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Atrial Fibrillation (cont.)

Blood Thinning Medications

Other drugs are used to help patients avoid blood clot formation that may lead to strokes or additional health problems. The decision to utilize other drugs can be augmented by the CHADS2 score that assigns points to various conditions (congestive heart failure, hypertension, age, diabetes, and previous stroke) in an AFib patient. The higher the points, the more likely the patient is to develop a stroke; some clinicians use this score to help determine what other drugs may help their patients with AFib avoid a stroke.

  • Warfarin (Coumadin): This drug is an anticoagulant (blood thinner). It reduces the ability of the blood to clot. It lowers the risk of an unwanted blood clot forming in the heart or in a blood vessel. Atrial fibrillation increases the risk of forming such blood clots. It is extremely important to follow the exact dosing prescribed and to have regular blood tests (International Normalized Ratio [INR]) when recommended by the doctor. Patients are urged to keep these important appointments to reduce their risk of blood clot formation or the risk of having an excessive tendency to bleed.
  • Eliquis: This new drug is also utilized to prevent stroke and is similar to dabigatran (Pradaxa) and rivaroxaban (Xarelto).
  • Aspirin and clopidogrel (Plavix): These are two commonly prescribed drugs used to reduce the chance of clot development in AFib patients, especially if patients cannot tolerate Coumadin; they also have been used in short-term treatments while a patient is undergoing evaluation for clot formation.
  • Heparin and enoxaparin (Lovenox): These similar drugs have been used in short-term treatment of AFib patients; occasionally, Lovenox has been used by some physicians for longer term treatment.
  • Dabigatran (Pradaxa): This thrombin inhibitor is approved for prevention of strokes and thrombus in nonvalvular AFib. There is some controversy about this new drug causing increased heart problems.
  • Rivaroxaban (Xarelto): This factor Xa inhibitor is approved for the prevention of strokes and embolisms associated with nonvalvular AFib; dosing is related to creatinine clearance (CrCl) levels (kidney function).

Atrial Fibrillation (AFib) Surgery

Before the development of catheter ablation, open heart surgery was done to interrupt conducting pathways in both atria. This is called the surgical maze procedure. Maze surgery is usually considered in patients who need some other type of heart surgery, such as valve repair or coronary artery bypass surgery.

Atrial Fibrillation (AFib) Follow-up

If patients have no other ongoing heart problems and medications succeed in controlling the patient's heart rate, the patient may be sent home from the emergency department. This is often done after consultation with the patient's doctor or cardiologist. Patients should follow-up with their health care professional within 48 hours.

If the heart rhythm does not convert to normal by itself, the patient may need electrical cardioversion, or defibrillation.

  • Patients in atrial fibrillation longer than 48 hours may need three weeks of treatment with an anticoagulant medication, such as warfarin, before cardioversion and usually for at least four weeks after.
  • Anyone with underlying heart disease or those that do not respond to rate-controlling treatment may require hospitalization and a consult with a cardiologist.
  • Patients undergoing surgery (pacemaker implantation) may require rehabilitation.
Medically Reviewed by a Doctor on 5/26/2015

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Patient Comments & Reviews

The eMedicineHealth doctors ask about Atrial Fibrillation (AFib):

Atrial Fibrillation - Effective Treatments

What types of procedures (for example cardioversion) have you undergone for AFib?

Atrial Fibrillation (AFib) - Blood Thinning Medications

Do you take blood thinners? If so, please share your experience with the medications you have taken or are currently taking.

Atrial Fibrillation - Symptoms

What are your atrial fibrillation symptoms?

Atrial Fibrillation - Experience

Do you or someone you love have AFib? Please share your experience if you feel it may help others.

Atrial Fibrillation - Non Blood Clotting Medications

Do you take non blood thinking medications for AFib? If so, please share your experience with finding the right medication.

Atrial Fibrillation Slideshow



Read What Your Physician is Reading on Medscape

Atrial Fibrilation »

Atrial fibrillation (AF) is a supraventricular tachyarrhythmia characterized by disorganized atrial electrical activity and progressive deterioration of atrial electromechanical function.

Read More on Medscape Reference »


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