness, fatigue, or it can even occur practically asymptomatically.
Each case of arrhythmia is different and we always try to select the most personalized treatment for the patient and type of arrhythmia. For example, some arrhythmias may require anticoagulant treatment, and others may not. Assessment by a cardiologist specializing in arrhythmias is essential to decide together with the patient and with all the information, which is the best strategy.
One thing is very clear and very evident in various studies, the arrhythmia must be treated and the patient must be returned to sinus rhythm. Many patients will require treatment to maintain sinus rhythm with antiarrhythmic drugs, but there is increasing evidence in favor of catheter ablation, given its good results, the low rate of complications and the possibility of abandoning antiarrhythmic drugs, some of them with significant adverse effects.
Currently, ablation procedures are minimally invasive and have very consistently demonstrated several aspects:
1) In patients with atrial fibrillation they largely prevent progression to persistent atrial fibrillation.
2) They are superior in terms of pharmacological treatment with antiarrhythmic drugs.
3) They improve the prognosis in certain scenarios in which significant heart failure coexists. Current techniques are mainly radiofrequency ablation, cryoballoon ablation and electroporation ablation.
The Cardiology and Cardiac Surgery Service of the Sagrada Familia Clinic is directed by Dr. Alberto Castro, and the Arrhythmia Unit provides comprehensive management of patients with arrhythmias from diagnosis to treatment with the most current technologies and is made up of Dr. Nuria Rivas, Dr. Raquel Adeliño, Dr. Sara Vázquez, Dr. Sabaté, Dr. Santos and Dr. Andreu Porta (coordinator).
