Non-Pharmacological Treatment of Atrial Fibrillation and the Appropriate Management

Non-pharmacological treatment of atrial fibrillation entails various therapeutic methods. They include surgery, radiofrequency ablation, pacemaker, and atrial defibrillator (Jones, Pollit, Fitzmaurice & Cowan, 2014). In the surgical treatment modal, the maze surgery is the common procedure. The procedure is conducted by separating the atrial appendages and dissecting the atrial wall in a particular pattern. The dissection path runs from the sinus node along to the atrioventricular node and thus allowing the organization of the atrial contractions. The depolarization follows the specific path to prohibit reentry and thus preventing more occurrences of atrial fibrillation. This is necessitated by the fact that the maze surgery creates a small area on the atrial myocardium as compared to the "wavelength" present in atrial fibrillation. Although this method is significant in preventing more effects of atrial fibrillation it is subject to side effects has a high mortality rate. Furthermore Shenasa & Camm, (2015), suggest that maze surgery is a major heart surgery procedure and hence accounts for approximately 2% of the perioperative mortality.

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The radiofrequency ablation method entails the induction of high-frequency current administered through ablation catheters mainly to get the heart back to the normal rhythm (Aliot, Haissaguerre & Jackman, 2011). The high frequency creates minor lesions in the heart that prohibits atrioventricular reentry. Ablation also minimizes the risk of the occurrence of other atrial fibrillation episodes since the heat destroys the tissues in the affected areas and thus stopping the abnormal heartbeat. Vinall & Di Biase, (2014), connote that radiofrequency ablation is approximately 90% successful and it is associated with minimal complications as it is encountered with the maze surgery. Nevertheless, it leads to bleeding and pain while inserting the catheters but serious complications are not common.

A pacemaker is significant to patients exhibiting the sinus syndrome and cases where the there is a high rate ventricular responses. While pacemaker therapy does not treat atrial fibrillation, it is significant in preventing cases of severe bradycardia where the heartbeat is too slow. It helps to increase the atrial pacing and hence assist to get the heart back to a normal rhythm. For the patients suffering from bradycardia, atrial pacing helps prevent atrial fibrillation by inhibiting long pauses where the atrial misses beats. Atrial pacing is also highly successful in reducing the risk of atrial fibrillation, and it is associated with minimal complications (Matusik, Lelakowski, Malecka, Bednarek & Noworolski, 2016). Nevertheless, the method cannot be sufficient to stop a heart attack that has already begun.

The use of an atrial defibrillator is also significant to get back the heart to a normal rhythm. Atrial defibrillation entails the administration of catheters in the heart, but unlike the radiofrequency ablation, here, the catheters carry low-frequency current (Ueberham, Dagres, Potpara, Bollmann & Hindricks, 2017). It is appropriate for patients suffering paroxysmal atrial fibrillation where these patients encounter fewer heart attacks approximately once in a month but have severe symptoms. While this method has a high success rate, it has some complications where patients experience a painful shock caused by the current passed through the catheters (Luis, Roper, Incani, Poon, Haqqani, & Walters, 2012).

Appropriate Care and Management for the Patients with Atrial Fibrillation

Following the prevalence of atrial fibrillation, there is a need to acquire the relevant information necessary to grant optimum care for the patients facing the problem. Nonetheless, appropriate care and optimal management for these patients require a collaborative effort from various palters including medical professionals, caregivers, and family members. More importantly, it is essential that integrated healthcare models should consider administering special care for atrial fibrillation patients by providing support. The support can be in the form of decision making and empowering the patients to won the care procedures by providing any necessary assistance. It entails providing the patients with an avenue to access specialized treatment from expert medical practitioners including stroke specialists, cardiologists, atrial fibrillation surgeons, and other general medical doctors (Barmano, Walfridsson, Walfridsson & Karlsson1, 2016).

Since atrial fibrillation is associated with unhealthy lifestyles that cause an abnormal heartbeat, some families opt to provide care for their patients form their homes. Although it may be useful, it is essential that these patients receive care from specialized caregivers as they offer a wide range of treatment options. More often, appropriate care involves administering mechanisms to prevent severe side effects caused by atrial fibrillation such as stroke. Caregivers have a wide range of methods that aid in regulating the heart rate of the patient to prevent further complications. The most significant process is the use of oral anticoagulation to control the heart rate and the rhythm reducing the risk of stroke (Dan, Bayes de Luna & Camm, 2014).

Patient education is also a significant approach to administering appropriate care to atrial fibrillation patients. It entails creating awareness and teaching the patients on the relevant information associated with atrial fibrillation including the causes, symptom, and the subsequent risks. This strategy is critical to allow the patients to understand and make appropriate decisions regarding the most appropriate choices on personal lifestyles and also learn the importance of speaking openly to the doctor and clarifying information. As a consequence, it helps the further risks of the condition and frequent hospitalizations (Barmano, et al 2016). Moreover, as discussed earlier, atrial fibrillation is associated with lifestyles, and if the patient continues to make unhealthy lifestyle choices, the situation may worsen causing severe effects.

References

Aliot, E., Haissaguerre, M., & Jackman, W. (2011). Catheter Ablation of Atrial Fibrillation. Somerset: Wiley.

Barmano, N., Walfridsson, U., Walfridsson, H., & Karlsson1, J. (2016). Structured care of patients with atrial fibrillation improves guideline adherence. Journal Of Atrial Fibrillation, 9(4). doi: 10.4022/jafib.1498

Dan, G., Bayes de Luna, A., & Camm, J. (2014). Atrial Fibrillation Therapy. London: Springer London.

Jones, C., Pollit, V., Fitzmaurice, D., & Cowan, C. (2014). The management of atrial fibrillation: summary of updated NICE guidance. BMJ, 348(jun19 1), g3655-g3655. doi: 10.1136/bmj.g3655

Luis, S., Roper, D., Incani, A., Poon, K., Haqqani, H., & Walters, D. (2012). Non-Pharmacological Therapy for Atrial Fibrillation: Managing the Left Atrial Appendage. Cardiology Research And Practice, 2012, 1-9. doi: 10.1155/2012/304626

Matusik, P., Lelakowski, J., Malecka, B., Bednarek, J., & Noworolski, R. (2016). Management of Patients with Atrial Fibrillation: Focus on Treatment Options. Journal Of Atrial Fibrillation, 9(3). doi: 10.4022/jafib.1450

Shenasa, M., & Camm, A. (2015). Management of atrial fibrillation. Oxford, United Kingdom: Oxford University Press.

Ueberham, L., Dagres, N., Potpara, T., Bollmann, A., & Hindricks, G. (2017). Pharmacological and Non-pharmacological Treatments for Stroke Prevention in Patients with Atrial Fibrillation. Advances In Therapy, 34(10), 2274-2294. doi: 10.1007/s12325-017-0616-6

Vinall, M., & Di Biase, L. (2014). The Left Atrial Appendage and Atrial Fibrillation. MD Conference Express, 14(9), 9-12. doi: 10.1177/155989771409002