Treatment of Atrial Fibrillation

When treating AF, there will be several considerations that your doctor will examine before deciding which treatment plan is the most suitable for you. This decision can also be affected by factors such as:1

Your overall health

The type of AF you have

Signs and symptomsalternatives.

Whether there is a clear underlying cause for the AF that can be treated.

Restoring heart rhythm regularity

Your doctor may prescribe the following to restore your heart’s natural beating pattern:1

Flecainide – a drug used to normalise heart rhythm

Beta-blockers – a class of medications used to treat heart conditions including AF

Controlling rate of heartbeat

Your doctor may prescribe the following to control the rate at which your heart beats:1,2

Beta-blocker – a class of medications used to treat heart conditions including AF

Calcium channel blocker – a group of medications that decrease blood pressure by relaxing heart muscle cells

Digoxin – a drug that slows down the heart rate

Anticoagulant medications3,4

Anticoagulants are types of drugs that manipulate the blood coagulation process. They inhibit thrombus formation, meaning that they prevent blood clots from forming too easily. Due to the pharmacological mode of action, the use of anticoagulants may be associated with an increased risk of occult or overt bleeding from any tissue or organ. The signs, symptoms and severity may vary according to the location (e.g. blood in urine, severe bruising) and degree or extent of the bleeding and/ or anaemia. Your doctor will work out which anticoagulant is right for you based on the indication and the presence of any other medical conditions. All licensed anticoagulants deliver a positive benefit–risk profile. Although all anticoagulants can increase the risk of bleeding, strategies are available to reduce or stop bleeding.

What Are Anticoagulants? Anticoagulants may play an important part in your management of atrial fibrillation, find out more about them here Read more about anticoagulants

Cardioversion1

Cardioversion is a procedure that can be undertaken to treat AF. It involves giving the heart an electric shock and is intended to normalize the electrical activity of the heart. In some cases, anticoagulation therapy may be needed for 3–4 weeks before the procedure and for at least 4 weeks after the procedure to minimize the risk of a blood clot forming.

Catheter ablation1

Catheter ablation is a technique that is used to treat AF when medication has been unsuccessful or poorly tolerated. It works by feeding catheters into the veins in the heart where there has been an abnormality in electrical activity. Catheter ablation is performed under general anaesthesia and takes between 2 and 3 hours. Driving is not recommended for the first few days after the procedure and the lifting of heavy objects should also be postponed until at least 2 weeks after the date you are discharged.

Pacemaker

A pacemaker is a small, battery-powered device used to standardize the rhythmic pattern of your heartbeat.1 A pacemaker should be implanted and this process is usually completed by a doctor in hospital. This treatment option is reserved for situations when oral alternatives are unsuitable (e.g. for an elderly patient who cannot swallow oral medication).

References

NHS. AF treatment [Internet]. [cited 2020 Oct 20]. Available from: https://www.nhs.uk/conditions/atrial-fibrillation/treatment/ NHS. AF treatment [Internet]. [cited 2020 Oct 20]. Available from: https://www.nhs.uk/conditions/atrial-fibrillation/treatment/ Return to content
NICE. Atrial fibrillation: management [Internet]. [cited 2020 Oct 20]. Available from https://www.nice.org.uk/guidance/cg180/chapter/1-Recommendations#rate-and-rhythm-control-2 NICE. Atrial fibrillation: management [Internet]. [cited 2020 Oct 20]. Available from https://www.nice.org.uk/guidance/cg180/chapter/1-Recommendations#rate-and-rhythm-control-2 Return to content
Warfarin 0.5 mg Tablets - Summary of Product Characteristics (SPC) – (eMC) [Internet]. [cited 2020 Oct 20]. Available from: https://www.medicines.org.uk/emc/medicine/27651#gref Warfarin 0.5 mg Tablets - Summary of Product Characteristics (SPC) – (eMC) [Internet]. [cited 2020 Oct 20]. Available from: https://www.medicines.org.uk/emc/medicine/27651#gref Return to content
NHS. Anticoagulant medicines [Internet] [cited 2020 Oct 20]. Available from: https://www.nhs.uk/conditions/anticoagulants/ NHS. Anticoagulant medicines [Internet] [cited 2020 Oct 20]. Available from: https://www.nhs.uk/conditions/anticoagulants/ Return to content