Patients & Family
Suppressive Therapies for AFib
- Treatment options
- Catheter ablation
- Surgical ablation
- Suppressive therapies for AFib
Suppressive Therapies for AFib
Cardioversion
Sometimes it is necessary to immediately treat a heart that is in AFib and restore it back to normal sinus rhythm. This has to be done by a doctor and will usually be carried out in a hospital. There are two ways that cardioversion can be done:
Electrical cardioversion – This type of cardioversion is carried out under general anaesthetic. The patient receives an electric shock to the heart that is delivered through a defibrillator, placed on the chest. The electrical shock stops the heart for a split second and when it begins to beat again, normal sinus rhythm may be restored.
Cardioversion with drugs - This type of cardioversion is carried out with medications known as antiarrhythmic drugs. Occasionally, the physician may administer an antiarrhythmic drug before electrical cardioversion, especially in cases where electrical cardioversion has been unsuccessful in the past.
Although cardioversion immediately restores normal sinus rhythm in more than 95% of patients, sometimes, the heart will return to AFib. More than half of the patients who receive cardioversion revert back to an abnormal, quivering heartbeat at some point.
Medication
When a heart is in AFib, it beats too frequently and irregularly. Medications for AFib may be used on their own or in combination with other treatments. Three types of medications can be prescribed, depending on the type of AFib. These medications either
- Act to slow the frequency of the heartbeat (these medications are known as rate control drugs)
- Act to correct the irregular rhythm of the heartbeat (these medications are known as rhythm control drugs)
- Thin the blood to reduce the risk of blood clots (these medications are known as anticoagulants)
Commonly-Used Medications for AFib(Fuster V, et al. 2006)
- Warfarin
- aspirin
- Cardiac glycosides: digitalis
- Calcium channel blockers: verapamil, diltiazem
- Beta-blockers: atenalol, metoprolol, propanolol
- Antiarrhythmic drugs: flecainide, amiodarone, sotolol, dofetilide
Medical devices
Your doctor may decide that the best way to control your AFib is to use an implantable medical device to help regulate the heartbeat.
There are two types of device that may be used.
An implantable defibrillator (ICD) or a pacemaker.
Patients who have undergone surgery for their AFib have an artificial pacemaker inserted to control their heart rate. This is called ablate and pace. However, this technique is not often used nowadays as catheter ablation is being increasingly utilised (Fuster V., et al 2006).
Artificial Pacemakers
The heart's natural pacemaker, the sinus node, may be defective, causing the heartbeat to be too fast, too slow or irregular. The heart's electrical pathways also may be blocked.
An artificial pacemaker is a small, battery-operated device that helps the heart beat in a regular rhythm. Some are permanent (internal) and some are temporary (external). They can replace a defective natural pacemaker or blocked pathway
- A pacemaker uses batteries to send electrical impulses to the heart to help it pump properly. An electrode is placed next to the heart wall and small electrical charges travel through the wire to the heart.
- Most pacemakers are demand pacemakers. They have a sensing device. It turns the signal off when the heartbeat is above a certain level. It turns the signal back on when the heartbeat is too slow.
