What treats atrial fibrillation besides cardiac ablation?

Medications, cardioversions, and other procedures are ways to treat atrial fibrillation besides cardiac ablation.

Medications are often used to treat atrial fibrillation. Sometimes medications to thin the blood are used to prevent clots from forming and going to the brain, which may cause stroke. Other medications are used to keep the heart rate down. Often these "rate control" medications include beta-blockers and calcium channel blockers.

Dr. Mohamed Djelmami Hani, MD
Cardiologist (Heart Specialist)

Before considering cardiac ablation, it is important to first eliminate the cause of atrial fibrillation, if known, such as high thyroid function.

Then, the primary treatment for atrial fibrillation is geared toward eliminating the bad rhythm and restoring normal rhythm. This is called “rhythm control.” If this fails, then all efforts will be focused on slowing down the heart rate while atrial fibrillation continues. This is called “rate-control.”

Cardiac ablation is one therapeutic option for atrial fibrillation. In most cases, it’s recommended after one or more medications have failed. The first choice in treating atrial fibrillation is usually a medication that can stop the electrical storm that causes atrial fibrillation. A handful of medications called “antiarrhythmics are available. If the first one fails, another is tried until good control of atrial fibrillation is achieved. All these medications have side effects that range from mild to severe. Hospital observation for two to three days is mandatory when starting some of them to monitor for early signs of severe side effects. If the patient tolerates them, these medications can achieve very good results in preventing atrial fibrillation.

In combination with medications, a procedure, cardioversion, can be performed in attempt to stop atrial fibrillation. It’s an outpatient procedure, in which the patient is completely sedated, then an electrical shock is delivered through a couple of patches attached to the chest to “reset” the heart rhythm, stop atrial fibrillation and allow the normal rhythm to return. With good sedation, the patient does not feel or remember the procedure.

An open-heart surgical procedure called “maze” is usually reserved for patients who are scheduled to undergo surgery for other conditions such as a bad valve or severe narrowing in heart arteries.

If all the above efforts fail, then other medications that prevent fast heart (but can’t stop atrial fibrillation) are offered. In some cases, this is the first option if it’s clear that stopping atrial fibrillation completely is unlikely to be achieved or the patient is too ill to tolerate treatment. If these medications fail, then a pacemaker with a simple ablation is offered. This ablation is usually easier, quicker and much safer than the ablation used to eliminate atrial fibrillation. It is usually performed at the same time as the pacemaker insertion.

All treatments focus on returning the heart to a normal rhythm. They depend on the severity of symptoms and may include medications, lifestyle changes such as reducing alcohol or caffeine, and surgery.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.