Treatment of atrial fibrillation
There are many treatment options available for atrial fibrillation. Your treatment will be tailored to you, and will depend on your own symptoms and the cause of your atrial fibrillation. The doctor treating you will discuss your treatment options with you.
The aim of treatment is to control your heart rhythm and rate, and reduce your risk of stroke or heart failure. You may not need any treatment at all, especially if your symptoms are mild.
Your doctor may suggest you improve your heart health by:
- exercising for 30 minutes every day
- eating a balanced diet with five portions of fruit and vegetables every day
- stopping smoking
- reducing alcohol and caffeine intake
There are several different types of medicine that can help control atrial fibrillation, including beta-blockers, calcium channel blockers, anti-arrhythmic medicines and digoxin. They all work in different ways to control your heart rate or restore a normal rhythm.
Your doctor may prescribe a combination of any of these medicines. You may have to take them for just a short period until you have other treatment such as electrical cardioversion to restore your heart rhythm, or you may have to take them for months or years. Alternatively, you may be given medicine to take just when you get symptoms.
If your atrial fibrillation has come on suddenly, you may be given anti-arrhythmic medicine, as tablets or through a vein to try and get your heart rhythm back to normal (this is called chemical or medical cardioversion), and is usually given within 48 hours of having symptoms.
Medicines to reduce your risk of blood clotting are called anticoagulants. These include warfarin, heparin and aspirin. You will probably be offered one of these in addition to any other treatments you have.
Always ask a doctor for advice and read the patient information leaflet that comes with your medicine.
An electric shock is used restore your heart’s normal rhythm. You may be given this if your symptoms have lasted longer than 48 hours and chemical cardioversion has failed. Electrical cardioversion is less likely to work if the arrhythmia has been present for over a year. It’s also not suitable if the irregular rhythm is coming and going, since it’s most likely that arrhythmia will return after treatment.
Surgery is only used when your atrial fibrillation hasn’t responded very well to other treatments, and may include the following:
- Pacemaker – a small device is implanted under the skin near your collarbone. It monitors your heartbeat and produces electrical signals to prevent pauses in the heart rhythm.
- Catheter ablation – small tubes called electrode catheters are passed into your veins in the groin and threaded up to the heart. The abnormal areas of your heart that are disrupting the electrical signals are identified and burnt or frozen. You will also need a permanent pacemaker if you have this procedure.
Availability and use of different treatments may vary from country to country. Ask your doctor for advice on your treatment options.