For Oregon Cardiology Patients

If you have been referred to Oregon Cardiology to consider a potentially curative procedure for atrial fibrillation (AF), this is where you should start. Before your visit, please review

• this page, including the flowchart below
• the Basic AF handout
• the Advanced AF handout
• the FAQ page
• the Before and After page

This website is intended to help you understand the potential benefits and risks of procedures for atrial fibrillation You’ll get much more out of your visit to Oregon Cardiology if you’ve reviewed this material first.

Who might benefit from a curative procedure for AF?

Most patients with atrial fibrillation are best managed with a “rate control plus warfarin” strategy, but some are not. For a curative procedure to help, one must:

• Have ensured that AF is the problem, rather than another arrhythmia such as Atrial Flutter (which is easily treated by catheter ablation)
• Have already treated underlying causes of AF, such as sleep apnea, thyroid disorders, and excessive alcohol intake
• Have important symptoms, as the procedures have been shown to reduce symptoms, but not stroke risk or other issues
• Have already failed antiarrhythmic therapy
• Have a reasonably high likelihood of long-term maintenance of normal rhythm based on the type of AF you have, the size of the left atrium, and certain other factors

Only a subset of patients have a high likelihood of a good outcome. Good outcome is unlikely if you have:

• Untreated conditions such as sleep apnea or excessive alcohol
• Persistent (continuous rather than intermittent) AF
• Left atrium more than mildly enlarged
• Decreased heart pumping function (low left ventricular ejection fraction)

Common Misconceptions

Some patients have unrealistic expectations about curative procedures for AF. Some of these expectations are fostered by misinformation on the internet. Common misconceptions include:

• That warfarin (Coumadin) can be discontinued in all cases after the procedure
• That the procedures are almost always successful
• That successful procedures are always permanent
• That the procedures have very low risk

If you have your procedure at Sacred Heart Medical Center at RiverBend:

• Note that all patients are required to undergo extensive testing prior to the procedure, primarily to ensure that you do not have other heart disease, such as a leaky valve or coronary artery disease, that may require a different surgical procedure
• Note that nearly all patients enter a research protocol that may require additional testing (but no additional expense to you)
• Note that all patients are required to undergo extensive monitoring (two weeks continuously every six months) indefinitely after the procedure