What Is the Best Treatment for Atrial Fibrillation?

Reviewed on 8/7/2020

What is atrial fibrillation?

Atrial fibrillation (AFib) is a heart disorder that causes an abnormally high heart rate.
Atrial fibrillation (AFib) is a heart disorder that causes an abnormally high heart rate.

Atrial fibrillation, or AFib, is a type of heart disorder that can cause an abnormally high heart rate. AFib occurs due to problems with an individual’s heart’s electrical activity. It results in poor pumping of blood by the heart because of which an individual is at a risk of blood clots, stroke, heart failure, and other problems. 

Strokes related to AFib are more severe and deadly. If an individual has AFib, they might develop the following symptoms:

What is the best treatment for atrial fibrillation?

The treatment goals for atrial fibrillation (AFib) include:

  • Re-establishing sinus rhythm (a normal heart rhythm)
  • Controlling the heart rate
  • Preventing blood clots
  • Reducing the risk of stroke

The best type of treatment that is recommended for a patient is based on their symptoms. Treatment options of AFib include:

  • Lifestyle changes: This is the most recommended way to prevent and reduce the risk of AFib.
  • Medications: These can prevent clots and strokes and control the patient’s heart rhythm.
    • Blood thinners (Aspirin and Heparin) can thin the blood and lower the risk of serious complications. 
    • Heart rate controlling medicines, such as beta-blockers that include Coreg (Carvedilol) and Lopressor and Toprol (Metoprolol), is the best way to treat AFib. These medications can control or slow the rapid heart rate so that the heart can function in a better way. 
    • Calcium channel blockers such as Diltiazem and Verapamil can slow the heart rate and control the heart contractions. 
    • Heart rhythm control medicines, such as sodium channel blockers that include Tambocor (Flecainide) and Rythmol (Propafenone), can reduce the electrical signals during heartbeat and may help the heart to function normally. These treatments are sometimes called chemical cardioversion.
    • Potassium channel blockers, such as Tikosyn (Dofetilide) and Betapace (Sorine, Sotylize, and Sotalol), can help in controlling AFib by slowing down electrical signals that cause irregular heart rhythm.
  • Procedures to treat AFib: Sometimes, if medicines do not work or if they cause side effects, patients are treated with procedures such as cardioversion or ablation
    • Electrical cardioversion: In this procedure, the doctor administers a shock to the heart to regulate the heartbeat. Usually, paddles or stick patches called electrodes are placed onto the patient’s chest or on their back. A mild electrical shock is given to the heart to get the heart's rhythm back to normal. Prior to the procedure, the patient may be given sedation. 
    • Cardiac ablation: In this procedure, the doctor puts a thin, flexible tube into a blood vessel through the patient’s leg or neck. Then they guide it to the heart. When it reaches the area that’s causing irregular heartbeats, it sends out electrical signals that destroy those cells. The treated tissue helps to get heartbeat regular again.
    • Surgical ablation involves cutting into the chest: This surgical procedure can be done in two ways depending on the patient’s condition
      • Maze procedure: This procedure is usually done during an open-heart surgery for another problem (bypass or valve replacement). The surgeon generally makes small cuts in the upper part of the patient’s heart. They’re stitched together to form the scar tissue that stops abnormal signals.
      • Mini maze: This is a less invasive procedure. The doctor usually makes several small cuts between the ribs and uses a camera to guide catheters (flexible tube) for cardiac ablation. The doctor then creates a scar tissue that may help the heart to function normally. 
  • AV node ablation: In this procedure, the doctor may insert a catheter into a vein near the thigh and slide it up to the AV node (a nerve that conducts electrical impulses between the top and bottom chambers of the heart). Radiofrequency energy is sent through the catheter to destroy the AV node. This stops the signals from reaching the ventricle
    • The doctor may implant a pacemaker into the chest. This pacemaker (electronic device) lies under the skin of the upper chest. This device delivers painless electric pulses that can create a normal heartbeat. 

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