• Your Care Team If You Have Atrial Fibrillation


    If you have atrial fibrillation (Afib or AF), you will meet a number of healthcare professionals.

    Many people learn that they may have Afib in the emergency department of their local hospital. That’s because Afib can develop with no obvious warning signs, and it can be frightening. You may have experienced dizziness or lightheadedness, perhaps with a fluttering in your chest or even chest pain. You or a family member may have called for emergency help. Calling 9-1-1 is the smart thing to do if you feel the symptoms of heart trouble because many cardiovascular conditions, including heart attack and pulmonary embolism, are life-threatening emergencies.

    If your Afib symptoms were milder and didn’t last long, you may have described them to your primary care provider, who may have recommended heart tests.

    Either way, managing Afib is a team effort.  Your doctors and other healthcare professionals will work together to diagnose which type of Afib you have and decide how best to manage it to reduce your symptoms and prevent stroke. Remember, you are the most important member of your team. The decisions you make about the different treatment options and the effort you put into managing your heart disease risk factors are ultimately up to you. However, you’ll get lots of help from the other members of your team.

    Depending on your situation and where you are being treated, your care team may include some or all of the following medical professionals:

    • Cardiologists. Cardiologists are physicians who specialize in diagnosing and treating heart problems. Depending on your treatment needs, you may remain under the care of a general cardiologist, or you may work with that cardiologist in conjunction with an electrophysiologist, an interventional cardiologist or a cardiovascular surgeon.
      • Electrophysiologists are cardiologists who have specialized knowledge and training in the electrical systems of the heart. Electrophysiologist have been trained to perform minimally invasive procedures such as pacemaker and ICD implantation, electrical cardioversion and ablation. These are among the treatment strategies used to manage Afib and other heart rhythm problems. Some electrophysiologists also perform left atrial appendage closure, a procedure appropriate for some people who have Afib and are unable to take medication that thin the blood to prevent stroke. Many people with Afib see their electrophysiologist regularly.
      • Interventional cardiologists specialize in diagnosing and treating problems in the heart and blood vessels. You may see an interventional cardiologist if you have had a heart attack that was treated with angioplasty and stenting or if you have blocked arteries that cause angina. Interventional cardiologists also perform minimally invasive procedures on leaky heart valves. Some interventional cardiologists also perform left atrial appendage closure.
      • Cardiothoracic surgeons specialize in treatment of the heart, lungs, esophagus and chest. These physicians have been specially trained to perform open-heart surgery, such as for coronary bypass surgery or heart valve surgery as well as surgery to treat atrial fibrillation or close the left atrial appendage (LAA).
    • Primary care physician. Primary care doctors evaluate patients for overall health and treats illnesses. Even if you are seeing a cardiologist, you will likely continue to see your primary care physician on a regular basis because he or she will continue to have a central role in the care of your Afib, including coordinating services with other members of your care team.
    • Sleep medicine physiciansSleep apnea is associated with atrial fibrillation. If left untreated, sleep apnea may cause more frequent episodes of Afib. You may be referred to a sleep medicine physician for a sleep study or to evaluate your CPAP (continuous positive airway pressure) mask.
    • Clinical nurse practitioners and physician assistants. Clinical nurse practitioners have advanced training to practice medicine with or without physician supervision (depending on the law in each state). Physician assistants are licensed to practice medicine with physician supervision. Both of these medical professionals perform exams and some procedures, take medical histories, recommend diagnostic tests and treatments, prescribe medications, and may refer their patients to other specialists. These professionals will often be your point of contact for reporting symptoms or perhaps side effects of medications you are taking.
    • Clinical nurse specialists and other nurses. If you decide to have a procedure to treat your atrial fibrillation, you will be cared for by a number of nurses who work with your cardiologist. Many of these nurses will have taken specialized training in a specific field of cardiac care, such as electrophysiology or interventional cardiology.
    • Diabetes educators. If diabetes has contributed to your atrial fibrillation, you may be referred to a diabetes educator who is trained to help you understand diabetes and what you need to do to manage your condition and maintain targeted blood glucose levels. In some cases, episodes of Afib can be triggered by diabetes that is either uncontrolled or not controlled well enough.
    • Physical and occupational therapists. If you do not already have an exercise plan, developing one will be critical to maintaining your best heart health. Physical therapists can assist you with an exercise plan as part of a cardiac rehabilitation program. You may also find that everyday tasks are not as easy to complete because of weakness, fatigue or other symptoms that may bother you after an episode of atrial fibrillation. An occupational therapist can help you rebuild your strength or make adaptations that allow you to more easily complete tasks.
    • Dietitians. Dietitians are trained to evaluate your diet and suggest heart-healthy changes in your eating that may help reduce your cholesterol level, lower blood pressure, and manage diabetes, if you have it. Because these disorders and others, including metabolic problems, can be linked to Afib, a heart-healthy diet is an important step toward controlling the symptoms of Afib and your overall health.
    • Mental health professionals. The symptoms of Afib and receiving a diagnosis that includes increased risk for stroke can be emotionally stressful. Psychologists and counselors can provide individual and group counseling and help you identify support groups.
    • Social workers or case managers. These professionals can help you navigate financial, insurance and legal aspects of your care. You can learn more about health insurance here.
    • Smoking cessation specialists. If you smoke, you may be referred to a smoking cessation program. These programs are led by counselors with special training and experience in helping people quit using tobacco. Often, the program is supervised by a physician so that your addiction to nicotine is treated in a way that takes into account any other medical problems for which you may also be receiving treatment. To learn more about programs to help you quit smoking, click here.
    • Pharmacists. We often overlook one of the key members of our healthcare team — our pharmacist. In addition to filling prescriptions for medication, your pharmacist can answer questions about drug interactions, insurance, generic medications and much more. Your pharmacist can provide valuable information if you have questions about medications such as anticoagulants. Learn more about how your pharmacist can help you here.

    Ask Questions

    Remember, your active participation in your care will be an essential part of managing your condition and making sure that your treatment strategy is in line with your goals and expectations. Being part of the team means asking questions – all of your questions - of your healthcare providers. If possible, you may want to bring a family member or friend with you to medical appointments. Having someone with you can remove some of the pressure to remember everything you want to ask or every answer you hear. Many people ask their companion to help by taking notes to review later.

    For tips and strategies on navigating the healthcare system, including health insurance and the Affordable Care Act, click here.