Medical treatment for Atrial Fibrillation is varied and the deciding factors include the severity of the symptoms, their frequency of occurrence, history of heart disease of the patient etc. The available treatments include medicines, lifestyle changes and certain medical procedures.
Medical treatment for Atrial Fibrillation is primarily concerned with the following objectives:
- Prevention of clot formation and thus countering the risk of stroke.
- Restoring proper heart rhythm through Rhythm control.
- Controlling the rate of ventricular contraction by the process of rate control.
The treatment for Atrial Fibrillation varies depending on the severity of the condition i.e. for instance patients who are diagnosed with Atrial Fibrillation but don’t have such pronounced symptoms may not need any treatment as the irregular heart rhythm may subside on it’s own. In case the condition is occurring for the first time the doctor may resort to use an electrical procedure or proceed to control the heart rhythm by proper medication. And in the event that the patient has had frequent episodes of Atrial Fibrillaton the electrical system of the heart may have become damaged resulting in permanent Atrial Fibrillation. In that case sufficient care and treatment is required to prevent complications.
Preventing a blood clot formation is of utmost importance in the treatment of Atrial Fibrillation. This is because in patients suffering from AF, there is a chance that a blood clot might travel from the heart to the brain resulting in a stroke. Doctors prescribe blood thinning medication to tackle this. The commonly used ones include warfarin, heparin and aspirin. Warfarin is the most effective in patients having risk factors of stroke. Patients are also prescribed routine blood tests to check the effectiveness of the medicine.
Rhythm control treatment aims at bringing the heart to it’s normal rhythm and it is used in cases where the patient has just started experiencing symptoms of atrial fibrillation or where rate control techniques have failed. The effectiveness of this procedure is in inverse relation with the span of the disease, i.e the chances of restoring the heart to it’s normal rhythm decreases with time. For instance in the case of patients who have experienced AF for more than 6 months. The chances of proper rhythm control experiences serious setbacks in the event of the enlargement of the atria or if any underlying heart condition becomes chronic. In such cases the chances are high that AF may recur even after the rhythm is controlled once through proper medication.
Rate control procedure consists of using prescription medicines to slow down the rate at which the ventricles are beating. It is the most commonly used procedure in case of patients suffering from AF as the patient feels much better if the heart beats at a normal controlled rate even though they experience abnormal rhythm and the heart doesn’t function as well as it used to. Beta blockers, calcium channel blockers and digitalis are the medicines used for rate control.
The following medicines are used for the treatment of Atrial Fibrillation: amiodarone, sotalol, flecainide, propafenone, dofetilide, ibutilide, quinidine, procainamide, and disopyramide.
There are numerous procedures employed to bring the heart back to it’s normal rhythm. Electrical cardioversion is a frequently used procedure. It involves low energy shocks administered to your heart to bring the abnormal irregular heartbeat to the normal rhythm. A procedure called transesophageal echocardiography is performed prior to performing cardioversion. This checks for the presence of any blood clots in the atria and if any, they are eliminated by the use of blood thinning medicines.
Catheter ablation is another procedure that is employed to treat AF when medication and cardioversion fails. The procedure involves inserting a wire into a vein in the arm or leg and is threaded all the way to the heart. This wire is then used to send radio wave energy which destroys any abnormal tissues that are interfering in the proper flow of electrical signals in the heart. In some cases catheter ablation technique is used to destroy the Atrioventricular node and a device called the pacemaker is inserted to restore the normal heart rhythm.
‘Maze’ surgery is another treatment option available for restoring the normal heart rhythm. In this procedure the surgeon makes small cuts or burns in the atria that check the spread of disorganized electrical signals in the heart. This procedure requires open heart surgery and is performed mostly when the patient requires heart surgery for other reasons.
Various other treatment options are employed aimed at treating the underlying conditions that may be causing Atrial Fibrillation or are major risk factors for AF. For instance the doctor may prescribe medicines for an overactive thyroid or to reduce blood pressure.
Lifestyle changes may also help in treating AF. These include avoiding caffeine, alcohol, following a healthy diet, reducing the salt intake, reducing stress, quitting smoking etc.