Nothing is more important than your health and it’s normal to have lots of questions when you receive a diagnosis of a condition such as AF. It’s not always easy to think of everything you want to ask when you are sitting across from your doctor, so here is a list of questions for you to download and review before your next appointment – select those that you would like to talk to your doctor about and add any of your own. We’ve also listed and answered here some of the most common general questions people ask about AF and its treatment.
Questions about atrial fibrillation (AF)
AF occurs when abnormal electrical signals disrupt your regular heartbeat –your heart loses its rhythm and starts to beat irregularly or too fast. This reduces your heart’s ability to pump blood efficiently around your body. Read more about AF here.
Symptoms of AF vary from person to person but most commonly include:
- Irregular heartbeat (palpitations, pounding or racing)
- Shortness of breath
- Tiredness or a general feeling of being unwell
- Chest discomfort or pain
- Dizziness or fainting
Some people with AF do not experience any symptoms. In ‘silent’ cases like this, AF might be picked up in a standard health check or when looking at another health issue.
The risk of AF increases with age and can be caused by a variety of factors that can cause damage to the heart. These include:
- High blood pressure
- Obesity (being overweight)
- Existing heart conditions, such as:
− Coronary artery disease (narrowed or blocked arteries)
− Previous heart attack or heart surgery
− Faulty heart valves
− Congenital (inherited) heart defect
− A problem with the natural pacemaker in the heart (the sinoatrial node) - Type 2 diabetes
- Overactive thyroid gland
- Sleep apnoea (when your breathing stops and starts while you are asleep)
- Lifestyle factors, including:
- Obesity (being overweight)
- Excessive alcohol consumption
- Physical inactivity
In some patients, AF occurs for no apparent cause.
In a healthy heart, organised pathways of electrical signals produce a steady rhythm, so your heart contracts to pump blood from the top to the bottom of the heart and then around the body. These regular beats are controlled by the sinoatrial (SA) node, which acts as the heart's natural pacemaker. During AF, abnormal signals completely disrupt the organised pathways and the controlled pace of your heartbeat. These disruptive signals are often initiated outside the heart but get transmitted into the left atrium of the heart via the pulmonary veins.
The most serious risk associated with AF is an up to 5x increased risk of stroke.2,3 A stroke might occur due to a blood clot that travels to the brain. Stroke is a medical emergency which can cause long-term damage to your health, or even death.
Because AF reduces your heart's ability to pump as it should, blood may not be cleared out of the heart efficiently. If blood is not kept moving by the circulation process, there is a risk of it pooling and stagnating − most often in a part of the heart called the left atrial appendage (LAA). This blood has the potential to form a blood clot, which could then be pumped out of the heart and travel to the brain, causing a stroke.
If you experience any of the following symptoms, even if they seem mild, it is advisable to seek medical attention immediately:
- Weakness, numbness, or paralysis in one side of your body (particularly in face, arms, or legs)
- Difficulty in speaking or in understanding speech
- Dizziness or loss of balance or coordination
- Fainting or loss of consciousness
- Severe headache
A variety of treatment options are available for AF. Some treatments focus on managing your heartbeat's rhythm (regularity) and rate (pace), while others focus on the managing the risk of stroke. Your doctor will recommend you a tailored treatment that fits your specific condition. Read more about treatment options for AF here.
Following a healthy lifestyle can have a positive impact on the health of your heart and reduce your risk of stroke1,2:
- Eat a healthy diet and maintain a healthy weight
- Exercise regularly
- Stop smoking
- Restrict/eliminate alcohol and caffeine
For more information on what you can do to improve your heart health and overall well-being, download our guide to healthy living here.
Questions about the treatment of AF
A variety of treatment options are available for AF:
- Short-term treatments to restore a regular heart rhythm, such as cardioversion.
- Longer-term treatments to restore and maintain a healthy heart rate and rhythm, including:
- Drug therapy
- Cardiac ablation - Treatments that focus on reducing the risk of stroke:
- Drug therapy
- Left atrial appendage closure (LAAC) which involves preventing blood entering the left atrial appendage which is where blood can pool and clot if your heart is not pumping efficiently.
Read more about the treatment options for AF here.
Read more about LAAC with WATCHMAN™ FLX here.
