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Common Atrial Fibrillation Treatments

Doctor discusses Afib treatments with cardiology patientFor some people, an underlying medical condition, like a thyroid disorder, or some other factor could trigger atrial fibrillation. If it is possible to treat the underlying condition, then you may be able to treat your heart rhythm issues permanently. If your atrial fibrillation symptoms become disruptive, your doctor may try and reset your heart rhythm.

In the end, the best treatment for atrial fibrillation (AFib) will depend on how long the patient has been living with this condition, how disruptive are their symptoms, and the underlying cause of their atrial fibrillation. In most cases, the primary goals of atrial fibrillation treatment are:

  • Control heart rate or reset rhythm
  • Prevent blood clots

You and your doctor will need to pick a treatment strategy based on a few different factors, which can include other cardiovascular issues and medications you may be taking to control your heart rhythm. In some cases, a more aggressive form of treatment, such as surgery or other invasive medical procedures, may be necessary.

Maintaining a Healthy Heart Rhythm

If your heart rate has been reset through something like electrical cardioversion, then anti-arrhythmic medications are usually prescribed to help prevent future episodes of atrial fibrillation. The most common medications include:

  • Propafenone (Rythmol)
  • Dronedarone (Multaq)
  • Amiodarone (Cordarone, Pacerone)
  • Sotalol (Betapace)
  • Flecainide (Tambocor)
  • Dofetilide (Tikosyn)

While these drugs can help maintain a healthy (normal) heart rhythm for people with atrial fibrillation, they can also cause adverse side effects, such as:

  • Dizziness
  • Nausea
  • Fatigue

In some rare circumstances, these medications can cause a life-threatening rhythm disturbance known as a ventricular arrhythmias which originates in the lower chambers of the heart. For other people, they may be taking anti-arrhythmic medications indefinitely. Sadly, even with the help of these medications, the risk of experiencing another afib episode is still high.

Surgery and Other Invasive Procedures for Atrial Fibrillation

In some cases, medication and cardioversion are just not enough to control the symptoms of atrial fibrillation. For these patients, their doctor may recommend a surgical procedure which will actually destroy the proportion of heart tissue that is the source of the erratic electrical signals and allow for the heart to return to a normal rhythm. More aggressive atrial fibrillation treatment options include:

  • Radiofrequency Catheter Ablation: If you have atrial fibrillation but an otherwise normal heart, then your condition could be caused by rapidly discharging triggers (known as “hot spots”). You can think of these hot spots as abnormal pacemaker cells which are firing so quickly that upper chambers of the heart begin to quiver instead of beating normally. Radiofrequency energy is applied to these hot spots via a catheter that is inserted in an artery near the groin and feed into the heart. The hot spots are destroyed and scar tissue takes its place. This can correct the arrhythmia without having to use medications or artificial pacemakers.
  • Surgical Maze Procedure: The maze procedure is performed during an open-heart surgery, so their is some risk involved for the patient. With a scalpel, surgeons make several precise cuts in the upper chambers of the patient’s heart producing a pattern of scar tissue. Since electricity cannot pass through scar tissue, it blocks the stray electrical impulses that are causing the atrial fibrillation. Sometimes, cryotherapy or radiofrequency can be used to create this scar tissue. The procedure has a high rate of success, but it is not recommended unless other measures of afib treatment have been unsuccessful. Some patients may require a pacemaker to be installed following the surgical maze procedure.

In order to treat your irregular heartbeat or prevent future blood clots, people may need to take a combination of medications designed to treat atrial fibrillation. However, there are others who experience minor afib spells without even realizing it, so these treatments are not always necessary.