When you have atrial fibrillation, the goal is to get your heart rate under control and sometimes try to bring your heart back to rhythm. In addition to want to prevent blood clots that can lead to a stroke. For many people with AFib, medicine is the best treatment option.
How Medicines Help
When you have AFib, abnormal electrical signals make your heart quiver or flutter. It can also beat too fast. This sensation is sometimes called palpitations.
AFib prevents blood from flowing normally from your heart's upper chambers (called the atria) to the lower ones (the ventricles). Blood can pool in the atria and form clumps called clots. If one travels to your brain, it could cause a stroke.
Medicines do a few different things. They can:
- Prevent blood clots. These types of medications lower your chances of having a stroke.
- Slow your heart rate . Some medications lower the number of times your ventricles contract each minute. This slowed rhythm gives them enough time to fill with blood before pumping it out to your body.
- Control your heart rhythm. Other medicines help your atria and ventricles work together to pump blood better.
Blood Thinners to Prevent Clots and Stroke
Blood-thinning medicines help prevent blood clots. They can lower your chances of a stroke by 50% to 70%.
Some examples of these drugs are:
- Apixaban (Eliquis)
- Clopidogrel (Plavix)
- Dabigatran (Pradaxa)
- Enoxaparin Enoxaparin (Lovenox)
- Rivaroxaban (Xarelto)
- Warfarin (Coumadin, Jantoven)
All of these medicines can raise your chances of bleeding. Be very careful when you play sports or do activities that could cause you to injure yourself and bleed.
Precautions: Blood thinners can make you more likely to bruise or bleed too much. If you take warfarin, for example, you'll see your doctor for a blood test every month to make sure it’s working and you're on the right dose.
- Call your doctor right away if:
- You have any unusual bleeding or bruising.
- You have an accident of any kind.
- You often find bruises or blood blisters.
- You feel sick, weak, faint, or dizzy.
- You think you’re pregnant.
- You notice red, dark brown, or black poop or pee.
- Your periods get heavier.
- Your gums bleed.
- You have a severe headache or stomach ache that won't go away.
- If you forget a dose, don’t take an extra one to make it up. Ask your doctor what to do.
- Ask your doctor about differences if you switch from one type to another.
- Tell other doctors and your dentist if you’re taking one of these mediations if you have a procedure that could cause bleeding.
- If you’re taking warfarin, tell any doctor who wants to give you a new medication. Some drugs and vitamins change the way it works in your body.
Beta-Blockers to Slow Your Heart Rate
One group of AFib medications alters the electrical signals in your heart to slow your heart rate. These medicines don't fix the abnormal heart rhythm, but they can help you feel better.
Beta-blockers are a type of blood pressure medicine. Some of them are:
- Atenolol (Tenormin)
- Bisoprolol (Zebeta, Ziac)
- Carvedilol (Coreg)
- Metoprolol (Lopressor, Toprol)
- Propranolol (Inderal, Innopran)
- Timolol (Blocadren, Istalol)
Side effects of beta-blockers can include:
Precautions: Beta-blockers don’t work for everyone:
- Let your doctor know if you have asthma. They can cause severe asthma attacks.
- If you have diabetes, be aware they could block signs of low blood sugar, like a rapid heartbeat. Check your blood sugar often.
- They can raise your triglycerides and lower your good cholesterol, but these are short-term changes.
- Don’t suddenly stop taking a beta-blocker -- you could raise your odds of having a heart attack or other problems.
Calcium Channel Blockers to Slow Your Heart Rate
These are another type of blood pressure medicine. They relax blood vessels in your heart and slow your heart rate. Examples are:
Some of the possible side effects of calcium channel blockers:
Precautions: Skip grapefruits and grapefruit juice if you’re taking calcium channel blockers. They can change the way these medications work.
Digoxin (Digox, Lanoxin) to Control Heart Rate
This medication works on your heart's electrical system to slow the rate that signals move from the atria to the ventricles. Side effects include:
Channel Blockers to Control Heart Rhythm
These medications control your heart rhythm by slowing the electrical signals through your heart. This type of treatment is called cardioversion with drugs, or sometimes chemical cardioversion.
Your doctor might recommend one of these medicines if rate control drugs alone haven't helped you. Heart rhythm medications work best if you just recently started having AFib. Options include:
Sodium channel blockers, which slow your heart's ability to conduct electricity:
Potassium channel blockers, which slow the electrical signals that cause AFib:
- Amiodarone (Cordarone, NexteronePacerone),
- Dofetilide (Tikosyn)
- Sotalol (Betapace, Sorine, Sotylize)
You’ll get this type of treatment in a hospital or at your doctor's office. Your doctor will watch your heart rhythm during treatment to see how well the medicine is working.
You might need to take a blood-thinning medicine for a few weeks before you start on one of these drugs to prevent a clot.Continue Reading Below
Medicines are one option for treating AFib. If they don't work or you can't live with the side effects, you do have other choices, including surgery. Discuss all of your options with your doctor.