Find the Right AFib Treatment Options and Expertise

If a doctor has diagnosed you with atrial fibrillation (AFib), you might wonder what it means for your health.

Atrial fibrillation, or AFib, is the most common diagnosis of an irregular heartbeat. By 2030, researchers estimate over 12 million people will have AFib in the United States. And it can affect anyone: in 2023, basketball legend Kareem Abdul-Jabbar appeared in a public service announcement after he learned he was affected by the condition. “Don’t wait,” he urges in the video available at notimetowait.com. “When I first noticed symptoms, I should have gone to the doctor and told them what was happening,” he says. 

When AFib occurs, the top and bottom chambers of the heart beat out of rhythm. When this happens, blood moves less efficiently, raising your risk of blood clots and stroke. An irregular flow of blood in the heart can cause a clot. If the clot breaks off, it can go to your brain and cause a stroke. AFib causes about one in every five strokes.

“There is a lot of fear around AFib,” acknowledges Faisal Merchant, MD, director of cardiac electrophysiology at Emory Healthcare. “But, for most people, it is not life-threatening. They can expect to live a healthy, long life.”

As an electrophysiologist, Dr. Merchant is a cardiologist who specializes in the heart’s electrical systems. Treating patients with AFib is about 50 percent of his work.

Here’s what you need to know about atrial fibrillation, second opinions, and available treatment options.  

Some people with AFib don’t have any symptoms. Others might notice signs such as:

• A feeling of rapid fluttering in their heart (palpitations)
• An irregular heartbeat
• Chest pain
• Extreme fatigue
• Lightheadedness
• Shortness of breath

As people get older, their risk of AFib grows. In addition, other factors can increase AFib risk, such as high blood pressure, obesity, European ancestry, diabetes, heart disease, smoking, and more.

Talk to your primary care doctor about your heart health if you notice any symptoms or have multiple risk factors. Together, you can discuss your AFib risk and determine your next steps.   

Whether newly diagnosed or years into treatment, sometimes it’s valuable for people with an AFib diagnosis to seek a second opinion. Because medicine is constantly evolving with new research and innovative techniques, you could learn about options that might work better for your individual situation.

“It never hurts to get a second opinion,” says Dr. Merchant. You could discover new treatment options, get a different medical opinion or gain reassurance you’re on the right path.

Other reasons patients with AFib seek a second opinion include:

• Their symptoms aren’t under control or their treatment isn’t working
• Their AFib is progressing
• They want to change medications or get off medications

Emory Heart & Vascular Center has the largest and most advanced electrophysiology program in Georgia. And our cardiologists and electrophysiologists offer the most advanced treatments available, including those still in clinical trials.

If you’ve already been diagnosed with AFib and want a second opinion, contact the Emory Arrhythmia Center at 678-582-8293. 

Experts at Emory offer a range of treatments, including innovative clinical trials. Treatments include lifestyle changes, medications, and surgery.

Dr. Merchant puts treatments into three categories based on their goals:

• To reduce AFib risk or prevent AFib from progressing. You can’t change some risk factors, like your age. However, physicians can work with you to help you improve your overall health. For example, patients may need to control or lose weight, eat better, exercise, or treat their sleep apnea.
• To treat AFib symptoms. We monitor and treat symptoms to keep your heart in rhythm more often and prevent complications. Medications or ablation may be right for you. Ablation destroys the small areas of the heart that cause AFib. Cardiologists and electrophysiologists can perform ablations using radiofrequency waves, freezing, or other newer energy sources. Emory leads many of the latest clinical trials in pulsed-field ablation.
• To prevent stroke. Because AFib increases the risk of blood clots, some patients take blood thinner medications. Procedures like left atrial appendage closure can also prevent stroke; they block the area where clots often form.

Patients with persistent AFib can find a variety of innovative solutions at Emory Healthcare. Our specialists perform many different ablations, which may offer you a better outcome. For example, our electrophysiologists and cardiac surgeons can work together to destroy problem areas inside and outside the heart in a single procedure.

Our experts can also use pacemakers with an AV node ablation to control the heart’s rhythm. The AV node connects the top and bottom of the heart. Once they ablate the AV node, surgeons insert a pacemaker to keep the heart in a regular rhythm.

Clinical trials test treatments to make options available to more types of patients. For example, atrial appendage closures are often only available for patients who cannot take blood thinners. Providers at Emory Healthcare also participate in clinical trials to study the effectiveness of these devices in patients who prefer not to use blood thinners. Patients who would otherwise be ineligible for the closure procedure receive the treatment in a trial.  

Treatment for AFib is rarely an emergency. So, Dr. Merchant has “time to get to know people and talk about what’s going on.” Patients often have fears about their condition, so he works to ease some of their anxieties. For example, Dr. Merchant routinely asks if their current treatment plan is still effective or if it gets in the way of their life, so he can better understand their concerns.

“Overtreating AFib is common,” he says. “But not all AFib needs to be treated; it can be monitored. And most people with AFib don’t need a procedure.” Dr. Merchant develops individualized treatment plans so he doesn’t overtreat AFib or overexpose his patients to medications or procedures. With thoughtful questions, he ensures his patients get the right level of treatment for their unique case of AFib. 

A provider who regularly sees the full range of AFib can ensure you get the proper treatment. The electrophysiology team at Emory Healthcare performs thousands of AFib procedures each year, which helps them stay at the top of their field. “The more you do something, the better you get at it,” said Dr. Merchant. The electrophysiology team performs over 1,000 ablations and 300 closure procedures yearly.  

If you think you may have AFib or some other heart concern, first talk with your primary care provider – don’t wait. They may run some tests or screen you to determine your next steps.

Find your heart health expert at Emory Heart and Vascular Center. Our research-based care benefits all kinds of patients. We work hard to help you prevent heart disease. And our specialists know the most innovative treatments for people with complex heart needs. To make an appointment, please call 404-778-7777.