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VCU Division of Cardiothoracic Surgery, Department of Surgery, Virginia Commonwealth University VCU Division of Cardiothoracic Surgery

VCU Division of Cardiothoracic Surgery

Atrial Fibrillation Program

Pauley Heart Center's Atrial Fibrillation Program offers the full spectrum of innovative therapies and treatments for AF patients. This includes medical management, cardiac assist devices, catheter ablation procedures using advanced mapping technology, and a variety of minimally invasive and surgical approaches.

The comprehensive program is a collaboration of cardiac specialists and cardiothoracic surgeons. It is led by Kenneth Ellenbogen, MD, Chairman of the Division of Cardiology and Director of Cardiac Electrophysiology, and Vigneshwar Kasirajan, MD, Chairman of the Division of Cardiothoracic Surgery.


About Atrial Fibrillation

Atrial fibrillation (AF) is a condition in which the upper part of the heart (the atria) beats irregularly and much too fast because it receives rapid, abnormal electrical signals. These signals cause the heart to quiver (fibrillate) and affect the heart's ability to efficiently pump blood to the rest of the body. As a result, the brain and other organs may receive too little blood to operate at their best.

Atrial fibrillation may only occur occasionally, or it may be a persistent condition. It is rarely painful, though it can produce an uncomfortable sensation in the chest. The decreased pumping power or the heart can also cause dizziness, lightheadedness, shortness of breath, weakness and fatigue. Some patients, however, have no sensation that their heart is fibrillating.

AF is a dangerous medical condition that becomes more difficult to treat over time and can lead to irreversible heart damage. AF can also lead to the formation of blood clots inside the heart that can cause a stroke. In fact, patients with atrial fibrillation are twice as likely to die and five times more likely to have a stroke. Medications can alleviate symptoms caused by AF, but they do not cure the underlying problem.

There are 2.3 million people in the United States that have AF, making it the most common type of arrhythmia. About 160,000 new cases are diagnosed every year. Eight out of every 100 people over the age of 65 are diagnosed with AF. Although it usually occurs in adults older than 60, younger adults can develop AF too.

While for many people there is no apparent cause for AF, it can be related to underlying conditions or risk factors including:

  • Previous heart attack, congestive heart failure, leaky valves, coronary artery disease or inflammation near the heart
  • High blood pressure or diabetes
  • Thyroid, lung or other illnesses
  • High levels of caffeine or alcohol use
  • Sleep disordered breathing

Atrial fibrillation may occur from time-to-time (paroxysmal), or be constant (chronic or persistent). If treated appropriately, atrial fibrillation and atrial flutter seldom cause serious or life-threatening problems.

To diagnose atrial fibrillation, the doctor may begin by feeling the patient's pulse and recording an electrocardiogram (ECG). If the pulse is irregular, AF is suspected. The diagnosis is then confirmed with an ECG - a simple, painless test that records the electrical activity of the heart.

Some patients may be asked to wear a small portable device with electronic memory to record a series of ECGs over time. These devices include Holter monitors, event recorders and loop recorders. A Holter monitor runs continuously, and usually is worn for 24 to 48 hours. An event recorder is switched on by the patient to record an ECG whenever he or she senses an irregular heartbeat. A loop recorder can be automatically triggered by an abnormal heart rhythm or a fast or slow heart rate.

Follow the links below to learn more about treatments for atrial fibrillation and patient follow up.




or visit the Atrial Fibrillation Program Website