Atrial Fibrillation Program

Overview: Individualized Care for Atrial Fibrillation

The Massachusetts General Hospital Corrigan Minehan Heart Center is among the world’s leading diagnostic and treatment centers for patients with all types of heart rhythm conditions, including atrial fibrillation.

As part of the Cardiac Arrhythmia Service, our Atrial Fibrillation Program provides highly individualized care for patients with this disease.

Delivering individualized care means recognizing that each patient’s situation is unique. Our model of care emphasizes working closely with you, your referring physician and a team of atrial fibrillation specialists at Mass General to develop a customized treatment plan that decreases your stroke risk and reduces or eliminates your symptoms.

Your treatment plan is based on factors such as:

• Age
• Lifestyle
• Severity of symptoms
• Type of atrial fibrillation
• The presence of associated heart disease in addition to atrial fibrillation

Diagnosis: a Team Approach to Care

Each member of your Corrigan Minehan Heart Center care team specializes in treating atrial fibrillation and other cardiac arrhythmias. Care teams typically include specialists such as an electrophysiologist (a cardiologist who specializes in heart rhythm conditions), a cardiologist, a cardiac radiologist, an echocardiographer and a cardiac anesthesiologist, as well as nurse practitioners and physician assistants.

• A team approach combined with high-volume experience enhances our ability to:
• Determine the cause of your condition
• Develop a treatment plan that optimizes safety and effectiveness
• Decrease your stroke risk and reduce or eliminate symptoms
• Monitor your progress and response to treatment

What to Expect

At your first visit, you will meet with one of our doctors along with a nurse practitioner or physician assistant. The doctor will conduct a physical exam and review your medical history and laboratory tests.

If more diagnostic information is needed, additional testing may be advised. Our team includes cardiac radiologists who evaluate your heart by using advanced imaging technology capable of rendering the heart in remarkable detail.

Patient education is a cornerstone of our care model. During your first and subsequent visits, we will partner with you to ensure that you understand your condition and treatment options. We want to be sure you have the information you need to make educated decisions about your immediate and long-term care.

Leading Treatments & Procedures

Our program is internationally recognized for the treatment of Atrial Fibrillation and other cardiac arrhythmias, and patients have access to the most advanced treatments.

Observation or medication is typically the first option for managing patients, but some require a procedural intervention to achieve control of their atrial fibrillation and its symptoms.

Medications include:

• Anticoagulants for stroke prevention
• Medications for heart-rate control during atrial fibrillation
• Antiarrhythmic medications for prevention of atrial fibrillation

Catheter Ablation

Catheter ablation is a minimally invasive procedure that aims to restore the normal heart rhythm by inactivating the tissue that triggers and perpetuates atrial fibrillation and other arrhythmias.

Our team of experts has made important contributions that have helped advance the field of catheter ablation using radiofrequency (heat) energy. Moreover, we pioneered the use of cryoablation (cold energy) as an alternative energy source and have found it to be very successful in many patients. Members of our team are also investigating the use of a visually-guided laser ablation as a new energy source to perform catheter ablation.

Types of catheter ablations:

• Pulmonary vein isolation (PVI) and catheter ablation is a minimally invasive procedure in which a flexible catheter is inserted into the heart via a vein in the leg to electrically isolate the pulmonary veins from the rest of the heart. This procedure can eliminate or significantly reduce the severity and frequency of atrial fibrillation episodes in the majority of patients
• Atrial flutter ablation is a minimally invasive procedure where the physician targets the area in which the circuit for atrial flutter is located. By inactivating this tissue, the atrial flutter can be eliminated
• AV node ablation is reserved for patients who have advanced heart disease in addition to having atrial fibrillation and/or atrial flutter. The AV node is ablated and a permanent pacemaker with or without a defibrillator is inserted. This procedure eliminates the arrhythmias and helps maintain a normal heart rate

Our program also offers:

• The WATCHMAN device, a left atrial appendage closure device designed to replace blood-thinning medications such as warfarin to prevent strokes in patients with atrial fibrillation. Our physicians pioneered the use of this device. WATCHMAN is for investigational use only in the United States
• Electrical cardioversion, a noninvasive procedure in which the normal heart rhythm is restored as a result of a synchronized electrical shock delivered to the heart through the chest wall using skin patches
• The MAZE procedure, reserved for patients who have atrial fibrillation and need open heart surgery for a heart valve repair/replacement and/or a coronary artery bypass. This procedure is performed by cardiothoracic surgeons in close collaboration with the electrophysiologists.