• Treating Atrial Fibrillation

    Animation Copyright © Milner-Fenwick
    Before beginning treatment, your doctor may want to further evaluate your heart.
    One test that may be recommended is an echocardiogram, in which sound waves are used to create an image of your heart as it pumps. The information from this and other tests will help you and you healthcare team decide on the treatment that is best for you.
    For some patients with atrial fibrillation, restoring the heart's natural rhythm is the goal of treatment. For others, just controlling the heart rate is a safer and more effective goal. For most patients with atrial fibrillation, preventing blood clots that could lead to a stroke is extremely important.
    To help achieve your goals, several treatment options may be recommended. One option may be to take medications, of which there are several types that may be prescribed.
    Antiarrhythmic medications may be given to restore the heart's natural rhythm. These include flecainide, sotalol, and amiodarone.
    Rate control medications help slow down the heart rate. Some examples of these medications include beta blockers, calcium channel blockers, and digoxin.
    Anticoagulants are often prescribed to reduce the risk of stroke. The two most often prescribed anticoagulants are warfarin, sometimes called Coumadin®, and aspirin.
    Another treatment option is electrical cardioversion. This is a procedure that can restore the heart's natural rhythm.
    Before having this procedure you'll be given a sedative to put you to sleep. An electrical shock is then delivered through the electrode pads, or paddles. This single shock wipes out the disorganized electrical activity in your heart, restoring the natural rhythm.
    Following electrical cardioversion, you may have a little chest discomfort or some redness on the chest temporarily; but overall, the procedure is very fast and safe. Most patients are allowed to go home a few hours after the procedure is completed.
    For some patients, a catheter ablation may be recommended. This procedure is not considered major surgery and is usually performed in an electrophysiology or heart catheterization lab.
    Before beginning, doctors will start an IV. It will provide you with medication to help you relax during the procedure. It may even put you to sleep.
    An area usually near the upper leg will be numbed and a small incision will be made. Here, one or more catheters will be inserted into a vein, and guided into your heart.
    To restore the heart's natural rhythm, the tissue conducting the abnormal impulses will be located. A catheter is placed against it, and radiofrequency energy is sent through the catheter, ablating or destroying the tissue and restoring the heart's natural rhythm.
    In some cases, the best treatment may be to ablate the AV node. This does not cure atrial fibrillation, but it does slow down the heart's rate, which reduces symptoms. After this procedure you may recover in the hospital for a few hours, or even overnight.
    A pacemaker helps speed up the heart when it beats too slowly. When the AV node is ablated, this device is implanted to help the heart maintain an effective rate. A pacemaker may also be recommended for some patients taking medications that slow down the heart rate.
    Another option, the MAZE Procedure, is an open-heart surgical procedure that can also help restore the heart's natural rhythm. However, this procedure is usually only recommended for patients already undergoing open-heart surgery for another reason.
    Don't get discouraged if one treatment option is unsuccessful. You may need to try several before getting your condition under control.
    Animation Copyright © Milner-Fenwick
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