Some patients require no treatment. The atrial fibrillation goes away by itself and the normal heart rhythm is restored. This is often the cause for people who have one episode of atrial fibrillation. Most people however require treatment with tablets.
The tablets are used for the following reasons:
Slow the heart rate — this usually relieves most of the symptoms of palpitations and breathlessness. Most people with chronic AF are on these tablets. These drugs are Digoxin (Lanoxin), Atenolol (Tenormin, Noten), Verapamil (Isopten, Vercaps) or Diltiazem (Cardizem).
Restore and maintain normal heart rhythm — these drugs are useful in people who have episodic (paroxysmal) atrial fibrillation to reduce the frequency of recurrences and sometimes prevent episodes altogether. These drugs include Sotalol (Sotacor), Flecainide (Tambocor) and Amiodarone (Cordarone).
Reduce risk of blood clots — anticoagulation. These drugs are used to prevent blood clots forming in the heart. Some patients only need Aspirin but others require Warfarin (Coumadin), an anticoagulant drug which requires regular blood tests to maintain careful control.
In some patients who have had an episode of AF, the tablets do not restore normal rhythm. In these cases, an electric shock is required to reset the heart rhythm (this is called a ‘cardioversion’). It is performed under a brief general anaesthetic and requires coming into hospital for a day.