Atrial fibrillation (AFib) is the most common type of serious heart arrhythmia. It’s caused by abnormal electrical signals in the heart. These signals cause your atria, the upper chambers of your heart, to fibrillate or quiver. This fibrillation typically results in a fast, irregular heartbeat.
If you have AFib, you may never have symptoms. On the other hand, you may have serious health complications. Your heart’s irregular beating can cause blood to pool in your atria. This can cause clots that travel to your brain and cause a stroke. According to the American Heart Association, people with AFib have five times the stroke risk of people without the condition. AFib can also worsen certain heart conditions, such as heart failure.
But take heart. You have several treatment options, including medications, surgery, and other procedures. Certain lifestyle changes can help, too.
Your doctor will put together a treatment plan to manage your AFib. Your treatment plan will likely address three goals:
- Prevent blood clots.
- Restore your normal heart rate.
- Restore your normal heart rhythm.
Medications can help achieve all three of these goals. If medications don’t work to restore your heart rhythm, other options are available, such as medical procedures or surgery.
The increased risk of stroke is a serious complication. It’s one of the major causes of premature death in AFib patients. To reduce the risk of a clot forming and causing a stroke, your doctor will likely prescribe blood thinning medications. These may include:
- warfarin (Coumadin)
- rivaroxaban (Xarelto)
- dabigatran (Pradaxa)
- apixaban (Eliquis)
- edoxaban (Savaysa)
Your doctor will check your blood regularly to make sure the medications are working.
Slowing down your heart rate is another important step in treatment. Your doctor may prescribe medications for this purpose. Three types of medications can be used to restore your normal heart rate:
Another step in AFib treatment is restoring the normal rhythm of your heart, called the sinus rhythm. Two types of medication can help with this. They work by slowing down electrical signals in your heart. These medications are:
- Sodium channel blockers such as flecainide (Tambocor) and quinidine (Nuedexta)
- Potassium channel blockers such as amiodarone (Cordarone, Nexterone, Pacerone)
Sometimes medications can’t restore sinus rhythm, or they produce too many side effects. In this case, you may have an electrical cardioversion. With this painless procedure, your healthcare professional gives your heart a shock to reset it and restore a normal beat.
Electrical cardioversion often works, but it’s not usually permanent. Afterwards, you may need to take medications to maintain the new, regular heartbeat.
Another option for restoring sinus rhythm when medications fail is called catheter ablation. A narrow catheter is threaded through a blood vessel into your heart. The catheter uses radiofrequency energy to destroy a small amount of tissue cells in your heart that send out signals that cause your abnormal heart rhythm. Without the abnormal signals, your heart’s normal signal can take over and create sinus rhythm.
If your heart rhythm doesn’t respond to medications, you may need a pacemaker. This is an electronic device that’s placed in your chest during a surgical procedure. It regulates your heartbeat to sinus rhythm.
Pacemakers are only used in certain patients, most often people who have AFib and a slow heartbeat. They’re used as a last resort after medications fail to work. This is because heart surgery comes with many risks.
A final treatment called the Maze procedure may be used to treat AFib when medications and other procedures have failed. It involves open-heart surgery, so the Maze procedure is more likely to be used if you have another heart condition that requires surgery.
A surgeon makes incisions in your atria that restrict the abnormal electrical signals to a certain area of your heart. It prevents the signals from getting to the atria to cause the fibrillation. Most people who have this procedure no longer have AFib and no longer need to take antiarrhythmic drugs.
Lifestyle changes are also important. These changes can help reduce your risk of complications from AFib.
You should stop or refrain from smoking and limit your intake of alcohol and caffeine. Also, you should avoid cough and cold medications that contain stimulants. If you’re not sure which to avoid, ask your pharmacist. Also, take note of any activities that produce or worsen your AFib symptoms and talk to your doctor about them.
For more tips, check out this article on lifestyle changes to help manage AFib.