Atrial Fibrillation - Treatment Overview
Treating atrial fibrillation is important for several reasons. An irregular, rapidly beating heart can weaken the heart muscle and cause it to dilate or stretch out. This can increase your risk of having heart failure or having chest pain or even a heart attack. Also, atrial fibrillation can greatly increase your risk of having a stroke. Atrial fibrillation can also cause symptoms that are hard to deal with.
Many people are able to live full and active lives while being treated for atrial fibrillation. To stay healthy, you will probably need to take medicines, including an anticoagulant or aspirin, a medicine to slow heart rate, or possibly a rhythm-control medicine.
Initial treatment
If atrial fibrillation is causing your heart to pump dangerously fast or your blood pressure to drop dramatically, you will probably be taken to the hospital for treatment to restore your blood pressure and heart rate to normal. If atrial fibrillation is not causing severe symptoms, you may be treated on an outpatient basis. Treatment for people who have just started having episodes of atrial fibrillation usually includes trying to convert the heart to a normal rhythm. Sometimes anticoagulant medicines are used to prevent clots and stroke.
- If you have had atrial fibrillation for less than 48 hours, your doctor may perform a procedure called cardioversion, using either medicine or a low-voltage electrical shock (electrical cardioversion), to return the irregular heartbeat to a normal rhythm (normal sinus rhythm).
- If atrial fibrillation has lasted for more than 48 hours, attempting cardioversion could cause a stroke. In this case, you may need to take an anticoagulant medicine, such as warfarin, for several weeks before your doctor tries cardioversion. Taking anticoagulants reduces the chance that a clot might travel from the heart to the brain after cardioversion.
- If you are not sure how long you have had atrial fibrillation, you are also at risk of having a clot in your heart. If you are not having severe symptoms, such as fainting, your doctor will probably also recommend that you take anticoagulants for several weeks before cardioversion to prevent a stroke.
- If you have
severe symptoms and you are not sure how long you have
had atrial fibrillation, your doctor may try to restore your heart to a normal
rhythm immediately. In this case, your doctor will use a
transesophageal echocardiogram to determine whether
you have a clot in your heart that could cause a stroke. The results of this
test will determine what your doctor does next:
- If the heart is clear of clots, cardioversion can be attempted. Anticoagulants are used after to prevent strokes.
- If there is a clot in the heart, your doctor will prescribe anticoagulants before trying cardioversion.
Cardioversion usually works to restore a normal sinus rhythm. But in many cases the heart rhythm goes back to atrial fibrillation.
Ongoing treatment
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