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Atrial Fibrillation Treatment

MEDICAL ENCYCLOPEDIA 
Atrial Fibrillation Treatment
Atrial Fibrillation
Causes and Risk Factors
Symptoms
Diagnosis
Treatment

Atrial fibrillation treatment
Treatment for atrial fibrillation (AF) depends on how severe or frequent the symptoms are and whether you already have heart disease. General treatment options include medicines, medical procedures, and lifestyle changes. Treatment of AF is designed to:

  1. Control how many times a minute the ventricles contract (rate control)
  2. Prevent blood clots from forming
  3. Restore the heart to a normal rhythm (rhythm control)
  4. Treat any underlying disorder that's causing or raising the risk of AF

Cardioversion
Ideally to treat atrial fibrillation, the heart rate and rhythm are reset to normal. To correct your condition, doctors may be able to reset your heart to its regular rhythm (sinus rhythm) using a procedure called cardioversion, depending on the underlying cause of atrial fibrillation and how long you've had it. Cardioversion can be done in two ways:

  • Cardioversion with drugs
  • Electrical cardioversion

After electrical cardioversion, anti-arrhythmic medications often are prescribed to help prevent future episodes of atrial fibrillation. Although these drugs can help maintain a normal heart rhythm in many people, they can cause side effects, including dizziness, fatigue and nausea.

Heart rate control
Sometimes atrial fibrillation can't be converted to a normal heart rhythm. Then the goal is to slow the heart rate to between 60 and 100 beats a minute (rate control). Heart rate control can be achieved two ways:

  1. Medications - Traditionally, doctors have prescribed the medication digoxin. It can control heart rate at rest, but not as well during activity. Most people require additional or alternative medications, such as calcium channel blockers or beta blockers.
  2. Atrioventricular (AV) node ablation - If medications don't work, or you have side effects, AV node ablation may be another option. The procedure involves applying radio frequency energy to the pathway connecting the upper and lower chambers of your heart (AV node) through a long, thin tube (catheter) to destroy this small area of tissue.

Medications
The choice of medication depends on the type of atrial fibrillation you have, the underlying cause, your other medical conditions and overall health, and the other medications you take. . Ironically, many anti-arrhythmia medications may induce abnormal heart rhythms. Anti-arrhythmia medications include:

  • anticoagulants or blood-thinning medications
  • beta-blockers
  • calcium channel blockers
  • digoxin
  • dofetilide
  • steroids

Recent evidence suggests that patients who receive high-dose steroid therapy are at increased risk of AF. This therapy, which is commonly used for asthma and certain inflammatory conditions, may act as a trigger in people who already have other risk factors for AF.

Most people who have atrial fibrillation or who are undergoing certain treatments for atrial fibrillation are at especially high risk of blood clots that can lead to stroke. The risk is even higher if other heart disease is present along with atrial fibrillation. Your doctor may prescribe blood-thinning medications (anticoagulants) such as warfarin in addition to medications designed to treat your irregular heartbeat.

Prevention
If you have heart disease or risk factors, you should work with your doctor to control your condition and lower your risk of complications, such as atrial fibrillation. You may be able to prevent atrial fibrillation (AF) by leading a healthy lifestyle and taking steps to lower your risk for heart disease. Recommendations include:

  • Control blood glucose (blood sugar) levels if you have diabetes
  • Follow a heart healthy diet that is low in saturated fat, trans fat, and cholesterol and that includes a variety of grains, fruits, and vegetables daily
  • Get regular checkups
  • Get regular physical activity
  • Keep your cholesterol (total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL)) and triglycerides at healthy levels with dietary changes and/or medicines
  • Limit or avoid alcohol
  • Maintain a healthy weight
  • Quit smoking
  • Take medicines as directed

Surgery
Sometimes medications or cardioversion to control atrial fibrillation doesn't work. In those cases, your doctor may recommend a procedure to destroy the area of heart tissue that's causing the erratic electrical signals and restore your heart to a normal rhythm. These options can include:

  1. Radiofrequency catheter ablation - For many people with atrial fibrillation and an otherwise normal heart, atrial fibrillation is caused by rapidly discharging triggers, or "hot spots." These hot spots are like abnormal pacemaker cells that fire so rapidly that the upper chambers of your heart quiver instead of beating efficiently.
  2. Surgical maze procedure - The maze procedure is often done during an open-heart surgery. Using a scalpel, doctors create several precise incisions in the upper chambers of your heart to create a pattern of scar tissue. Because scar tissue doesn't carry electricity, it interferes with stray electrical impulses that cause atrial fibrillation.
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Tags: abnormal heart rhythms, irregular heartbeat, medical procedures, treatment options, atrioventricular, anticoagulants, heart surgery, Heart Disease, complications, heart rhythm, alternative, Cholesterol, medications, treatments, medication, arrhythmic, Arrhythmia, heart rate, treatment, pacemaker
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