Why Treating AFib Early with Ablation Is Key to Long-Term Heart Health.

A wild flip-flop or flutter in the chest. A sense of deep, unexplained fatigue. Atrial fibrillation (AFib) could be behind these uncomfortable symptoms.

AFib is the most common heart rhythm disorder. The Centers for Disease Control and Prevention estimates that 12.1 million people in the U.S. have AFib.

Often caused by wear and tear, AFib is when the heart’s two, smaller upper chambers (the atria) beat out of rhythm and incredibly fast—sometimes up to 400-600 beats per minute. The heart’s main pumps, the ventricles, just can’t keep up. This jumpy rhythm is often behind symptoms such as palpitations, shortness of breath, and fatigue. 

For many years, medication was the primary strategy to treat AFib. Yet several studies have helped us better understand how the disease progresses, and the field of electrophysiology has had a major shift. Now, we can offer a definitive treatment called cardiac ablation, a minimally invasive procedure to correct the broken electrical signals at the root cause of arrhythmia.

With AFib, it’s important to be seen by a highly experienced team MedStar Health’s nationally recognized Comprehensive Atrial Fibrillation Management Program is one of the most sought after and experienced in the country. 

Our experts frequently perform the most advanced procedures, including modern pulsed field ablation. As one of the first centers in the region to offer this new technology, our team-based approach helps us develop treatments customized to each patient. 

The data is clear: Timely, earlier action with cardiac ablation, especially safer modern techniques, can stop AFib from progressing and give people better long-term outcomes.

Timing matters: The danger of negative structural remodeling.

A short-circuit in the heart’s electrical flow, AFib is a problem that will usually get worse over a lifetime. Often, AFib will advance from occasional symptoms (paroxysmal) to ongoing (persistent) AFib. 

Without proper management, AFib can cause permanent changes in the heart. Constant strain from irregular rhythms can cause the atria to get larger or dilate. Once this occurs, it can “lock” the rhythm, making it more difficult to treat. This process is called negative structural remodeling.

Persistent arrhythmias are associated with major long-term risks, such as:
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• Stroke: Preventing stroke is one of the main reasons to treat AFib, because stroke can cause permanent damage to the brain or be fatal.

• Cardiomyopathy: These physical changes to the heart muscle make it more difficult to pump blood to the body, weakening the heart and raising the risk for heart failure.

• Cognitive decline: In the long term, unmanaged AFib has been associated with intellectual challenges and dementia.

New heart monitoring devices, including Apple Watch, Fitbit, KardiaMobile, event monitors as well as implanted loop monitors and other smart tools are helping us identify AFib earlier. These tools aren’t perfect, but they can give us a window to spot AFib and step in before negative structural remodeling can take hold.

Related reading: Post-approval Cryoablation Research Streamlines Treatment for Persistent AFib.

Ablation: A better treatment option.

For many years, AFib treatment focused on using antiarrhythmic drugs (AADs) and blood thinners to help patients control their heart rate. Newer research suggests that restoring a normal heart rhythm instead can help prevent long-term damage, reduce symptoms, and improve our patients’ quality of life. 

While medications can be an important part of treatment for many patients, they can cause negative side effects and reactions including nausea, shortness of breath, severe chest pain, and headache. While AADs can help to limit Afib, their success has not been as effective as ablation strategies.

Ablation can eliminate AFib. The goal is to restore a normal heart rhythm by blocking the electrical signals that cause the arrhythmia. To do this, we precisely wall off the damaged heart tissue at the root of the short circuit so the heart can beat normally again. 

A growing body of research shows that early ablation provides much better long-term benefits for patients than medication alone. A 2024 study, showed that in patients with AFib, earlier ablation was associated with a much lower risk of AFib coming back. The same study also showed early ablation significantly lowered the risk of heart failure, stroke, and death compared to late ablation. 

Ablation can help patients avoid long-term daily drug therapy and medication side effects. Because ablation silences the abnormal connections that drive AFib, patients get quick relief from symptoms and see their quality of life improve significantly. 

Safer, faster pulsed field ablation.

Dramatic advancement in technology is one of the reasons why ablation is now recommended as a first-line therapy for AFib. 

Traditionally, ablation used thermal energy (heat or cold). Although these methods are effective, they carry a risk of injury to healthy tissues and nearby organs like the esophagus, lungs, and phrenic nerve, which controls the diaphragm muscle that’s key in breathing. Pulsed field ablation (PFA) gives us a safer option.

PFA is the newest type of ablation, first approved for use in the U.S. by the Food and Drug Administration in 2023. A cardiac electrophysiologist threads a thin tube called a catheter through the veins from the leg to the heart. There, PFA precisely destroys diseased heart tissue with pulses of electric current delivered in microseconds.

Following the procedure, patients typically rest in the hospital for a few hours, then return home that same day. Within two days, they are usually able to return to normal activities with the exception of strenuous exercise. 

Related reading: Pulsed Field Ablation: A New, Safer Treatment for Atrial Fibrillation.

Working together to restore your rhythm.

To ensure everyone receives the benefits of a full continuum of care, our teams include specialists in cardiac electrophysiology, cardiac surgery, primary care, and cardiac rehabilitation. We work together to make sure every aspect of your AFib care is managed, from diagnosis to recovery.

If you have symptoms of AFib or have been recently diagnosed, don’t wait to get treatment. Earlier care is better, and together we can help you find relief from symptoms and get back to your normal rhythm.