What Are the Treatments for AFib?

Atrial fibrillation is a problem with your heart's electrical activity. You and your doctor have treatment options if your symptoms become too severe.

With AFib, your heart quivers, beats too quickly, 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 also prevent clots and help keep your heart healthy.

Medications

These can slow your heart rate, control your heart rhythm, and prevent clots.

Heart-rate controlling medicines: These slow your rapid heart rate so your heart can pump more effectively. Some of these drugs include:

Heart-rhythm controlling medicines: They slow the electrical signals to bring your heartbeat into a normal rhythm. These treatments are also called “chemical cardioversion.”

These medications include:

You might get them in your doctor's office or at a hospital. Your doctor will monitor you to make sure the medicine is working.

Blood thinners: They prevent clots and include:

Blood thinners can make you more likely to bruise or bleed too much. You'll see your doctor for a blood test every month to make sure the medication is working and you're on the right dose.

Procedures

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.

Cardioversion: A doctor gives you a mild electric shock to reset your heart rhythm.

First, you'll have a test called a “transesophageal echocardiography” (TEE) to see whether you have any blood clots in the top chambers of your heart, called the atria. If you do have one, you'll need to take blood thinners before the procedure.

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You get cardioversion in a hospital after you have been given something that will make you sleep. Electricity travels to your heart through paddles or patches placed on your chest. You might need to have this procedure more than once to correct your heart rhythm.

Ablation: Your doctor burns off the tiny parts of your heart that are causing the abnormal beats. She threads a thin tube, called a catheter, through a blood vessel in your leg or groin up to your heart.

Energy travels through the tube. It burns off the areas of tissue that cause the abnormal signals. Scars form in the burned areas and block any abnormal electrical signals.

After some ablation procedures, you'll need a pacemaker to keep your heart in rhythm.

Surgery

This might be an option if your symptoms are severe or you can't take medicine to treat AFib.

Left atrial appendage (LAA) occlusion: Most strokes in people with AFib happen when blood clots form in the upper left part of their heart, the left atrium. LAA occlusion seals off this part of the heart to prevent blood clots and strokes. Your doctor can do surgery or use a catheter that she inserts into a blood vessel in your leg.

Maze procedure: During this type of surgery, the doctor makes very small cuts in the top part of your heart. After she sews up the cuts, scar tissue forms.

This scar tissue prevents the abnormal signals that cause AFib. Some people will need a pacemaker after maze surgery.

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 underlying 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.

You might also need to make these changes to your daily life to keep your heart healthy:

  • Limit sugar, salt, and fat in your diet
  • Quit smoking
  • Cut down on alcohol and caffeine
  • Exercise and eat healthier to control your weight
  • Avoid certain cough and cold medicines that contain stimulants, which make your heart beat faster
WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on October 09, 2016

Sources

SOURCES:

Agency for Healthcare Research and Quality: "Treatment of Atrial Fibrillation."

American Heart Association: "Atrial Fibrillation Medications," "Non-surgical Procedures for Atrial Fibrillation (AFib or AF)," "Surgical Procedures for Atrial Fibrillation (AFib or AF)," "What is Atrial Fibrillation (AFib or AF)?"

Cleveland Clinic: "Atrial Fibrillation (AFib)."

National Heart, Lung, and Blood Institute: "How Is Atrial Fibrillation Treated?" "What is Cardioversion?"

The Society of Thoracic Surgeons: "Atrial Fibrillation Surgery -- Maze Procedure."

UAB Medicine: "Left Atrial Appendage Occlusion."

Mayo Clinic: “Sleep Apnea.”

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