Not all irregular heartbeats are life-threatening, but atrial fibrillation is a common heart problem that can lead to stroke, heart failure, and other serious heart-related conditions. Atrial fibrillation (AFib) leads to a rapid, flutter-like heartbeat that makes the heart muscle pump less effectively.
Treatment for atrial fibrillation has two primary goals: preventing stroke and reducing AFib symptoms.
Treatment options to prevent stroke with atrial fibrillation
AFib increases your chances of having a stroke by four to six times, so preventing a stroke is an important and life-saving aspect of treating AFib.
The primary method of preventing stroke involves taking anticoagulants, better known as blood thinners, which stop blood clots from forming. Common types of blood thinners include warfarin and the newer class of novel oral anticoagulants (NOACs).
Treatment options to reduce atrial fibrillation symptoms
Not all AFib patients experience symptoms, but for those who do, doctors may try rhythm or rate control to reduce symptoms.
In the past, rhythm control methods were less effective; however newer agents and improved catheterization approaches may be callling this into question.
Rate control lowers the heart rate to reduce AFib symptoms like palpitations. Current medications for rate control include beta blockers and calcium channel blockers. In addition to slowing heart rate, calcium channel blockers also reduce the strength of the heart’s contraction.
Two other AFib treatment methods doctors may use include cardioversion and ablation. A cardioversion, also known as a rhythm reset, is an electric shock delivered to the chest that “resets” the pattern of the heart, according to the American Heart Association. An ablation is a procedure that burns away the piece of electrical tissue in the heart that is causing AFib.
“We’re able to go into the heart with catheters, and then we burn away the area where we think the atrial fibrillation is coming from,” says Rachel Bond, MD, a Cardiologist at Lenox Hill Hospital in New York City.
Like other AFib treatment options, patients may choose ablation if medication or cardioversion is unwanted, or doctors may suggest it if other treatments have been ineffective.
- PropranololGeneric Inderal
- CoumadinJantoven and Warfarin
- PradaxaDabigatran
“Each patient comes to the table with a different set of risk factors, and a different story behind their atrial fibrillation,” says Michelle Weisfelner Bloom, MD, a Cardiologist at Stony Brook University Medical Center. “We try to individualize based on their profile.”
Dr. Bloom is a Cardiologist, an Associate Professor of Medicine at Stony Brook University Medical Center, a fellow of the American College of Cardiology and the Heart Failure Society of America.
Dr. Goldberg is a Cardiologist and served as the Medical Director of the NYU Langone Health Joan H. Tisch Center for Women’s Health. She is currently an Associate Clinical Professor of Medicine at NYU Grossman School of Medicine.
Rachel Bond, MD, FACC, is a Cardiologist at Dignity Health and served as Associate Director of the Women's Heart Health Program at Northwell Health, Lenox Hill Hospital and an Assistant Professor of Cardiology at Hofstra Northwell School of Medicine.
References
American Heart Association (2024). About arrhythmia.
American Heart Association. (2023). Atrial fibrillation (AF or AFib).
American Heart Association. (2023). Non-surgical procedures for atrial fibrillation (AFib or AF).
American Heart Association. (2024). Symptoms, diagnosis, & monitoring of arrhythmia.
Camm, J. (2023). Why is rhythm control for atrial fibrillation becoming more popular? European Society of Cardiology.
Kumar, K, et al. (2023). Rhythm control versus rate control in atrial fibrillation. UpToDate.
MedlinePlus. (2024). Atrial fibrillation.
MedlinePlus. (2016). Arrhythmia.
National Institute of Neurological Disorders and Stroke. (2022). Atrial fibrillation and stroke.
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