Expert Available to Discuss Atrial Fibrillation

Reporters seeking background information about Vice President Cheney’s treatment for atrial fibrillation are welcome to contact the UVA Public Relations office to arrange an interview with:

J. Michael (Mike) Mangrum, MD, Associate Professor of Medicine,
and director of the Atrial Fibrillation Center at the UVA Health System

Dr. Mangrum’s Afib FAQ’s:

Following is a transcript of a recent interview with Dr. Mangrum

Q. What it is Atrial Fibrillation (afib) and how common is it?

Dr. Mangrum: It’s very common. In fact, afib is the most common abnormal rhythm that people have. It affects about 2.5 million people in America alone, and the prevalence is increasing over time. And it’s estimated that by the year 2030, about 5.6 million people in America will have atrial fibrillation, which occurs when the atria (the top chambers of the heart) quiver at a rate of roughly 400 beats a minute.

Q. What are the symptoms of Afib?

Dr. Mangrum: Patients are quite symptomatic. They have a reduction in their heart function, and they feel palpitations, may feel dizziness, some may even pass out. Fifteen percent of all strokes are attributable to atrial fibrillation. Patients who have afib are at risk of stroke from the disorder because the atria are quivering and clots can form in the atrium.

Q. What causes Afib?

Dr. Mangrum: There are multiple causes. The strongest factor is aging. In fact about 10 percent of people over the age of 80 have atrial fibrillation. As our population ages, the number of people in America with afib will increase.

Another common cause of afib is hypertension. Over time, hypertension increases the left atrial size and pressure within the left atrium that causes some scarring, and the scarring predisposes a patient for atrial fibrillation. Some people have primarily an electrical problem with their heart that causes afib.

Q. How is Afib treated?

Dr. Mangrum: Medications are the first line of therapy and the most common treatment. Antiarrhythmic drugs try to keep the patient in normal rhythm. Results vary by drug, but in general medications have an efficacy rating of 40-60 percent in maintaining normal rhythm.

If antiarrhythmic drugs do not help, then the next line of therapy is cardiac ablation. Ablation is designed to get rid of the atrial fibrillation. It is a procedure that uses catheters, threaded thru the veins, up into the heart. These areas are mapped with sophisticated imaging equipment, and then ablation is performed, usually in the left atrium. Ablation uses energy to destroy the tissue causing afib and is a highly specialized procedure. It is not available in all places. Success rates for cardiac ablation range from 50-85 percent, depending on the patient. Success rates are typically lower in patients who have long standing atrial fibrillation with a lot of other heart disease. Patients who have a pristine heart and just have atrial fibrillation tend to experience greater success with ablation.