Reporter: Aviva Lev-Ari, PhD, RN
Written by
Hugh G. Calkins, M.D., Director of the Arrhythmia Service
and Electrophysiology Lab at The Johns Hopkins Hospital,
and Ronald Berger, M.D.
- Hugh Calkins, M.D. is the Nicholas J. Fortuin, M.D. Professor of Cardiology, Professor of Pediatrics, and Director of the Arrhythmia Service, the Electrophysiology Lab, and the Tilt Table Diagnostic Lab at The Johns Hopkins Hospital. He has clinical and research interests in the treatment of cardiac arrhythmias with catheter ablation, the role of device therapy for treating ventricular arrhythmias, the evaluation and management of syncope, and the study of arrhythmogenic right ventricular dysplasia.
- Ronald Berger, M.D., Ph.D., a Professor of Medicine and Biomedical Engineering at Johns Hopkins, is Director of the Electrophysiology Fellowship Program at The Johns Hopkins Hospital. He serves on the editorial board for two major journals in the cardiovascular field and has written and coauthored more than 100 articles and book chapters.
If you’ve ever run up a flight of stairs, chased a tennis ball across the court, or reacted in fright at a scary movie, you know what a pounding heart feels like… But for the 2.3 million Americans who suffer from atrial fibrillation (AF or AFib), a racing heart is a way of life. Simple tasks like getting out of bed in the morning or rising from a chair can cause dizziness, weakness, shortness of breath, or heart palpitations. For these people, AF severely impairs quality of life – and even when symptoms stemming from AF are mild, the disorder can seriously impact health, increasing the risk of stroke and heart failure. AF can be a debilitating even deadly condition. Fortunately, it can be successfully managed – but there are various approaches for treating AF or preventing a recurrence. How do you and your doctor choose which approach is right for you? If you or a loved one has AF, there are so many questions: Do I need an anticoagulant… should I be taking medication to control my heart rate… will my symptoms respond to cardioversion… if I need an antiarrhythmic drug to control AF episodes, which one should I take… when is an ablation procedure appropriate… and more. It’s critically important to learn everything you can now — so you can partner with your doctor effectively, ask the right questions, and understand the answers. To help you, we asked two eminent experts at Johns Hopkins to share their expertise and hands-on experience with arrhythmia patients in an important new report, Atrial Fibrillation: The Latest Management Strategies. Dr. Hugh Calkins and Dr. Ronald Berger are ideally positioned to help you understand and manage your AF. Together with their colleagues at Johns Hopkins, they perform approximately 2,000 electrophysiology procedures and 200 pulmonary vein isolation procedures for atrial fibrillation each year.
Anticoagulation Therapy: What You Should Know
While AF is generally not life threatening, for some patients it can increase the likelihood of blood clots forming in the heart. And if a clot travels to the brain, a stroke will result. Anticoagulation therapy is used to prevent blood clot formation in people with AF…
- Why is anticoagulation therapy with warfarin (Coumadin) needed for some people with AF?
- How is the use of warfarin monitored?
- How does a doctor determine if a patient with AF needs to take warfarin?
- What’s the CHADS2 score and how is it used?
- If a patient’s CHADS2 score is 1, how do you decide between aspirin and warfarin, or nothing at all?
- Why is it so difficult to keep within therapeutic range with warfarin?
- Can I test my INR (a test measuring how long it takes blood to clot) at home?
- What happens if my INR is too high?
- What options are available if a patient cannot take warfarin?
- What are the benefits of dabigatran, a new blood-thinning alternative to warfarin therapy?
Symptom Control: The Art of Rate and Rhythm Control
For many patients and their doctors, it’s difficult to achieve and maintain heart rhythm. Two key management strategies are used: heart rate and heart rhythm control. In Atrial Fibrillation: The Latest Management Strategies, you’ll read an in-depth discussion of the benefits of rate versus rhythm control for AF:
- What have we learned from the AFFIRM study, and how has this knowledge affected the management of AF?
- What is catheter ablation of the AV (atrioventricular) node?
- Why is cardioversion needed?
- Are there different types of cardioversion?
- What is chemical cardioversion? What is electrical cardioversion?
- Can medication be used to convert the heart back to normal sinus rhythm?
- Which antiarrhythimic drugs are used to treat AF?
- How is catheter ablation for AF performed?
- What is pulmonary vein antrum isolation (PVAI) and how is it performed?
- Who are the best candidates for PVAI?
http://www.johnshopkinshealthalerts.com/catalog/special_report/6044-1.html
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