Atrial fibrillation (Afib) is an unsteady beating of the heart that can lead to blood pooling in the heart, blood clots and stroke. McLeod Cardiologist Amit Pande, MD, walks through the many medications used to manage Afib and other treatments as well:
Here’s a summary of Dr. Pande’s comments:
With atrial fibrillation there are two things happen to the heart. The rhythm is irregular and it is fast. The top chambers of the heart (atria) are not beating synchronously. They are essentially beating sluggishly. Because of that, you can develop blood clots. So, one of the treatments is blood thinners.
For years, used Coumadin, but in the last 3 to 4 years we have the new oral anticoagulants, such as Eliquis, Xarelto, Pradaxa and Savaysa. Those agents have proven to be as effective as Coumadin but better at preventing strokes, less chance of intracranial bleed, negative effects on the stomach or GI bleeds. And they don’t require any monitoring.
With the heart beating irregularly and fast, we have to slow down the heart rate. Continuously beating too fast will develop into heart failure. For that condition, we use beta blockers — Digoxin or Lanoxin — as well as calcium channel blockers — Diltiazem, Cardizen and Verapamil.
Then, in addition to all of that, there are these options where you try to restore the rhythm back to normal. In addition to beta-blockers and calcium channel blockers, we use Flecainide, Rythmol, Sotalol, Tikosyn and Amiodatrone. We also try to correct the magnesium and potassium levels of patients.
Several medical procedures can be used on Afib. One, we try to electrically convert them back to regular rhythm. We put the patient to sleep and shock the heart back into rhythm. If you are still in Afib, then we send you to our Electrophysiologist.
We also implant pacemakers and defibrillators. With Afib, you are managing the electrical circuits of the heart.
Many times, slow heart rate becomes a problem. Pacemakers ensure that a patient’s heart rate doesn’t become too slow. There are certain pacemakers, which have algorithms in them, so if you go into Afib, they can over drive the rhythm and put you back into sinus rhythm.1