Atrial Fibrillation

Heart specialists at UT Southwestern Medical Center have extensive expertise in the most advanced care for heart rhythm disorders. As a leading center for research and patient care for atrial fibrillation, we offer the latest treatments to our patients, giving them the best possible outcomes.

Clinical Heart and Vascular Center

Leaders in Heart and Vascular Care

Combining attentive, compassionate care with our extensive clinical and research resources, UT Southwestern's cardiology experts and vascular specialists deliver individualized care within pre-eminent health care facilities.

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What Is Atrial Fibrillation?

Atrial fibrillation (AFib) is a common type of arrhythmia, or abnormal heartbeat, that causes a rapid, irregular heart rhythm. Arrhythmias result from disturbances in the heart’s electrical system, which regulates heart rate and rhythm. If left untreated, AFib can increase the risk of heart failure, stroke, and other complications.

At UT Southwestern, our specialists are experts in minimally invasive procedures, such as catheter ablation, that treat AFib and other heart rhythm disorders. We use advanced techniques and devices such as cryoablation (freezing small areas of heart tissue), pressure-sensitive catheters, and pulsed field ablation (PFA) for better precision.

Our Heart Rhythm Management team is conducting numerous clinical trials of new treatments and devices, which means our patients have access to the latest technologies.

What Are the Risk Factors of Atrial Fibrillation?

Certain factors can increase the risk of developing AFib. Not everyone with risk factors will develop AFib, and people without risk factors can develop the condition.

Risk factors include:

Age: Most people who develop AFib are older than 60.
Heart disease: Conditions such as heart valve problems, congenital heart disease, congestive heart failure, coronary artery disease, or previous myocardial infarction or previous heart surgery can increase the risk.
High blood pressure: Hypertension, especially if not well-controlled, can increase the risk.
Alcohol use: Drinking alcohol, especially binge drinking, can trigger AFib in some people.
Obesity
Being male
Family history of AFib
Sleep apnea
Other chronic conditions: Thyroid problems, metabolic syndrome, diabetes, chronic kidney disease, or lung disease increase the risk.

What Are the Symptoms of Atrial Fibrillation?

AFib does not always cause symptoms, and sometimes symptoms can come and go suddenly. People can have the condition without realizing it.

The symptoms include:

Pulse that feels too fast, too slow, pounding, fluttering, or irregular
Sensation of an abnormal heartbeat (palpitations)
Fatigue or weakness
Dizziness or lightheadedness
Decreased ability to exercise
Shortness of breath
Chest pain
Confusion

How Is Atrial Fibrillation Diagnosed?

At UT Southwestern, our experienced heart specialists begin with a thorough evaluation, which will include a:

Physical exam
Discussion of personal and family medical history
Discussion of symptoms and risk factors
Ordering targeted cardiac tests

Depending on each patient’s individual case, our doctors might recommend one or more tests, such as:

Electrocardiogram (ECG or EKG): A noninvasive test in which electrodes are attached to the chest to record the heart’s electrical activity, to check for abnormal heart rhythms
Blood tests: Tests to check for thyroid problems or other substances that can indicate or rule out AFib
Chest X-ray: Imaging that doctors use to check for heart or lung abnormalities or look for other possible causes of symptoms
Echocardiogram: A noninvasive imaging study using ultrasound (sound waves) to produce video images of the heart to check heart structures such as valves
Event monitor: A long-term portable ECG device attached to the patient’s chest that the patient activates when experiencing a rapid heartbeat, to record the heart’s electrical activity over a few weeks
Holter monitor: A portable ECG device attached to the patient’s chest that automatically records the heart’s electrical activity over a 24-hour period
Stress test: An EKG and other tests conducted while the patient is performing physical activity or has taken medication to increase the heart rate, to evaluate heart function and check for abnormal heart rhythms

What Are the Treatments for Atrial Fibrillation?

Treatment goals for AFib are to:

Control heart rate
Restore a normal rhythm
Prevent blood clots
Reduce the risk of strokes

Our heart specialists develop a personalized treatment plan that takes into account whether patients have other heart problems and are able to take medications to control heart rate and rhythm. Treatment options can include one or more of the following:

Medications, such as:
- Blood thinner to reduce the risk of stroke
- Antiarrhythmic drugs
Electrical cardioversion: Doctors perform this procedure on patients who are under sedation, using paddles or patches placed on the chest to deliver an electric shock to the heart to restore its rhythm. Cardioversion gets a patient back in normal rhythm but doesn’t keep the patient in a normal rhythm.
Cardiac ablation: Cardiac ablation is a technique in which the doctor electrically disconnects the pulmonary veins from the left atrium. In the majority of patients, this cures their AFib.
Left atrial appendage (LAA) closure: The LAA is a small pouch in the left atrium where blood can pool in people with AFib, increasing the risk of blood clots. Clots from the heart can detach, travel through the blood stream, and cause a stroke. Removing or cutting off blood flow into the LAA with a device reduces the risk of stroke. Anticoagulants (blood thinners) prevent blood clots, but some people cannot take these drugs long-term due to a history of bleeding or because of a major bleeding risk. For those patients, our heart specialists perform a catheterization procedure to close the LAA. We implant a small, basket-shaped device called a Watchman™ into the LAA to close it off permanently. Our heart specialists are experts at using the Watchman device with patients who have AFib and are at increased risk for stroke but have issues taking anticoagulants.
Maze procedure: Our heart surgeons perform open-heart surgery to neutralize the erratic electrical signals on the heart, using either a scalpel or ablation.

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Lifestyle Changes

At UT Southwestern, our heart specialists also often recommend healthy lifestyle choices that can prevent or treat heart disease.

Lifestyle changes include:

Weight loss
Aggressive treatment of hypertension
Treatment of sleep apnea
Avoidance of excessive alcohol
Cessation of smoking
Physical fitness

Learn more about our Preventive Cardiology Program, which provides patients with personalized plans.

Which Clinical Trials for Atrial Fibrillation Are Available?

Clinical trials often give patients access to leading-edge treatments that are not yet widely available. Eligible patients who choose to participate in one of UT Southwestern’s clinical trials might receive treatments years before they are available to the public.

Clinical trials in cardiac electrophysiology at UT Southwestern include: