Cambridge Cardiac Care Centre

Rapid Access Atrial Fibrillation Clinic

A specialized clinic tailored to Atrial Fibrillation patients

The Afib clinic at Cambridge Cardiac Care is an innovative, multi-disciplinary medical unit, designed to address atrial fibrillation, specifically. We developed this unique Rapid Access program to reduce the risk of stroke, reduce hospital admissions and improve the life-long wellbeing of our Afib patients. That is why we work hard to eliminate barriers to access: the clinic is free-of-charge, multi-lingual, wheelchair-accessible and open to all Afib patients regardless of their geographical place of residence. The only requirements are a referral from your health care provider and a personal commitment to improving your heart health.

The Afib Team

Multi-disciplinary but with a single focus

Guided by our lead physician and two dedicated Afib nurses, this science-based program draws on an elaborate team of allied health care professionals, carefully selected to meet the specific needs of the Afib patient. Focusing on accurate diagnosis, event-prevention, comprehensive therapy and lifestyle intervention, patients receive personalized, guideline-based care in a supportive environment.

Testing for Afib

Accurate diagnosis means getting the right tests by the right people.

Atrial fibrillation can take many forms and is caused by a number of conditions. It is important to determine exactly what is going on, and why, in order to develop an appropriate plan of care. Afib patients can expect to have the following cardiac tests done in their initial work-up in a thorough, timely manner:

  • ECG
  • Holter monitoring
  • Ambulatory Blood Pressure Monitoring
  • Echocardiogram
  • Stress testing

Why you need prevention-rehab now.

The P.R.E.V.E.N.T. & Rehabilitation Clinic

If you have been referred to the Afib clinic, you have direct, Rapid Access to our P.R.E.V.E.N.T. and Rehabilitation clinic: the largest unit of its kind in the region. Why? Because in many cases, time is of the essence. Even if you are not experiencing symptoms, the risk is real: without warning, Afib can lead to a stroke or heart failure... or both. Studies show that cardiac rehabilitation can reduce the risk of future cardiac events and disease progression by upto 90%! Afib does not have to result in an emergency, if you learn to manage it now. Learn how at The P.R.E.V.E.N.T. and Rehabilitation clinic.

What tests might I need?

Accurate diagnosis means the right tests, by the right people, at the right time.

It is important to determine exactly what is going on, and why, in order for your cardiologist to develop an appropriate plan of care. You can expect to have some, or all, of the following tests done in preparation for your assessment by the cardiologist:

Physical Exam

  • Come prepared knowing your symptoms, medical and family history!
  • Measurements of blood pressure, height & weight and listening to heart & lungs stethescope
  • Be completely honest! It's your health!

Blood Test

  • Blood tests may be done at any lab that is convenient for you. Some blood tests require you to fast 8-10 hours, others do not. Please check the requisition or check with your health care provider.
  • Blood tests help determine your risk for development or progression of various heart diseases.
  • Measurements of substances like liver enzymes, sodium, potassium and creatinine can indicate the health of other organs that may be effected by heart disease.
  • Biomarkers like BNP might also be used for diagnosis of heart failure (CHF).

Chest X-Ray (CXR)

  • Chest X-rays are performed in radiology labs
  • Chest x-rays can show whether the heart is enlarged (like in heart failure)
  • Chest x-rays can also show fluid or congestion in the lungs

Electrocardiocgram (ECG)

  • During an ECG, electrodes are placed on the chest and detect the electric signals in the heart
  • This can indicate prior heart attacks, and abnormal heartbeats (like atrial fibrillation)
  • They can also be used to detect whether the left ventricle is thickened/enlarged
  • Electrocardiocgram testing at CCCC

Echocardiogram (Echo)

  • An echo machine bounces sound waves off the heart to examine its structure and motion of fluids like blood
  • This can be used to measure the structure of the heart (how thick/rigid the walls are) and how well the heart pumps (ejection fraction) as well as the structure and function of valves
  • They can also be used to detect whether the left ventricle is thickened/enlarged
  • Echocardiography testing at CCCC

Stress Test

  • In a stress test, you will exercise on a treadmill while equipment measures your heart
  • Stress tests examine the response of the heart to exertion and whether blood flow to the heart is impaired
  • Stress tests help determine what kind of exercise is appropraiate
  • Stress testing at CCCC

Nuclear Imaging (MIBI/MUGA)

Cardiac Catheterization / Angiogram

  • A very thin tube called a catheter is inserted into a blood vessel and threaded towards the heart
  • A dye is released that is visible by x-ray
  • The movement of the dyed fluid throughout the heart can show blocked or narrowed arteries as well as how much blood is flowing through the heart
  • Cardiac Catheterization Lab at St. Mary's General Hospital

The Stroke Connection

Manage your Afib. Manage your Risks.

