Treating AFIB

Living with A-Fib: You Do Have Treatment Options

Atrial fibrillation (A-fib) is a potentially dangerous heart rhythm disorder in which the upper chambers of the heart beat in a fast and irregular rhythm. Since the quivering atria do not pump all of the blood on to the ventricles, there is a significant risk of blood clots that can lead to a stroke or a pulmonary embolism. Symptoms of A-fib may include:

  • Shortness of breath.
  • Palpitations or fluttering in the chest.
  • Chest pain or discomfort.
  • Weakness, dizziness, or fainting.

The frequency and duration of A-fib symptoms can vary from patient to patient. In some instances, the A-fib remains constant while in others the heart may go in and out of A-fib. Based on your particular symptoms and risk factors, there are a number of treatment options available to:

  • Reduce the elevated heart rate.
  • Restore the heart to its normal sinus rhythm.
  • Lower the risk of blood clots and stroke.
  • Prevent heart failure and other heart arrhythmias.
Slowing the Heart Rate

A normal heart rate is between 60 and 100 beats per minutes. During an A-fib attack, the atria may beat or quiver as often as 400 times per minutes. Medications are the most common method used to slow the heart rate. Medicines used to treat A-fib with an elevated heart rate include:

  • Beta blockers, including acebutolol, atenolol, metoprolol, nadolol, nebivolol, bisoprolol, and propranolol.
  • Calcium-channel blockers, including amlodipine, diltiazem, felodipine, and verapamil.
  • Digoxin.
Restoring Natural Heart Rhythm

A number of drugs are available to try to restore and maintain the heart’s natural sinus rhythm, including flecainide, amiodarone, propafenone, sotalol, and dofetilide. Although both rhythm and rate control can be effective in preventing A-fib attacks, the drugs used for rhythm control tend to have more side effects than the ones used to control the heart rate. In some instances, a patient with A-fib may require cardioversion to get the heart back to a normal rhythm. Cardioversion is typically performed either with drugs or by administering a low-dose electric shock.

Surgical Options

Catheter and AV node ablation are minimally invasive procedures that destroy small sections of the heart muscle where the irregular heart beat is originating. A Maze procedure involves creating small areas of scar tissue in the heart that block the irregular electrical impulses that cause A-fib. Maze procedures can also be performed during open heart surgery to correct or repair other issues.

Anticoagulation Therapy

One of the primary dangers of A-fib is the risk of developing blood clots. Based upon other risk factors, such as your age and overall health, your doctor may recommend some form of anticoagulant therapy, including daily aspirin therapy, warfarin, rivaroxaban, apixaban, or dabigatran.

Treating the Underlying Cause of A-fib

Atrial fibrillation can be the result of underlying health conditions, such as coronary artery disease, rheumatic heart disease, or thyroid disorders. If your A-fib is due to coronary artery disease, your doctor may recommend lifestyle changes, cholesterol-lowering medicines, angioplasty, or even bypass surgery in addition to the above therapies. Medication or surgery is often used to treat A-fib resulting from thyroid disorders. Heart valve replacement surgery will often improve or eliminate A-fib related to rheumatic heart disease.

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