Atrial Fibrillation - Medications

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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 atrial fibrillation, the next step when the ventricles are beating too rapidly usually is to slow the rate at which the ventricles beat.

Available medications. Patients with atrial fibrillation 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:

These medications slow the heart rate by retarding conduction of the electrical discharges through the AV node. These medications, however, do not usually convert atrial fibrillation 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 atrial fibrillation, 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 breath.

With chronic, sustained atrial fibrillation, doctors may decide to leave some patients in atrial fibrillation 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 rate.

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 (Coumadin).

Return to Atrial Fibrillation

See what others are saying

Comment from: Brenda, 55-64 Female (Patient) Published: March 04

I am a 55 year old female. In late 2012 my heart was racing and I felt funny, blood pressure was 199/110 and heart rate 140. I ended up going to the emergency room and after a few hours I was released with tachycardia. There was no follow up. Last week I felt the same way. Blood pressure at home was 179/113 HR 131, in hospital up to 160 for 9 hours. Next morning sinus rhythm with medications (not sure what) with hospital stay of 3 days with atrial fibrillation. I was placed on a whole full strength aspirin daily and metoprolol 25mg twice daily. I am still feeling heavy chested as I would call it. Follow up with cardiologist is on Friday. I am worried I will get another attack.

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Comment from: geokat, 65-74 Male (Patient) Published: June 02

I have just had a heart oblation for atrial fibrillation. It has made a huge difference after 10 days of rest. I also have lost 5 more lb. but I am on weight watchers too. I feel great. If you have a fibrillation do it, it is a life changer.

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