‘Atrial fibrillation begets atrial fibrillation’ is a common phrase that has been used in reference to atrial fibrillation. Put simply, the more atrial fibrillation your heart has, the more atrial fibrillation it is likely to have. In a significant proportion of patients with atrial fibrillation, the heart rhythm abnormality will start with infrequent episodes. Over time, the episodes become more frequent and eventually may progress to continuous atrial fibrillation. So, is there an argument for early intervention to change the trajectory of the arrhythmia?

Symptoms of atrial fibrillation

In atrial fibrillation, the heart rate becomes irregular and can lead to the heart beating very fast. It is common for the heart rate to increase to over 100 beats per minute.

Atrial fibrillation is associated with a range of symptoms including palpitations, fatigue, difficulty breathing and dizziness. During episodes of atrial fibrillation, symptoms can be debilitating.

Therefore, allowing atrial fibrillation to progress can have a significant detrimental impact on your quality of life. Furthermore, amongst patients in whom atrial fibrillation has progressed to a continuous form, the success rates of potentially curative interventions, including catheter ablation procedures, is lower. These factors argue for earlier referral and intervention in patients with atrial fibrillation.

Treatments available for atrial fibrillation

The two main options to prevent episodes of atrial fibrillation are medications (antiarrhythmic drugs) or catheter ablation procedures. Antiarrhythmic medications can suppress episodes of atrial fibrillation. Catheter ablation procedures on the other hand have the potential to eliminate your heart rhythm abnormality. A more detailed discussion on the choice between antiarrhythmic drug therapy and ablation procedures in included here.

Catheter ablation is an established technique for management of atrial fibrillation and has been performed routinely for more than two decades. When performed by experienced operators who undertake a high volume of procedures, catheter ablation is a safe and superior alternative to anti-arrhythmic drugs for the maintenance of a normal rhythm.

In recent years, increasing evidence has emerged to indicate that catheter ablation has a role as a first-line treatment option for atrial fibrillation. A decision between catheter ablation and antiarrhythmic drugs requires a detailed discussion with a specialist in the area.

Dr Mahida has a particular interest in management of patients with atrial fibrillation and catheter ablation for atrial fibrillation. He sees patients with atrial fibrillation and other heart rhythm abnormalities at the Spire Manchester Hospital and Spire Liverpool Hospital.