Cardioversion treatment is used to get the heart back into a normal rhythm right away. There are two options for treatment:
Electric shocks to your heart
Drugs given through a vein
These treatments may be done as emergency methods, or planned ahead of time.
Daily medicines taken by mouth are used to:
Slow the irregular heartbeat: These drugs may include beta-blockers, calcium channel blockers, and digoxin.
Prevent atrial fibrillation from coming back: These drugs work well in many people, but they can have serious side effects. Atrial fibrillation returns in many people, even while they are taking these medicines.
Blood thinners are medicines that are used to reduce the risk of developing a blood clot that travels in the body (and that can cause a stroke, for example). They include heparin, warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto), and dabigatran (Pradaxa).
These drugs increase the chance of bleeding, so not everyone can use them. Antiplatelet drugs such as aspirin or clopidogrel may also be prescribed. Your provider will consider your age and other medical problems when deciding which drugs are best.
A procedure called radiofrequency ablation can be used to scar areas in your heart where the heart rhythm problems are triggered. This can prevent the abnormal electrical signals that cause atrial fibrillation or flutter from moving through the heart. You may need a heart pacemaker after this procedure. All people with atrial fibrillation will need to learn how to manage this condition at home.
Treatment can often control this disorder. Many people with atrial fibrillation do very well.
Atrial fibrillation tends to return and get worse. It may come back, even with treatment.
Clots that break off and travel to the brain can cause a stroke.
When to Contact a Medical Professional
Call your provider if you have symptoms of atrial fibrillation or flutter.
Talk to your provider about steps to treat conditions that cause atrial fibrillation and flutter. Avoid binge drinking.
January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2014;130(23):2071-2104. PMID: 24682348 www.ncbi.nlm.nih.gov/pubmed/24682348.
Morady F, Zipes DP. Atrial fibrillation: clinical features, mechanisms, and management. In: Mann DL, Zipes DP, Libby P, et al, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 38.
Olgin J, Zipes DP. Specific arrhythmias: diagnosis and treatment. In: Mann DL, Zipes DP, Libby P, et al, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 37.
Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.