Atrial Fibrillation Treatments: An Overview

Atrial fibrillation (AFib) is the most common type of arrhythmia (irregular heartbeat). AFib can cause uncomfortable symptoms like a racing heartbeat, shortness of breath, and dizziness. It can also increase your risk of serious complications, like blood clots and stroke.¹

Some treatments for AFib can reduce the risk of serious complications, while others can help manage day-to-day AFib symptoms. 

AFib can cause symptoms like racing heartbeat, chest pain, shortness of breath, tiredness, and dizziness. Treatments for AFib that manage the heart’s rate and rhythm can help improve symptoms and improve quality of life.^3,4

The most serious health concern for people with AFib is an increased risk of stroke.⁴ People living with AFib are five times more likely to have a stroke than those without AFib.⁵

The higher risk of stroke with AFib is due to blood pooling in the atria (the upper chambers of the heart). When the heart is beating irregularly with AFib, it doesn’t pump enough blood out of the atria. When blood is still for too long, it’s easier to form blood clots in a small part of the atria in the heart called the left atrial appendage (LAA). Blood clots formed in the LAA can be pumped out of the heart and to the brain, where they can cause a stroke.^{2, 6}

Treating AFib symptoms often involves medications that regulate the heart rate and rhythm. While these treatments don’t cure AFib, they can help you manage your symptoms.⁷  

Medications to control your heart rate can help if your heart beats too fast. These medications work by slowing your heart rate so you can function better. Examples of heart rate-controlling medications for AFib include:⁷

• Beta blockers — including metoprolol, carvedilol, bisoprolol, and atenolol
• Calcium channel blockers — including diltiazem and verapamil
• Digoxin 

Heart rhythm-controlling medications (also called antiarrhythmic medications) can help reset your heart to a normal rhythm (sinus rhythm). They work by slowing electrical signals in the heart that cause AFib. There are two main types of medications that can help control the heart’s rhythm:^7,9

• Sodium channel blockers — including flecainide and propafenone
• Potassium channel blockers — including amiodarone, sotalol, and dofetilide

Blood thinner medications can help prevent blood clots in people with AFib. These medications don’t actually thin your blood. Instead, they prevent the formation of clots that can lead to a stroke and other serious health problems.

There are two main types of blood thinner medications used in AFib — antiplatelets and anticoagulants. ^7,8

Antiplatelet drugs prevent platelets (a type of blood cell) from sticking together to form a clot. Aspirin and Plavix^® (clopidogrel) are examples of antiplatelet drugs. ^7,8

Anticoagulants help prevent clots by slowing down the body’s process of forming clots. Examples of anticoagulants include: ^7,8

• Coumadin^® (warfarin)
• Eliquis® (apixaban) 
• Pradaxa® (dabigatran) 
• Lixiana® (edoxaban) 
• Xarelto® (rivaroxaban) 

Taking blood thinners increases your risk of bleeding. It’s important to take extra care when participating in activities or sports that risk trauma. ^7,8

Learn more about how blood thinner medications work. 

If medications aren’t enough to manage AFib, medical procedures can help treat atrial fibrillation. Some procedures aim to reduce your risk of stroke and others can help restore a normal heart rhythm.¹⁰  

An LAA closure is a procedure to close off or block the LAA.¹⁰ Since 90% of stroke-causing blood clots are formed in the LAA, closing it off can significantly reduce the risk of stroke.¹¹

This procedure may be a good option for people when blood thinners aren’t a good fit. After this procedure, many people can stop taking blood thinner medications to prevent blood clots.¹⁰

There are different methods and types of devices that doctors use to close off the LAA. The WATCHMAN Implant is a device that helps block the opening of the LAA. Other medical devices are available that can clamp or band the LAA to close it off.¹²

Cardioversion is a medical procedure that can help reset your heart’s normal rhythm. There are two types of cardioversion — electrical cardioversion and pharmacologic (chemical) cardioversion. In electrical cardioversion, a doctor will deliver an electrical shock outside of the chest. In pharmacologic cardioversion, a doctor will give you medications to reset your heartbeat.^15,16

A pacemaker is a small medical device that’s surgically implanted. It sends electrical signals to your heart to help control the rate and rhythm. These devices begin to send signals to the heart when it’s beating too fast, too slow, or irregularly.¹⁰

An implantable cardioverter defibrillator (ICD) is a medical device that’s surgically implanted into your chest and designed to prevent sudden cardiac death. When this device detects a dangerously fast heartbeat, it delivers a small electric shock to restore the heart to a normal heart rhythm. ICDs are different from pacemakers, but some devices can also work as a pacemaker.¹⁰

The maze procedure is a complex medical procedure done during open-heart surgery. During this procedure, surgeons will create a maze pattern of scar tissue in the heart that blocks abnormal electrical signals that cause AFib. Although this surgery can help many people restore a normal heartbeat, recovery is long and can take one month or longer.^10,17