Atrial fibrillation treatment varies depending on your symptoms and other personal factors. Treatment may include lifestyle changes, medication, non-surgical procedures, a hybrid surgical approach or a combination of treatments.
Healthcare providers will often suggest that patients receiving treatment for atrial fibrillation adapt a heart-healthy lifestyle that includes these steps:
- Eat a healthy diet. This includes eating fruits and veggies, lean meats, nuts, beans, fish and whole grains, while limiting sodium, added sugars and unhealthy fats.
- Limit alcohol. Men should have no more than two drinks per day and women should aim for no more than one drink per day.
- Reach and maintain a healthy weight.
- Get seven to nine hours of quality sleep per night.
- Manage other health problems, such as high blood pressure and diabetes, by taking medications properly and following your provider’s guidance.
- Stay physically active. Try to get at least 30 minutes of moderate exercise most days of the week. Talk to your provider about what exercises are good for you. Be sure to watch for signs that your heart is working too hard; if you become short of breath or dizzy while exercising, stop and rest right away.
- Stay up to date on flu and COVID-19 vaccines to help avoid getting sick.
Your healthcare provider may recommend medicines to control heart rate or rhythm or direct oral anticoagulants to prevent blood clots.
- Anti-arrhythmics: These medicines control your heart rhythm.
- Beta blockers: These medicines block the effects of adrenaline on the heart, which slows the heart rate and lessens the force of heart contractions.
- Blood thinners: Atrial flutter, like other forms of arrhythmia, can increase your risk for blood clots that can lead to stroke. Like the name implies, blood thinners thin the blood and reduce the risk for clots.
- Calcium channel blockers: These medicines block calcium channels to the heart cells, which slows the heart rate and helps manage arrhythmias.
The American Heart Association reports that between 60% and 80% of people with AFib also have hypertension (high blood pressure), so healthcare providers may recommend medications and lifestyle changes to lower blood pressure, too.
A non-surgical procedure may be needed to treat AFib, especially when lifestyle changes and medicines aren't enough to control symptoms. Common non-surgical procedures for atrial fibrillation are:
- Pulse field ablation (PFA): PFA is a minimally invasive treatment. It uses short, high-energy electrical pulses to target and treat heart tissue causing the abnormal heart rhythm. With its precision, PFA can offer a quicker treatment option with less risk to surrounding structures. Your electrophysiologist will insert a catheter – a thin, flexible tube – into a blood vessel, typically in the groin. The catheter is then guided to the heart to deliver the electrical pulses.
- Catheter ablation, or radiofrequency ablation: In this procedure, a catheter is inserted into a blood vessel and threaded to the heart. Electrodes inside the catheter allow your cardiologist to find the problem areas. Your doctor can then destroy the abnormal tissue with radiofrequency energy.
- Cryoablation: A catheter is used to find and freeze the problem areas that cause an irregular heartbeat.
- Electrical cardioversion: Before electrical cardioversion, you are given anesthesia to put you to sleep. During the procedure, your provider attaches electrodes to your chest or both your chest and back. Next, one or more brief electrical shocks is sent to your heart to restore a normal rhythm. Medicine or ablation is needed to maintain this normal rhythm.
- WATCHMAN procedure: During this minimally invasive procedure, a doctor makes a small incision near the groin and guides a catheter to the left chamber of the heart. Once there, a device is implanted to close the left atrial appendage, the part of the heart where most strokes originate. The WATCHMAN isn’t a treatment for AFib, but it is recommended to reduce stroke risk in patients with persistent AFib. This procedure is performed in collaboration with the UK Gill Heart & Vascular Institute’s structural heart team.
Surgical treatments are used in emergencies, if you’re having heart surgery for another condition or other treatments haven’t worked. These procedures include:
- Maze procedure. During the maze procedure, the surgeon makes tiny cuts in the atria to create scar tissue, interrupting electrical signals that cause atrial fibrillation.
- Pacemaker implantation. In this procedure, the surgeon places a small, battery-operated device called a pacemaker under the skin, usually near the collarbone. The pacemaker is used in these instances:
- When you’re on large amounts of medication to slow the heartbeat but your heart slows down too much.
- When you undergo an AV node ablation and your heart needs more support for a regular beat.
