Atrial Fibrillation
Medications
Medicine treatment decisions are based on the cause of your atrial fibrillation, your symptoms, and your risk for complications. You will likely take a medicine to help prevent a stroke. You may also take a medicine that controls your heart rate or your heart rhythm.
Treatment with medicine is often needed for many years when heart disease is the cause of atrial fibrillation.
Rate-control medicines 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 medicines 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 medicines were found to be preferable to antiarrhythmic medicines 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 medicines were expensive, often had side effects, and did not produce better results in this group of people.3
Unlike antiarrhythmic medicines, rate-control medicines usually do not return your heart to a normal rhythm. In other words, your heart rhythm will still be irregular. But these medicines 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 medicines are sometimes used to try to convert atrial fibrillation to a normal sinus rhythm. Rhythm-control medicines, also called antiarrhythmic medicines, are also used to try to maintain normal sinus rhythm when symptoms persist despite rate-control medications and in certain other cases.
Anticoagulant medicines, 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?
For more information on anticoagulants, see:
Atrial fibrillation: Should I take anticoagulants to prevent stroke?
Atrial fibrillation: Taking anticoagulants safely.
If you are at low risk of stroke or cannot take anticoagulants, your doctor may recommend that you take aspirin. It is not as effective as anticoagulant medicines in preventing clots, but it does not have as many side effects. You may take other antiplatelet medicines, such as clopidogrel (Plavix), along with aspirin or instead of aspirin. When aspirin and clopidogrel are used together, they may reduce the risk for stroke more than aspirin alone. But this combination is also more likely to cause bleeding than aspirin alone.
What to Think About
Some of these medicines may also be used to treat coronary artery disease, heart failure, and high blood pressure.
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| Author: | Robin Parks, MS | Last Updated: December 18, 2008 |
| Medical Review: |
Caroline S. Rhoads, MD - Internal Medicine
John M. Miller, MD - Electrophysiology |
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