Atrial Fibrillation
Medications
Medication treatment decisions are based on the cause of your atrial fibrillation, your symptoms, and your risk for complications.
Treatment with medication is often needed for many years when heart disease is the underlying cause of atrial fibrillation.
Rate control medications are used if your heart rate is too fast. Your doctor may give them to you to see if your atrial fibrillation symptoms are present when your heart rate is under control. These medications include beta-blockers, calcium channel blockers, and/or digoxin. Rate control medicines may not be an option if you have a lot of symptoms with atrial fibrillation.
In a study called the AFFIRM trial, rate control medications were found to be preferable to antiarrhythmic medications as a first treatment for certain people with atrial fibrillation, specifically older people at risk for stroke who did not have severe symptoms. The study found that antiarrhythmic medications were expensive, often had side effects, and did not produce better results in this group of people.8
Unlike antiarrhythmic medications, rate control medications usually do not return your heart to a normal rhythm; in other words, your heart rhythm will still be irregular. However, these medications can keep your heart from beating at a dangerously fast rate. Most people tolerate an irregular heart rhythm if the rate is kept between 60 and 100 beats per minute.
Rhythm control medications are sometimes used to try to convert atrial fibrillation to a normal sinus rhythm. Rhythm control medications, also called antiarrhythmic medications, are also used to try to maintain normal sinus rhythm when symptoms persist despite rate control medications and in certain other cases.
Anticoagulant medications, such as warfarin (Coumadin, for example), are recommended for most people with atrial fibrillation who are at average to high risk of stroke.
If you are age 55 or older and have atrial fibrillation, you can find your risk of having a stroke in the next 5 years using this Interactive Tool: What Is Your Risk for a Stroke if You Have Atrial Fibrillation?
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For more information on anticoagulants, see:
Should I take anticoagulants to prevent stroke?
What is the best way to take anticoagulants for atrial fibrillation?
If you are at low risk of stroke or cannot take anticoagulants, your doctor may recommend that you take ASA. It is not as effective as anticoagulant medications in preventing clots, but it does not have as many side effects. Other antiplatelet medications, such as clopidogrel (Plavix), may be used if you are unable to tolerate ASA.
What to Think About
Some of these medications may also be used to treat coronary artery disease, heart failure, and high blood pressure.
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| Author: | Douglas Dana Robin Parks, MS | Last Updated: April 19, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Laurence Epstein, MD - Cardiac Electrophysiologist Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology | |
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