Treatments for atrial fibrillation include:
- medicines to reduce the risk of stroke
- medicines to control heart rate and rhythm
- procedures to restore normal heart rhythm
Your GP may treat you or they may refer you to a heart specialist (cardiologist).
Your healthcare team will decide the most appropriate treatment for you.
They will try to find the cause of the atrial fibrillation. If a cause can be identified, you may only need treatment for this.
For example, if you have an overactive thyroid gland, medicine to treat it may also cure your atrial fibrillation.
If they cannot find an underlying cause, the treatment options are:
- medicine to reduce the risk of a stroke
- medicines to control rate of atrial fibrillation
- medicines to try and restore the heart to normal rhythm
- electric shock treatment (cardioversion)
- catheter ablation
- having a pacemaker fitted
Medicines to control atrial fibrillation
Medicines called anti-arrhythmics can control atrial fibrillation by:
- restoring a normal heart rhythm
- controlling the heart rate
The choice of anti-arrhythmic medicine depends on:
- the type of atrial fibrillation
- any other medical conditions you have
- side effects of the medicine
- how well the atrial fibrillation responds
Some people with atrial fibrillation may need more than 1 anti-arrhythmic medicine to control it.
Medicines to reduce the risk of a stroke
Your GP will assess your risk and try to minimise your chance of having a stroke.
They will check your medical history before deciding which medicines are best to reduce your risk of having a stroke.
Cardioversion may be recommended for some people with atrial fibrillation.
It involves giving the heart a controlled electric shock to try to restore a normal rhythm.
Cardioversion is usually done in hospital so your heart can be carefully monitored.
If you have had atrial fibrillation for more than 2 days, cardioversion can increase the risk of a clot forming.
You'll be given an anticoagulant for 3 to 4 weeks before cardioversion. Anticoagulants are medicines to help reduce blood clots. You will be on anticoagulants for at least 4 weeks after cardioversion to reduce the chance of having a stroke.
In an emergency, cardioversion can be done without going on medicine first.
You may need to continue taking anticoagulants after cardioversion if:
- there is a risk of atrial fibrillation returning
- you have an increased risk of having a stroke
Catheter ablation is a procedure that destroys the diseased area of your heart and interrupts abnormal electrical circuits.
It's an option if medicine has not been effective.
Catheters (thin, soft wires) are guided through one of your veins into your heart. They are used to record electrical activity and used to identify the source of the abnormality.
Radio waves are transmitted through 1 of the catheters to destroy the tissue.
The procedure can take as little as 15 minutes or it may take up to 3 or 4 hours. You may have the procedure under general anaesthetic. This means you are unconscious or asleep during it.
You should be able to do most of your normal activities the day after the procedure. But you should not lift anything heavy for 2 weeks. Avoid driving for the first 2 days.
A pacemaker is a small device that's usually implanted in your chest, just below your collarbone.
It helps your heart beat regularly.
Having a pacemaker fitted is usually a minor procedure that's done under local anaesthetic. This means you'll be awake during the procedure but the area being operated on is numbed.
You may need a pacemaker if you cannot take medicines or they haven't helped. This tends to be in people age 80 and older.