The ABCDE of Atrial Fibrillation Management
By guest blogger Dr Oliver Segal Consultant Cardiologist and Electrophysiologist...
Atrial fibrillation (AF) is an abnormal heart rhythm (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. AF symptoms often include heart palpitations, shortness of breath and generalised weakness.
The aim of treatment is to alleviate symptoms and prevent complications, particularly stroke. Treatments include anticoagulants to reduce the risk of stroke, and treatments that aim to restore or maintain a normal heart rhythm or slow heart rate in people who remain in atrial fibrillation.
Non-pharmacological treatments include electrical cardioversion (used to ‘shock’ the heart back to its normal rhythm) and catheter ablation, which aims to cure atrial fibrillation. See below for further details about these methods.
AF management: “ABCDE”
Anticoagulants are medicines that help prevent blood clots. They’re given to patients at a high risk of getting clots, to reduce their chances of developing serious conditions such as strokes, or blood clots in a major artery when AF is present.
Beta-blockers, or beta-adrenergic blocking agents, are medications that lower heart rate and help to try to prevent episodes of AF. They also reduce blood pressure and are used to treat a number of other conditions including angina.
Ablation for AF is now by far the most-commonly performed ablation procedure in the world. It is a technique of heating or freezing small areas of tissue within the heart; the aim is to destroy that tissue to prevent the occurrence of abnormal heart rhythms. It is the only method used to cure AF and is offered to patients with symptoms that cannot be controlled with medications, or to those in which the AF causes impairment of heart function.
Digoxin is a medication used to slow the heart rate in patients with atrial fibrillation.
Electrical cardioversion is a procedure in which an electric current is used to reset the heart’s rhythm back to its normal normal sinus rhythm. The electric current is applied through adhesive patches that are placed on the chest wall. It is only ever temporary, but can still be useful to quickly restore normal rhythm when drugs have failed or are inappropriate.
These management options are not exhaustive and an atrial fibrillation specialist should be consulted to discuss the course of treatment that is right for a particular patient.
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