Treatment of atrial fibrillation after aortic valve replacement

At the recent Heart Valve Summit, I was overwhelmed with wonderful patient questions for our “Ask Adam Anything” event. For example, Eileen asked me about atrial fibrillation (AFib) which is an abnormal heart rhythm. Eileen’s question was, “Is atrial fibrillation after heart valve surgery common?”

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Adam's Newest Blogs
Adam's Newest Posts
How long does AFib last after aortic valve replacement?
Is AFib common after aortic valve replacement?
How do you fix AFib after heart surgery?
What is the drug of choice for atrial fibrillation?

As you may know… Atrial fibrillation is closely associated with heart valve disease. For that reason, I wanted to get Eileen an expert opinion. So, I tracked down Dr. Marc Gillinov who is the new Chair of Cardiac Surgery at the Cleveland Clinic. So you know, Dr. Gillinov is a guru when it comes to valvular heart disease and atrial fibrillation. You should also know that Dr. Gillinov has successfully treated many, many, many patients from our community including Anita Devine, Jeff Pirofsky and Fran Zilko.

Here are the highlights from my interview with Dr. Gillinov about atrial fibrillation after heart surgery.

As Dr. Gillinov shares in the video, the “temporary” occurrence of atrial fibrillation resolves over time in about 94% of patients. That said, you may be wondering what should be done for the 6% of patients that continue to experience Afib. Doctor Gillinov shared there are three steps that patients should take to potentially remedy their Afib — see an electrophysiologist, have a cardioversion, and have an ablation if symptoms continue.

I hope this helped Eileen (and perhaps you) learn more about atrial fibrillation after surgery. On behalf of our community, I want to extend a huge “Thank You!” to Dr. Gillinov for taking the time to share his research and clinical experience with our community!

See Dr. Gillinov’s Interactive Surgeon Profile
Visit the AFib & Heart Valve Education Center

Keep on tickin!
Adam

P.S. For the hearing impaired members of our community, I have provided a written transcript of my interview with Dr. Gillinov below.

Adam Pick: Hi, everybody. It’s Adam with HeartValveSurgery.com and we are here at the Heart Valve Summit in Chicago, Illinois. I am thrilled to be with Dr. Marc Gillinov. Marc, it’s great to see you again.

Marc Gillinov: Thank you.

Dr. Marc Gillinov

Adam Pick: This is the Chair of Cardiac Surgery now at the Cleveland Clinic. Marc, thanks so much for being with us.

Marc Gillinov: My pleasure.

Adam Pick: We have questions coming in from all over the country, all over the world, about heart valve surgery and AFib has come up, Marc. We’ve got a question from Eileen. She asks, “Is AFib after heart valve surgery common?”

Marc Gillinov: Yes. Let me start though with one word, one word to remember when you’re talking about AFib after heart valve surgery. The one word is temporary. AFib after heart valve surgery is almost always temporary. That’s the key thing to remember. Now for the details; getting down to the wheats.

About half of people get AFib after heart surgery, particularly heart valve surgery, and again the word is temporary. It is gone within six weeks in 94% of people. That’s from a large randomized control in a sponsored trial. So, 94% of the time it goes away within six weeks. It goes away mo matter how we treat it. If I give you a Beta-blocker, an antiarrhythmic medication like Amiodarone, if I try to use the paddles and shock you out of it, or if I do practically nothing, it almost always goes away; back to that word, temporary.

Adam Pick: Marc, I guess one of the questions – one, it’s fantastic that 94% of the patients will see the AFib taper off in a temporary way. I guess one of the questions patients might have is why do I get AFib after heart surgery? Why is that?

Marc Gillinov: Short answer is we don’t know. Longer answer, it’s a response to many facets of the heart surgery. It may be mechanical manipulation; we’re touching your heart. We’re inside your heart. We’re working on your valves, so there’s a mechanical manipulation. There’s inflammation associated with that which tends to go away. There’s an increase in your stress response, the fight or flight response. You have increased epinephrine or adrenaline in your system, and those probably relate – the inflammation and stress response – because those are temporary and to a certain extent [para] of the course of the AFib. One thing we know for sure, we can’t prevent it very well, but it does go away.

Adam Pick: Well, I hope that helped Eileen and all the other members of the community. I know it helped me, Marc. On behalf of our patients and our community, whether it’s Anita Divine or Jeff Pirofsky, who you’ve helped over the years, we cannot thank you enough for all the great things you’re doing at the clinic and taking care of our patients here at HeartValveSurgery.com. Thank you so much.

Marc Gillinov: My pleasure.

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

Adam's Newest Blogs

Adam's Newest Posts

How long does AFib last after aortic valve replacement?

About half of people get AFib after heart surgery, particularly heart valve surgery, and again the word is temporary. It is gone within six weeks in 94% of people. That's from a large randomized control in a sponsored trial. So, 94% of the time it goes away within six weeks.

Is AFib common after aortic valve replacement?

Atrial fibrillation is also associated with significant cardiovascular morbidity and mortality. New-onset atrial fibrillation has been recognized as a common occurrence after noncardiac and cardiac surgery, such as aortic valve replacement (AVR).

How do you fix AFib after heart surgery?

Some treatments used for afib after open heart surgery include:.

Blood thinners to help lower the risk for a dangerous blood clot, Pianko says. ... .

Anti-rhythmic drugs such as amiodarone to help restore the heart's normal rhythm..

Beta blockers and calcium channel blockers that help control the heart rate..

What is the drug of choice for atrial fibrillation?

Beta blockers and calcium channel blockers are the drugs of choice because they provide rapid rate control. These drugs are effective in reducing the heart rate at rest and during exercise in patients with atrial fibrillation.