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:
- Age – The risk of AF increases with age.
- Signs and symptoms – Certain types of AF are symptomatic and your doctor may choose a treatment based on a symptom initially presented.
- Existing conditions – e.g. Hypertension, diabetes or hyperthyroidism (an overactive thyroid gland) may influence your doctor’s choice of medication or procedure.
- Medication – If you are taking medication that could potentially interact with a treatment that your doctor has in mind, your doctor will review your medication and find the most suitable alternatives.
Restoring heart rhythm regularity
Your doctor can prescribe the following to restore your heart’s natural beating pattern:
- Flecainide – a drug used to normalise heart rhythm
- Beta-blockers – a class of medications used to treat heart conditions including AF
- Amiodarone – an antiarrhythmic drug used in patients with irregular heartbeats
- Dronedarone – a drug which is like amiodarone in structure and function (it is only prescribed in certain instances)
Controlling rate of heartbeat
Your doctor can prescribe the following to control the rate at which your heart beats:
- 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 Medications
Anticoagulants are types of drugs that manipulate the blood coagulation process (the so-called plasmatic coagulation). They inhibit thrombus formation, meaning that they prevent blood clots from forming too easily. What are anticoagulants? Anticoagulants may play an important part in your management of atrial fibrillation, find out more about them here Read more about anticoagulantsAnticoagulants generally include non-VKA oral anticoagulants (NOACs), heparins and vitamin K antagonists. All of these have different ways of working. 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 which may results in post haemorrhagic anaemia. The signs, symptoms and severity will 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.
Cardioversion
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.Cardioversion usually takes place in a hospital but is prohibited in circumstances where AF has been present for more than 2 hours.
Catheter ablation
Catheter ablation is a technique which 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).
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