New Atrial Fibrillation Program reduces stroke risk, improves quality of life
EDMONTON — People with an irregular heartbeat now benefit from a one-stop, comprehensive treatment option: the new Atrial Fibrillation Program at the Mazankowski Alberta Heart Institute.
After a one-year pilot, the program is now established as an ongoing treatment path where patients receive the education, lifestyle advice, medication and procedures they require to get their racing heartbeat under control, and improve their quality of life and longevity.
“Managing atrial fibrillation (AF) is the key,” says nurse practitioner Marcie Smigorowsky. “This is a chronic disease; it has no cure. It can produce a rapid, irregular heart rate of 150 or higher due to chaotic electrical activity in the atriums (upper chambers) of the heart. The consequences, if it’s not diagnosed and well-managed, are severe: stroke and heart failure.
“Atrial fibrillation is on the rise,” she adds. “It increases as we age and with other co-morbidities, such as sleep apnea and high blood pressure. And so the numbers are growing. Our program helps to manage patients in a faster, more streamlined way and also ensures followup for them.”
With its team-based approach to care, the AF program has reduced the wait time to see a specialist from several months to 30 days or less. Gathering all of the appropriate resources in one location reduces time, travel and number of appointments for AF patients, as well as ensures consistency of care and best practices.
The Mazankowski’s AF team — Smigorowsky and cardiologists Dr. Roopinder Sandhu and Dr. Tomasz Hruczkowski — have also laid the groundwork with emergency departments, where AF patients often present for the first time, and with primary care physicians and others, to ensure these patients are given a timely referral to receive the specialty care the AF clinic provides.
The clinic currently manages about 400 patients, and sees 70 new patients a year.
“While family practitioners are our partners in managing patients with AF, Canadian cardiovascular guidelines suggest that when patients are first diagnosed, they should also be referred to specialty care for assessment of their AF, so their background and history can be reviewed and a treatment plan arranged,” says Smigorowsky. “It’s extremely important to assess their risk factors quickly; they may need to be on blood thinners.”
AF affects about 350,000 Canadians; their risk of stroke is three to five times greater than those without it. After age 60, it’s estimated that AF causes one-third of all strokes.
Some people with AF may feel perfectly fine and be unaware they have the condition until they have a routine test called an electrocardiogram, which charts their heartbeat. Others with AF may experience various symptoms including irregular and fast heartbeat; heart palpitations or a rapid thumping in their chest; chest discomfort, chest pain or pressure; shortness of breath, particularly with exertion or anxiety; fatigue; dizziness, sweating or nausea; light-headedness or fainting.
“If you’ve ever played any sports, and you reach the point where you’re just about ready to throw up, that’s what AF feels like,” says patient Lanny Magnussen. “I also feel like I’m choking. It’s a very unpleasant feeling. My heart will beat really hard till it hurts, up to 160 or 170 beats a minute.”
The 63-year-old Edmontonian has survived multiple heart attacks and now attends the AF clinic. “They are marvelous at helping me manage and reduce my symptoms. It’s fabulous care. Absolutely fabulous care. My wife and I think of Marcie as our angel.”
In addition to education, counselling and blood thinners, other options for AF care include:
- Antiarrhythmics: Specialized drugs used to treat abnormal heart rhythms.
- Electrical cardioversion: A procedure in which a low-voltage electric current, applied through metal paddles or patches on the chest wall, is used to reset the heart’s rhythm back to normal.
- Ablation: The use of radio-frequency or cryogenics, respectively, to burn or freeze the tiny spot on the heart wall that’s the source of the irregular electrical activity and heartbeat.
“The idea behind this clinic is also patient education,” says Smigorowsky. “If we spend a lot of time teaching with our patients, because it is a chronic illness, then their anxiety tends to come down. They become more knowledgeable and engaged in their care. I also spend more time with patients who are new to our clinic, to make sure that I understand what’s happening with them, so we can come up with the right treatment plan together.”
Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than four million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.