Cardiac ablation deactivates or "neutralises" the heart tissue responsible for transmitting the abnormal electrical signals that cause AF. Unlike heart surgery, it's a minimally invasive procedure performed by inserting long thin tubes called catheters through a small incision in your groin and advancing them through your blood vessels into your heart. Your specialist (cardiologist or electrophysiologist) monitors on screens the precise position of the catheters inside your vessels and your heart. Once in position, energy is delivered through a catheter to neutralise the target cardiac tissue, so it can no longer transmit electrical signals.
More recent treatment guidelines (which review latest clinical evidence to make their recommendations) include an increased number of categories of AF patient who might benefit from cardiac ablation.1
Cardiac ablation relies on energy being delivered to the target tissue to neutralise it. This energy can be:
- Thermal (temperature-based):
- Radiofrequency ablation (RFA) uses extreme heat.
- Cryoablation uses extreme cold. - Pulsed field ablation (PFA) represents a cutting-edge development in ablation technology and uses a non-thermal ablation method in the form of microsecond high-energy electrical pulses to neutralise the target tissue. Because cardiac cells are more sensitive to this electrical field than cells from other tissue, surrounding structures, such as the oesophagus or the phrenic nerve, will not be affected.4-8
The distinctive flower-shaped FARAPULSE™ Pulsed Field Ablation System is amongst the most widely used and broadly studied device for pulsed field ablation.4-8
Questions about FARAPULSE™ Pulsed Field Ablation System
There are different types of atrial fibrillation (AF) and different types of cardiac ablation. Your doctor will assess your case to determine if cardiac ablation with the FARAPULSE™ PFA System is an appropriate treatment for you. Their assessment will consider the following:
The FARAPULSE™ PFA System may be right for you if:
- You suffer from paroxysmal AF (AF episodes come and go, often resolving without treatment)
- You meet the criteria for a cardiac ablation procedure called pulmonary vein isolation (PVI)
The FARAPULSE™ PFA System is not right for you if:
- You suffer from persistent or permanent AF
- You do not meet the criteria for a PVI cardiac ablation procedure
As with any medical procedure, there are risks involved with pulsed field ablation with the FARAPULSE™ PFA System. See the Important Safety Information below for a list of possible complications, and ask your doctor about the risks and benefits of the FARAPULSE™ PFA System.
The electrical signals that cause AF are often transmitted into the heart via the tissue at the connection points between the pulmonary veins and the left atrium. Pulmonary vein isolation (PVI) is a cardiac ablation procedure with the goal of blocking transmission of these signals by targeting and neutralising the tissue at these specific connection points. By doing so, PVI helps prevent AF episodes from occurring.
For many people, ablation can eliminate or significantly reduce the symptoms and risks associated with AF, allowing them to return to normal activities with an improved quality of life. However, atrial fibrillation is a progressive disease, and while ablation can modify its progression, it is not always a permanent cure. While many patients experience long-term relief, some may still have episodes of AF and might need additional treatments or medications.refs Your doctor will monitor your progress and work with you to manage your condition effectively.
- Cardiac cells are more sensitive than other tissue to the pulsed, high-energy electrical fields created by the FARAPULSE™ PFA System, so surrounding structures to your heart, such as the oesophagus or the phrenic nerve, are better protected than when thermal energy is used8
- Extensive studies have shown PFA with FARAPULSE™ to be generally safe, with minimal side effects4-10
- Patients report minimal pain and fast recovery after their FARAPULSE™ PFA procedure9,10
- A study has shown that patients who underwent FARAPULSE™ PFA ablation had a significant improvement in quality of life.11
- Extensive studies have shown PFA with FARAPULSE™ to be generally safe, with minimal side effects.4-10
- The ADVENT clinical trial compared traditional thermal ablation to pulsed field ablation (PFA) for treating atrial fibrillation and found that PFA is just as effective and safe.8
- A separate study has shown that patients that underwent FARAPULSE™ PFA ablation had a significant improvement in quality of life.11
- The Farapulse™ Pulsed Field Ablation System is backed by over 10 years' research and has been used to treat ~70,000 AF patients around the world.12
Visit Treatment with the FARAPULSE™ PFA System to learn what to expect before, during and after your PFA procedure, and to view an animation of how the procedure is performed. You can also download a PDF.
The FARAPULSE™ Pulsed Field Ablation System is the amongst the most widely used PFA technology in the world and is now available at approximately 400 medical centres in Europe.12 If you and your doctor agree that that PFA with the FARAPULSE™ System is the right treatment for you, talk to them about which centre they will refer you to. You can search treatment centres that offer PFA with FARAPULSE™ here.