Types of Atrial Fibrillation

What Type of Afib Do You Have?

Atrial fibrillation is not only the most prevalent cardiac arrhythmia in patients over 60, it is also the most complex. The causes of afib are not yet completely understood. The mechanism which allows certain types of atrial fibrillation to continue in a self-sustaining manner has not yet been discovered. Not all types of atrial fibrillation are easily diagnosed, and many people, including doctors, simply do not understand the prevalence, severity and risks of atrial fibrillation.

If you have been diagnosed with AF, and your physician has assured you that afib is a benign condition, think again. The American Heart Association, the American College of Cardiology and the American Stroke Association consider afib a serious cardiac arrhythmia. You have options for treatment. Dr. David Affleck of Western Cardiovascular Associates offers the mini-maze state-of-the-art surgical treatment of atrial fibrillation. Whether you live in Salt Lake City, Ogden, or Utah Valley, or anywhere in the country, contact Western Cardiovascular Associates or call 801-743-4750 today.

Medical vs. Surgical Classification for Atrial Fibrillation

Atrial fibrillation is a specific type of cardiac arrhythmia, and within this classification there are different ways to describe atrial fibrillation. Classification of atrial fibrillation is complicated because the descriptions used for cardiac arrhythmias tend to be based on the treatment being offered. Physicians that rely on medical management for treating atrial fibrillation use one set of classifications and surgeons tend to use a different classification system. The two classification systems do not contradict each other as much as they over lap each other.

AF Medical Classifications

If you have been diagnosed by your primary care physician, you were probably classified with one of the following:

• Paroxysmal AF is recurrent and self terminating - meaning the afib stops on its own without medication, cardioversion or other medical intervention. This type of AF can be difficult to diagnose because afib has to occur for an EKG heart monitor to document the occurrence. For this type of AF, irregular electrical impulses are thought to initiate in the pulmonary veins, making surgical PV isolation the most effective treatment option available.
• Persistent AF is recurrent and requires medical intervention to return the heart to a normal sinus rhythm. Persistent AF usually means that there is self-sustaining mechanism for irregular electrical impulses within the heart structure. Surgery which includes PV isolation and disruption of the autonomic ganglia plexus thought to create self-sustaining irregular electrical impulses is the most effective option available.
• Permanent AF is self-sustaining and resistant to medical intervention. Surgery has proven to be the only viable option for terminating permanent AF.

AF Surgical Classifications

Surgeons tend to classify atrial fibrillation as either continuous or intermittent based on the James L. Cox classification system. This classification may seem overly simple after reading the medical classification system, but surgeons like Dr. Cox are interested in the mechanisms that initiate and sustain afib so those mechanisms can be surgically ended.

• Intermittent AF is understood to be caused by irregular electrical impulses that initiate in the pulmonary veins. Intermittent AF is either self limiting or eliminated after medical intervention. Intermittent AF tends to include both the paroxysmal and persistent classifications in the medical model. Intermittent AF is almost always curable with surgical ablation.
• Continuous AF has a self sustaining mechanism that cannot be converted to sinus rhythm with any medical intervention. Continuous AF is thought to occur because the cardiac conduction system has been electrically remodeled and no longer requires an irregular impulse from the pulmonary veins to initiate the onset of atrial fibrillation. Continuous AF is only treatable with surgical ablation.

Dr. David Affleck of Western Cardiovascular Associates surgically restructures and remodels the pathways of irregular electrical impulses in the heart that cause atrial fibrillation with the mini-maze minimally invasive closed chest surgical ablation procedure. Whether you live in Salt Lake City, Ogden, or Utah Valley, or anywhere in the country, contact Western Cardiovascular Associates or call 801-743-4750 today.