How Are Medications Used to Treat Atrial Fibrillation?

Medications are prescribed in the management of AF depending on the overall treatment goal. If the goal is to restore normal heart rhythm, a type of drug called an antiarrhythmic is prescribed. If it's not possible to achieve this goal, doctors will try to manage your disease by slowing down the heart rate. In both cases, your doctor will give you medications called anticoagulants to decrease blood clot formation.

• Restore normal heart rhythm. These medications help return the heart to normal sinus rhythm and maintain normal sinus rhythm.
  • Many medications are available to restore and maintain a normal heart rhythm, including: Quinidex (quinidine); Pronestyl (procainamide); Norpace (disopyramide phosphate); Tambocor (flecainide acetate); Rythmol (propafenone); Betapace (sotalol); Tikosyn (dofetilide) and Cordarone (amiodarone).You may have to stay in the hospital when you first start taking these drugs so that your heart rhythm can be carefully monitored. These medications are effective 30%-60% of the time, but may lose their effectiveness over time. You may need to try several medications so your doctor can find the best one for you.

  • Some rhythm control medications may actually cause more arrhythmias, so it is important to discuss your symptoms and any changes in your condition with your doctor.

• Heart rate control. Rate control medications, such as Lanoxin (digoxin), Toprol, Lopressor (metoprolol), beta-blockers and calcium channel blockers, are used to help slow the heart rate during atrial fibrillation. These medications do not control the heart rhythm.

Blood thinners or anticoagulation drugs. Anticoagulant or antiplatelet therapy medications, such as Coumadin (warfarin), reduce the risk of blood clots and stroke. Although anticoagulant or antiplatelet drugs reduce the risk of stroke, they do not eliminate the risk. Regular blood tests are required when taking Coumadin to evaluate the effectiveness and minimize the risks of the drug. Some people may be treated with aspirin instead of Coumadin. Talk to your doctor about the anticoagulant medication that is right for you.

Lifestyle Changes

In addition to taking medications, there are some changes you can make to improve your heart health.

• If you notice that your irregular heart rhythm occurs more often with certain activities, you should avoid them.
• Quit smoking.
• Limit your intake of alcohol. Moderation is the key. Ask your doctor for specific alcohol guidelines.
• Limit or stop using caffeine. Some people are sensitive to caffeine and may notice more symptoms when using caffeinated products (such as tea, coffee, colas, and some over-the-counter medications).
• Beware of stimulants used in cough and cold medications. Some of these types of medications contain ingredients that promote irregular heart rhythms. Read the label and ask your doctor or pharmacist what type of cold medication is best for you.

Procedures

When medications do not work to correct or control AF, or when medications are not tolerated, a procedure may be necessary, such as: electrical cardioversion, pulmonary vein isolation, catheter ablation of the AV node, or device therapy.