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What Are the Treatments for AFib?
ARTICLES ONATRIAL FIBRILLATION TREATMENTS
With AFib, your heart quivers, beats irregularly, or skips beats. It can't pump blood through its chambers and out to your body as well as it should. Sometimes blood can pool in the heart and form clots, which could lead to a stroke.
Treatments such as medications, nonsurgical procedures, and surgery can slow your heartbeat and bring it back into a normal rhythm. AFib treatments can also prevent clots and help keep your heart healthy.
Medications
These can prevent clots and strokes, slow your heart rate, and control your heart rhythm.
Blood thinners : These medications thin your blood to lower your chance of having those problems. But they can raise your risk of bleeding, so you might have to cut back on some activities that can lead to injuries. The most common are:
Heart rate medicines: The most common way to treat atrial fibrillation is with drugs that control your heartbeat. These slow your rapid heart rate so your heart can pump better.
You may need other drugs. Some are called beta-blockers. They also slow your heart rate. Some examples are:
Heart rhythm medicines: They slow the electrical signals to bring your heartbeat into what’s called a normal sinus rhythm. These treatments are sometimes called chemical cardioversion:
Sodium channel blockers, which slow your heart's ability to conduct electricity:
Procedures to Treat AFib
If medicines don't work or they cause side effects, you can try one of two procedures called cardioversion or ablation. These treat AFib without surgery.
Electrical cardioversion : The doctor gives your heart a shock to regulate your heartbeat. They’ll use paddles or stick patches called electrodes onto your chest.
First, you'll get medicine to make you fall asleep. Then, your doctor will put the paddles on your chest, and sometimes your back. These will give you a mild electrical shock to get your heart's rhythm back to normal.
Most people only need one. Because you’re sedated, you probably won’t remember being shocked. You can usually go home the same day.
Your skin may be irritated where the paddles touched it. Your doctor can point you toward a lotion to ease pain or itching.
Cardiac ablation: There are two major options:
Catheter ablation , also called radiofrequency or pulmonary vein ablation, isn’t surgery, and it’s a less invasive ablation option. Your doctor puts a thin, flexible tube into a blood vessel in your leg or neck. Then they guide it to your heart. When it reaches the area that’s causing the arrhythmia, it sends out electrical signals that destroy those cells. The treated tissue helps get your heartbeat regular again.
There are two main types of catheter ablation:
Maze procedure: This is usually done while you’re having open-heart surgery for another problem, like a bypass or valve replacement. The surgeon makes small cuts in the upper part of your heart. They’re stitched together to form the scar tissue that stops abnormal signals.
Mini maze: Most people with AFib don’t need open-heart surgery. That’s where this less invasive option comes in. The doctor makes several small cuts between your ribs and uses a camera to guide catheters for either cryoablation or radiofrequency ablation. Some hospitals offer robot-assisted surgery that uses smaller cuts and allows for greater precision. Your doctor will put a video camera or tiny robot into your chest. It’ll guide the creation of scar tissue that may help keep your heartbeat at the right pace.
Convergent procedure: This pairs catheter ablation with a mini maze. The doctor uses radiofrequency ablation in the pulmonary vein, and a surgeon makes a small cut under your breastbone to use radiofrequency energy on the outside of your heart.
AV node ablation: You might get this procedure if:
Treating the Causes of AFib
If problems such as high blood pressure, cholesterol, or an overactive thyroid caused your AFib, you'll need to treat the root cause. Your doctor might prescribe medications to get those conditions under control.
Your doctor may also recommend screening and treatment for sleep apnea, a disorder in which breathing starts and stops throughout the night.
Lifestyle Changes
Your doctor also might recommend you take some simple steps to help keep your heart healthy:
ARTICLES ONATRIAL FIBRILLATION TREATMENTS
- AFib Treatments
- AFib Medications
- Cardiac Ablation
- Pacemaker for AFib
- Flying With AFib
- Living With AFib
With AFib, your heart quivers, beats irregularly, or skips beats. It can't pump blood through its chambers and out to your body as well as it should. Sometimes blood can pool in the heart and form clots, which could lead to a stroke.
Treatments such as medications, nonsurgical procedures, and surgery can slow your heartbeat and bring it back into a normal rhythm. AFib treatments can also prevent clots and help keep your heart healthy.
