What medications have you taken to treat atrial fibrillation?
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Slowing the heart rate with medications
Having excluded or corrected the factors that cause
AFib, the next
step when the ventricles are beating too rapidly usually is to slow the rate at
which the ventricles beat.
Available medications to slow heart rate in AFib
Patients with AFib and healthy AV nodes usually
have ventricles that beat rapidly. Medications are necessary to slow down the
rapid heart rate. Medications to slow the heart rate in atrial fibrillation include:
Beta blockers such as propranolol (Inderal), atenolol (Tenormin), metoprolol
(Lopressor), esmolol (Brevibloc)
Calcium channel blockers such as verapamil (Calan), diltiazem (Cardizem)
These medications slow the heart rate by retarding conduction of
the electrical discharges through the AV node. These medications, however, do
not usually convert AFib back into a normal rhythm. Other drugs or treatments are
necessary to achieve a normal heart rhythm.
Benefits of controlling the rate: In patients with rapid ventricle
contractions as a result of AFib, slowing the rate of ventricular contractions
improves the heart's efficiency in delivering blood (by allowing more time
between contractions for the ventricles to fill with blood) and relieves the
symptoms of inadequate flow of blood -- dizziness, weakness, and shortness of
With chronic, sustained AFib, doctors may decide to leave some patients in
provided that their heart rates are under control, the output of blood from the
ventricles is adequate, and their blood is adequately thinned to prevent
strokes. This form of treatment is called rate control therapy (see below).
Limitations of medications for controlling the heart rate: In patients
with diseased AV nodes, ventricular contractions may be slower than in patients who
have normal AV nodes. Moreover, some elderly patients with atrial fibrillation are extremely
sensitive to medications that slow the rate of ventricular contractions, usually
because of a diseased AV node. In these patients, the heart rate can become
dangerously slow with small doses of medications to slow the heart. This
condition is referred to as tachycardia-bradycardia syndrome, or "sick sinus
syndrome." Patients with tachycardia-bradycardia syndrome need medications to
control the fast heart rate and a pacemaker to provide a minimum safe heart
Medications used in slowing atrial fibrillation generally cannot convert
atrial fibrillation to a normal rhythm. Therefore these patients are at risk for the formation of
blood clots in the heart and strokes and will need prolonged blood thinning with
anticoagulants like warfarin