Antiarrhythmic Medicines for Atrial Fibrillation

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Antiarrhythmic Medicines for Atrial Fibrillation


Generic NameBrand Name
amiodaroneCordarone, Pacerone
sotalolBetapace AF

How It Works

Antiarrhythmic medicines help return the heart to its normal sinus rhythm, maintain the rhythm after it has been achieved, and/or reduce the heart rate while you are in atrial fibrillation. These medicines stabilize the heart muscle tissue. Antiarrhythmics such as amiodarone or sotalol also slow the heart rate by blocking impulses that pass through the AV node in the heart.

Why It Is Used

Antiarrhythmic medicines are used to convert atrial fibrillation to a normal rhythm or to maintain a normal heart rhythm after a procedure to stop atrial fibrillation.

Your doctor may recommend these medicines if you:

Antiarrhythmics are used carefully, because they can cause dangerous side effects.

Doctors may recommend the "pill in the pocket" approach for people with paroxysmal atrial fibrillation. With this approach, you can take a single dose of an antiarrhythmic drug when you feel palpitations instead of taking the medicine every day. For some people, this stops atrial fibrillation episodes. It may also reduce medicine side effects and the need to be seen in the emergency room or be hospitalized. But not everyone can use this treatment. Before you can take the "pill in the pocket" approach, your doctor will want to make sure that you do not have any other heart disease and that your heart's electrical system is normal.

How Well It Works

Antiarrhythmic medicines help return the heart to its normal rhythm and keep atrial fibrillation from returning. These medicines might help relieve symptoms such as palpitations or shortness of breath.1

Side Effects

Some antiarrhythmic medicines raise your risk of having a dangerous arrhythmia such as ventricular tachycardia or ventricular fibrillation. Your doctor will check you closely while you take these medicines. The risk of side effects might be greater if you have severe heart disease.

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

Heart symptoms such as:

  • New or worse dizziness or lightheadedness.
  • Severe heart palpitations.
  • Severe weakness.

Severe allergy symptoms such as:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat, which may occur with hives.

Antiarrhythmic medicines can cause less serious side effects that may go away after taking the medicine for a while. Call your doctor if these side effects continue or if they bother you a lot.

  • Stomach problems, such as diarrhea, pain, or nausea.
  • Loss of appetite.
  • Feeling weak or tired.


Call your doctor if you have any side effects from amiodarone. Side effects may include:

  • Cough or trouble breathing.
  • Dizziness, lightheadedness, or fainting.
  • Trembling or shaking.
  • Weakness in the arms or legs.
  • Blurry vision or other vision changes.


Call your doctor right away if you have:

  • Dizziness, lightheadedness, or fainting.
  • Fast or irregular heartbeat.


Call your doctor right away if you have symptoms of heart failure, such as:

  • Shortness of breath when you rest or do activities that did not cause problems before.
  • Swelling of feet or legs.
  • Sudden weight gain, such as 3 lb or more in 2 to 3 days.


Call your doctor right away if you have:

  • Chest pain.
  • Shortness of breath.
  • Irregular heartbeat.
  • Swelling in feet or legs.
  • Trembling or shaking.


Call your doctor right away if you have:

  • Chest pain.
  • Shortness of breath.
  • Changes in your heartbeat such as fast, slow, or irregular.
  • Dizziness, lightheadedness, or fainting.
  • Swelling in feet or legs.

Other side effects of propafenone may include a change in taste, such as metallic taste in your mouth.


Call your doctor right away if you have:

  • Dizziness, lightheadedness, or fainting.
  • Fast heartbeats.

Other side effects of sotalol may include a slow heart rate.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Antiarrhythmic medicines might interact with many other medicines that you might take. Tell your doctor all of the medicines that you take. Be sure to include nonprescription medicines, vitamins, and natural supplements.

Grapefruit juice can affect some antiarrhythmic medicines such as sotalol. Ask your doctor if your medicine is affected by grapefruit juice and if you need to make any changes to avoid problems. For more information, see Grapefruit Juice and Medicines.


If you take amiodarone, your doctor will check you carefully for side effects to make sure you can take the medicine safely. Talk to your doctor if you have any side effects or any concerns about taking amiodarone. Because amiodarone can cause serious side effects, it is typically used for people who have severe symptoms when other medicines have failed.


Dronedarone (Multaq) should not be used by some people who have heart failure, because it can cause serious problems, including death. If you have heart failure, talk to your doctor about whether this medicine is safe for you.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.



  1. Lane DA, et al. (2011). Atrial fibrillation (chronic), search date June 2011. BMJ Clinical Evidence. Available online:


ByHealthwise Staff
Primary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical ReviewerJohn M. Miller, MD, FACC - Cardiology, Electrophysiology
Last RevisedDecember 14, 2012

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