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Treatment Options for Atrial Fibrillation

Treating Atrial Fibrillation is an ongoing partnership between you and your medical team

Atrial Fibrillation is a life-long condition. You will find that your AFib and your needs will change over time, so developing a good relationship with your medical team, including your GP and your cardiologists is very important. 

Working out the right treatments for your Atrial Fibrillation can be a gradual process, and there will be some ‘trial and error’ – there is not one generic treatment for every person. Your treatment will be tailored to you. You may find a medication strategy that worked well for you, can also gradually become less effective over time. Some people may have side-effects from some of the medications too. There are also continual advances in the different procedures available to help. Your treatment strategies need to evolve, and there may be other options available, so keep communicating with your medical team. 

The Four Pillars of Atrial Fibrillation Management

There are four pillars to the management of AFib. These are:

  1. Stroke Prevention
  2. Rhythm Control
  3. Rate Control
  4. Lifestyle Modification

Learn about the management of Atrial Fibrillation with Dr John Hayes

In this video, Dr John Hayes discusses the important treatment considerations for people with Atrial Fibrillation

1. Stroke Prevention and Atrial Fibrillation

stroke is an injury to the brain caused by a loss of blood supply and therefore oxygen and nutrient supply to the brain.  It is estimated that around 25% of us will have a stroke in our lifetimes. 

Strokes cause classic symptoms which if you recognise, you should seek help immediately.   

Symptoms of Stroke: Remember “FAST” 

  • Face – Sudden weakness or droopiness of the face, or problems with vision 
  • Arm – Sudden weakness or numbness of one or both arms 
  • Speech – Difficulty speaking, slurred speech, or garbled speech 
  • Time – Time is particularly important in stroke treatment. The sooner treatment begins, the better the chances are for recovery.  

According to the Australian Stroke Foundation, more than 80% of strokes can be prevented.  Atrial Fibrillation is a major cause of stroke and with appropriate treatment, it is a preventable cause. Other chronic medical conditions also significantly increase stroke risk and some of these conditions are hypertension, high cholesterol, blood vessel disease (vascular disease) and diabetes. 

People who have Atrial Fibrillation are 5 times more likely to have a stroke.  Another way to state this: AFib increases your risk of stroke by 500%!  As a result, preventing a stroke is the most important goal of managing your Atrial Fibrillation.   

How is Atrial Fibrillation related to Stroke?

Atrial Fibrillation is a cause of stroke because it can cause blood clots to form in the heart (usually in the left atrial appendage – a small sack attached to the side of the left atrium).  Those blood clots can then travel from the heart inside the arteries up and into the brain. Blood clots can block the blood vessels in the brain and stop the blood from flowing. 

Medications for Stroke Prevention

Medications that reduce the ability for blood to clot can prevent strokes.  These medications are called anticoagulants and are commonly referred to as ‘blood thinners’.  

Procedures for Stroke Prevention

For people in whom anticoagulant ‘blood thinner’ medication is not safe to use, then a procedure is called Left Atrial Appendage Closure (Left Atrial Appendage Occlusion) may be recommended. 

2. Rhythm Control

Rhythm control treatments are focussed on preventing your heart from having an Atrial Fibrillation episode, as well as getting you back into normal heart rhythm when you are in an Atrial Fibrillation episode.  

Medications for Rhythm Control

Antiarrhythmic medications are used to try to prevent and reduce the amount of Atrial Fibrillation episodes a person gets, as well as to help the heart rhythm return to normal when an Atrial Fibrillation episode occurs. 

There are several options, so speak with your doctor about what is recommended for you. 

Procedures for Rhythm Control

These procedures vary depending on your diagnosis and treatment plan, but may include:

  • Cardioversion
  • Radiofrequency Ablation
  • Cryoablation 

3. Rate Control

Your heart rate may need medications or procedures if it is beating too fast, too slowly, or irregularly. Some people may experience a combination of all three of these at different times. 

Medications for Rate Control

Beta-Blockers and Calcium Channel Blockers are commonly used to slow down your heart rate, and improve blood flow through your body. Your doctor will advise you on specific medications that are useful for rate control depending on your specific symptoms. 

Procedures for Rate Control

These procedures vary depending on your diagnosis and treatment plan, but may include implantation of a pacemaker or other cardiac devices.

4. Lifestyle and Risk Factor Modification

While there are some Atrial Fibrillation risk factors that you cannot do anything about, such as older age and your family historythere are many ways to help reduce your risk of progressing Atrial Fibrillation by taking your own action.   

Lifestyle Changes

Make healthy behaviour part of your everyday routine, focussing on a nutritious diet and appropriate exercise, quitting smoking, reducing alcohol intakereducing anxiety and stress and having a good sleep routine. 

Medical Risk Factors

Make time for a regular health check with a doctor or specialist and be aware of both your family history and your personal risk for conditions such as cardiovascular disease, diabetes, high blood pressure, high cholesterolobstructive sleep apnoea and hyperthyroidism.