Treatment

The good news is that with the right treatment, you can live a long, healthy life with AFib. But you need to be in tune with your heart and body. If untreated, atrial fibrillation can lead to blood clots, stroke and other heart-related problems, including heart failure. 

Your treatment will likely depend on:

• Your age
• Your symptoms and how often the episodes happen
• Whether your heart rate is under control
• Your risk for stroke (see the CHADS₂VASC score to find out your risk and need for blood thinners)
• Other medical conditions, including if you have heart disease 

Treatment of AFib focuses on lifestyle changes and either rate control or rhythm control. Therapies to prevent stroke are also important. 

Lifestyle Changes

Lifestyle changes may include:

• Eating a heart-healthy diet full of fresh fruits and vegetables, fiber-rich foods, lean meats and fish, and unsaturated fats like olive oil
• Limiting alcohol
• Exercising regularly – aim to get 30 minutes of physical activity most days
• Managing stress levels
• Not smoking
• Taking your medication(s) as directed and managing other conditions 
• Treating sleep apnea

In addition to lifestyle changes, treatments often include medications, procedures, or both.

Medications

Medications are used to:

• Prevent clots from forming or to break up an existing clot
• Restore your heart’s rate or rhythm 

Medications to prevent or treat blood clots and stroke include blood thinners, also called anticoagulants, for example:

• Warfarin (brand name: Coumadin, Jantoven)
• Dabigatran (brand: Pradaxa)
• Rivaroxaban (brand: Xarelto)
• Apixaban (brand: Eliquis) 
• Edoxaban (brand: Savaysa)

Talk with your care team about which blood thinner is right for you. Keep in mind that if you take a blood thinner, you must be very cautious about falls and other accidents that might cause bleeding. There are medicines or antidotes that can reverse the blood-thinning power of warfarin, but those don't exist yet for the newer medications. 

Read More: Medications to Prevent Stroke

You might also have limits on what you can eat. For example, foods like spinach, kale and other vegetables are rich in vitamin K, which can disrupt the way warfarin works. That’s why you have to be careful to eat the same amount every day if you take warfarin. You also need to have your blood checked often when taking this medicine (called your INR/PT).  

If you have major bleeding on a blood thinner, your care team may talk with you about a procedure that closes the left atrial appendage – a common location for clots in patients with atrial fibrillation.

Procedures

Your treatment may also involve medical procedures such as:

• Cardioversion – low-voltage electrical shock is applied to the chest with paddles to restore a normal rhythm
• Ablation – a tube is inserted into a vein in the leg and threaded to the heart to fix the faulty electrical signals
• Surgical maze – small scar lines are made on the heart to create a “maze” that prevents or redirects the abnormal beats from controlling the heart. This is done through open-heart surgery.
• Pacemaker – an implantable device that prevents your heart rate from beating too slowly. This is used if your medications are causing too slow of a heart rate, or if an ablation is done to prevent your heart rate from going fast.