People with atrial fibrillation are at 3 to 5 times greater risk of stroke than the average. In fact, Afib causes 30% of all strokes in the 60+ population. And the numbers in younger people with risk factors in addition to Afib are not that far behind. Women are at even greater risk.

Everything depends on your risk factors

It is important to get a proper and thorough risk assessment by your physician and then start managing those risks right away. In some cases it will be a matter of simply reducing salt intake, for some it may be to quit smoking, for others it will be incorporating a tailored exercise routine and for others still it’s all of the above. Everything depends on your risk factors and how well you manage them. A personalized care-plan must be established and put into action, one that accounts for all your unique health and lifestyle factors. That’s why we have invested in such a robust program that addresses your specific situation from all its angles. Get educated about your condition, take advantage of the resources provided and ask questions every step of the way.

Patient Education

Atrial Fibrillation (Afib) Simplified

What is Atrial Fibrillation?

Afib is the irregular beating of the top chamber of your heart. To understand why the heartbeat can become irregular in this way, first we need to understand how the heart beats in the first place. In a healthy heart, an electrical impulse sends a wave through the heart muscle causing its chambers to contract (squeeze) in a regular, predictable rhythm, keeping the blood moving as it pumps through the heart to the rest of the body’s organs. When there is a disturbance in the electrical signal, an irregular heart rhythm (a.k.a. arrhythmia) occurs. Atrial fibrillation is a type of arrhythmia.

What’s the big deal?

Afib patients are 3 to 5 times more likely to have a stroke. That means brain damage. That is a big deal. Regardless of age, the dangers of a stroke increase significantly with added risk factors like smoking, high blood pressure, and diabetes. What’s more, from the age of 55 the risk doubles every decade. If you are female, it’s even higher. Remember: you don’t have to have symptoms to be at risk. Get to know your risk factors so you can start to control them right away.

If you have atrial fibrillation, it is critical that you, your family and friends all learn to spot the signs of a stroke. Remember F.A.S.T.

  • F ace drooping (e.g. an uneven smile)
  • A rm or leg weakness
  • S peech is slurred
  • T ime to call 911

How does Afib cause a stroke?

The abnormal heartbeat and inefficient pumping action of the Afib heart can cause blood to pool and even sit still for an unpredictable period of time. When blood pools it clots. A clot can then make its way to the brain, cutting off blood flow and vital oxygen, killing brain cells within minutes. This is what we call an ischemic stroke.

As an Afib patient, your risk increases if you are female, as your age advances, or if you have any of the following pre-conditions:

  • Diabetes
  • Hypertension (high blood pressure)
  • Vascular disease (coronary artery disease, angina, leg blockages (PAD), etc)
  • Stroke (prior stroke, TIA or thromboembolism)
  • Congestive heart failure

How does Afib cause Heart Failure?

Congestive heart failure (CHF) is the result of weakened heart muscle. With the rapid and unpredictable beating caused by Afib, the heart muscle tires and even thins over time. The heart is simply not strong enough in CHF to pump oxygen-rich blood to the body’s organs. It is called heart “failure” not because your heart is going to stop working but because it is failing to pump efficiently. CHF is progressive so it is vitally important to address it at the earliest signs and, better yet, prevent it at the first detection of Afib.

What are the symptoms of Afib?

No two Afib patients’ symptoms are alike. Some will report less noticeable symptoms than others. Don’t let that fool you. If you have been told that you have Afib, you are at a significantly higher risk of stroke whether you feel symptoms or not. ALWAYS follow the advice, medication regimen and lifestyle changes recommended to you by your healthcare provider to reduce your chances of stroke and/or congestive heart failure.

