Electrophysiology Program: Atrial Fibrillation (AFib) Program

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Atrial fibrillation occurs when rapid, disorganized electrical signals cause the heart’s two upper chambers (the atria) to contract very quickly and irregularly (fibrillate). Atrial fibrillation causes blood to gather in the atria because it is not pumping completely into the ventricles (the lower chambers of the heart).

Atrial fibrillation, also known as "AFib", is the most common condition associated with an abnormal rate or rhythm of the heartbeat (arrhythmia). More than 2.3 million people in the United States are affected by atrial fibrillation, and more than 160,000 new cases are diagnosed every year. Untreated, atrial fibrillation can raise the risk of stroke more than five-fold and has also been shown to double the risk of death.

There are three main types of atrial fibrillation:

Paroxysmal atrial fibrillation alternates back and forth between normal and abnormal rhythms
Permanent atrial fibrillation abnormal rhythms are present all of the time
Persistent atrial fibrillation abnormal rhythms last longer than one week, or require a small delivery of electrical energy or medications to reset the heart back to a normal rhythm (sinus)

The UF Health Cardiovascular Center in Jacksonville is uniquely qualified to diagnose and treat atrial fibrillation with access to the latest research and technologies that help control the condition as quickly as possible, so patients can get back to a full, healthy life.

Video: About Atrial Fibrillation

Symptoms of Atrial Fibrillation

Some people who have atrial fibrillation don’t experience any symptoms. Those who do have symptoms may experience one or more of the following:

Chest pain
Confusion
Heart palpitations
Irregular heartbeat
Lightheadedness or dizziness
Shortness of breath
Trouble exercising
Weakness or fatigue

Some patients who experience atrial fibrillation over a long period of time may become used to feeling fatigued and not notice symptoms.

Risk Factors

There are a number of risk factors associated with atrial fibrillation. Patients with one or more of the following conditions have a much higher chance of developing atrial fibrillation than the general population:

Atherosclerotic heart disease
Congestive heart failure
Heart valve disease
High blood pressure
Obesity
Obstructive sleep apnea
Thyroid problems

Diagnosis of Atrial Fibrillation

When patients come to the UF Health Cardiovascular Center, our heart team experts will discuss their symptoms and make an assessment. If our experts suspect a patient may have atrial fibrillation, we may suggest one or more of the following tests:

A blood test can help rule out a thyroid problem or other substances in the blood that could be causing the atrial fibrillation.
A chest X-ray can help determine if a patient has another condition in the lungs that could be causing symptoms.
An echocardiogram provides video images of the heart in motion so a doctor can determine if a patient has underlying structural heart disease.
An electrocardiogram (ECG) is the primary method for diagnosing atrial fibrillation. It measures the activity of the heart.
A Holter monitor assesses the heart’s activity over a longer period of time (usually at least 24 hours) to give doctors a fuller picture of the heart’s rhythms.

Once our heart team experts have diagnosed a condition, we will work with the patient to develop an individualized treatment plan.

Treatment of Atrial Fibrillation

If a patient has atrial fibrillation, symptoms may come and go over time, or may be persistent. A Cardiologist will discuss the symptoms with the patient so he or she can determine proper treatment based on a patient’s unique needs. Treatment will depend on:

How long a patient has had atrial fibrillation
Risk factors which may be present for stroke
Severity of your symptoms
The underlying cause of the atrial fibrillation

In general, the goals of treatment of this condition are to reset the rhythm of the heart, control the heart rate and prevent blood clots. Our heart team experts tailor a specific therapy on an individual basis, offering many advanced and state-of-the-art treatment options.

The majority of patients with atrial fibrillation need some type of anti-coagulant (“blood thinner”) to lower their risk of stroke. Patients who are older and have coexisting cardiac or vascular conditions are at a higher risk. Our heart team experts will be able to accurately determine the level of this risk and prescribe an appropriate therapy.

Additional state-of-the-art therapies include:

Direct-current cardioversion (DCCV) uses electric shock to momentarily stop — and then restart — the heart’s activity. This shock is delivered via paddles or patches on the chest while patients are sedated.
Drug-induced cardioversion uses medications known as anti-arrhythmics to help correct a heartbeat. These medications may be delivered orally (by mouth) or intravenously (by vein).
Convergent ablation (also known as a hybrid procedure), in which a cardiothoracic surgeon first uses a small incision in the chest to deliver heat (radiofrequency energy) and a cardiologist then performs a standard radiofrequency catheter ablation to alter heart tissue, stopping the arrhythmia. This procedure is best used for patients who have persistent atrial fibrillation.
Cryothermal balloon ablation, which uses a cold temperature balloon energy to alter heart tissue, stopping the arrhythmia.
Minimally invasive surgical ablation (also known as a mini-maze procedure), which uses small incisions in the chest to reach the heart with an ablation device to alter the heart tissue.
Left atrial appendage closure, during which a closure device is introduced through a large vein in the leg and delivered to the heart to close the left atrial appendage. Doing so can help reduce the risk of stroke and a patient may also no longer need to take long term blood thinning anticoagulant medications.
Open surgical (maze) procedures, during which the chest cavity is opened to reach the heart and a number of incisions are made on the left and right atria to form scar tissue. The scar tissue conducts electricity, allowing for the interruption of abnormal rhythms.
Pacemaker (PPM) implantation and AV nodal ablation, which places a small device in the chest or abdomen to help control heart rhythms with low-energy electrical pulses after a catheter is passed into the blood vessels and radiofrequency energy is delivered to the heart tissue that allows impulses to transfer from the top of the heart to the lower chambers.
Radiofrequency catheter ablation, a procedure that uses a catheter in the blood vessels to reach the heart and uses a high-frequency radio pulse to generate heat, stopping the arrhythmia.

Why Choose UF Health Jacksonville for Treatment

The UF Health Cardiovascular Center includes internationally recognized heart team experts who are leaders in cardiac care, research and education. Our cardiologists participate in numerous national and international clinical trials and offer accredited fellowship training programs in cardiology, electrophysiology and interventional cardiology.

Our Comprehensive Atrial Fibrillation Program individualizes treatment for each patient based on their type of atrial fibrillation. Working together with Cardiothoracic surgeons, our cardiologists offer a variety of medications and treatment options which can increase quality of life and minimize risk of stroke.

These heart team experts provide services at the UF Health Cardiovascular Center – Jacksonville, which has fully integrated, comprehensive heart programs, including a coronary interventional program, nuclear program, electrophysiology program, non-invasive program and peripheral interventional program.

UF Health Jacksonville is renowned for treating patients with complex diseases and being on the forefront of advancing the science of interventional cardiology. Using the most sophisticated equipment available, the center offers state-of-the-art diagnostic, therapeutic and rehabilitative cardiac services. Many leading-edge interventional therapies are offered in Northeast Florida only at the UF Health Cardiovascular Center – Jacksonville.

Jacksonville Atrial Fibrillation Specialists

2791 John N. Catanzaro, M.D., M.B.A., FACC, FESC, FHRS

Associate Professor
Associate Medical Director, Electrophysiology Program; Program Director, Clinical Cardiac Electrophysiology Fellowship
Specializes in Cardiovascular Disease; Clinical Cardiac Electrophysiology
3863 Stephen G. Keim, M.D.

Assistant Professor
Medical Director, Electrophysiology
Specializes in Clinical Cardiac Electrophysiology
3874 Prakash Goutham B. Suryanarayana, M.B.B.S. (M.D.)

Assistant Professor
Associate Program Director, Electrophysiology Fellowship
Specializes in Clinical Cardiac Electrophysiology