Medications
These can prevent clots and strokes, slow your heart rate, and control your heart rhythm.
Blood thinners : These medications thin your blood to lower your chance of having those problems. But they can raise your risk of bleeding, so you might have to cut back on some activities that can lead to injuries. The most common are:
- Apixaban (Eliquis)
- Aspirin
- Dabigatran (Pradaxa)
- Enoxaparin (Lovenox)
- Heparin
- Rivaroxaban (Xarelto)
- Warfarin (Coumadin, Jantoven)
Heart rate medicines: The most common way to treat atrial fibrillation is with drugs that control your heartbeat. These slow your rapid heart rate so your heart can pump better.
You may need other drugs. Some are called beta-blockers. They also slow your heart rate. Some examples are:
- Atenolol (Tenormin)
- Bisoprolol (Zebeta, Ziac),
- Carvedilol (Coreg)
- Metoprolol (Lopressor, Toprol)
- Propranolol (Inderal, Innopran)
- Timolol (Betimol, Istalol)
Heart rhythm medicines: They slow the electrical signals to bring your heartbeat into what’s called a normal sinus rhythm. These treatments are sometimes called chemical cardioversion:
Sodium channel blockers, which slow your heart's ability to conduct electricity:
- Flecainide (Tambocor)
- Propafenone (Rythmol)
- Quinidine
- Amiodarone (Cordarone, Nexterone Pacerone),
- Dofetilide (Tikosyn)
- Sotalol (Betapace, Sorine, Sotylize)
If medicines don't work or they cause side effects, you can try one of two procedures called cardioversion or ablation. These treat AFib without surgery.
Electrical cardioversion : The doctor gives your heart a shock to regulate your heartbeat. They’ll use paddles or stick patches called electrodes onto your chest.
First, you'll get medicine to make you fall asleep. Then, your doctor will put the paddles on your chest, and sometimes your back. These will give you a mild electrical shock to get your heart's rhythm back to normal.
Most people only need one. Because you’re sedated, you probably won’t remember being shocked. You can usually go home the same day.
Your skin may be irritated where the paddles touched it. Your doctor can point you toward a lotion to ease pain or itching.
Cardiac ablation: There are two major options:
Catheter ablation , also called radiofrequency or pulmonary vein ablation, isn’t surgery, and it’s a less invasive ablation option. Your doctor puts a thin, flexible tube into a blood vessel in your leg or neck. Then they guide it to your heart. When it reaches the area that’s causing the arrhythmia, it sends out electrical signals that destroy those cells. The treated tissue helps get your heartbeat regular again.
There are two main types of catheter ablation:
- Radiofrequency ablation: The doctor uses catheters to send radiofrequency energy (similar to microwave heat) that creates circular scars around each vein or group of veins.
- Cryoablation: A single catheter sends a balloon tipped with a substance that freezes the tissues to cause a scar.
Maze procedure: This is usually done while you’re having open-heart surgery for another problem, like a bypass or valve replacement. The surgeon makes small cuts in the upper part of your heart. They’re stitched together to form the scar tissue that stops abnormal signals.
Mini maze: Most people with AFib don’t need open-heart surgery. That’s where this less invasive option comes in. The doctor makes several small cuts between your ribs and uses a camera to guide catheters for either cryoablation or radiofrequency ablation. Some hospitals offer robot-assisted surgery that uses smaller cuts and allows for greater precision. Your doctor will put a video camera or tiny robot into your chest. It’ll guide the creation of scar tissue that may help keep your heartbeat at the right pace.
AV node ablation: You might get this procedure if:
- You don’t respond to medications
- You can’t take medications because of side effects
- You aren’t a good candidate for a procedure that cures you.
Treating the Causes of AFib
If problems such as high blood pressure, cholesterol, or an overactive thyroid caused your AFib, you'll need to treat the root cause. Your doctor might prescribe medications to get those conditions under control.
Lifestyle Changes
Your doctor also might recommend you take some simple steps to help keep your heart healthy:
- Change your diet -- eat heart-healthy, low-salt food. Go for fruits, veggies, and whole grains.
- Get more exercise -- more physical activity strengthens your heart
- Quit smoking
- Stay at, or try to reach, a healthy weight
- Control your blood pressure
- Manage your cholesterol
- Drink alcohol in moderation