The most common symptoms related to atrial fibrillation include:

  • Shortness of breath
  • Coughing and wheezing
  • Sudden weight gain (e.g. 2-3 pounds overnight or 3-5 pounds in a week)
  • Abdominal pain
  • Chronic fatigue (feeling weak or tired)
  • Dizziness & light-headedness
  • Heart palpitations (uneven, fluttering or racing heart beat)
  • Chest discomfort, tightness or pain

What kind of lifestyle do I have to adopt with Afib?

In addition to consistently taking your medications as prescribed by the cardiologist, you’ll have to make some lifestyle changes to minimize your chances of having a stroke. Most people with Afib lead active, normal lives when, in addition to medication compliance, they adopt these lifestyle changes:

  1. Adhere to the D.A.S.H. diet (D.A.S.H. in English; D.A.S.H. in Portuguese). Also known as Diet Approaches to Stop Hypertension (high blood pressure). D.A.S.H. puts necessary restrictions on sodium (salt), sugar, saturated fats, and overall calories. It recommends a diet rich in fruits, vegetables, fish, low-fat dairy and lean meats.
  2. Adjust diet to address diabetes concern. It is important to eat at regular intervals (if you are a diabetic, no more than 6 hours between meals). Limiting sugary foods and drinks is a crucial step.
  3. Manage vitamin K levels carefully. Vitamin K is found in leafy green vegetables (like kale and spinach) which are an important component of the D.A.S.H. diet. However, vitamin K can interfere with some older blood thinners like warfarin that may be prescribed to Afib patients. It is important to ask your healthcare provider or dietitian to calculate the optimal amount of leafy greens that you should consume, based on the medications you are prescribed.
  4. Follow recommended exercise regimen. Appropriate levels of exercise can be an important component to mitigating heart failure and stroke risk in most people with Afib. You must receive the green light from your physician before engaging in high intensity exercise. If you are on blood-thinners for Afib, avoid high-risk activities like scuba diving, skydiving or contact sports. Building up your endurance gradually is most advisable: you might walk for 5 to 15 minutes per day and slowly work your way up to 30+ minutes per day, over time.

What is an atrial fibrillation ablation procedure?

During an atrial fibrillation ablation, a special catheter or wire is used to cauterize and block damaged electrical pathways from sending faulty signals to the rest of the heart. This prevents the abnormal signals from entering the left atrium of your heart and causing atrial fibrillation. Here are helpful guides to learn more about ablation:

Electrical Cardioversion of AFIB

A cardioversion is a procedure done at a hospital in the ER, ICU or monitored ward that involves the delivery of an electrical shock to your heart to restore your heart’s normal rhythm from an abnormal one like atrial fibrillation. An intravenous catheter will be inserted in your arm to deliver fluids and medications so you are asleep during the procedure. Pads are placed on your chest and back and hooked up to an external defibrillator. When you are asleep the physician delivers an electrical shock. Usually, one shock is required. If the first shock does not work, the physician can try two to three more times with higher energy. The cardioversion is over within a few minutes and the recovery time is quick, with most patients going home within a few hours after the procedure if this was a planned, elective procedure. After the procedure you should not operate a car, drink alcohol, operate heavy machinery or make any important decisions for 24 hours.

Please visit the Ottawa Heart Institute for more information on cardioversions and links on do's and don'ts before and after the procedure.

Wait Times

Drag to see the table

Cardiac Test Routine Test Wait Time Urgent Test Wait Time
ABPM 2 weeks Same day
ECG 24 hours Same day
Echocardiogram 2 weeks 36 hours
Stress Test (Exercise / Treadmill) 2 weeks Same day
Stress Echocardiogram 2 weeks 24 hours
Holter Monitor - 24 Hour 2 weeks 24 hours
Holter Monitor - 48 Hour 2 weeks 24 hours
Holter Monitor – 72 Hour 2 weeks 48 hours
Holter Monitor - 2 Weeks 2 weeks 48 hours
Spirometry 24 hours Same day

The above wait-times indicate the standard benchmarks that Cambridge Cardiac Care strives to meet each and every day. Unforeseen circumstances and Public Health mandates, may effect these wait times. Rest assured that timely access is a driving force at CCC: we will get you in as soon as possible, based on your assessed level of urgency.