Atrial Fibrillation (cont.)
What medications treat atrial fibrillation (AFib)?
The choice of medication depends on the type of atrial fibrillation diagnosed, the underlying cause, other medical conditions that contribute to the patient's overall health, and other medications. Ironically, many anti-arrhythmia medications may induce abnormal heart rhythms.
Anti-arrhythmia medications include:
- Miscellaneous anti-arrhythmia medications: These drugs control the heart rhythm rather than the rate. They reduce the frequency and duration of atrial fibrillation episodes. They are often given to prevent the return of atrial fibrillation after cardioversion. The most commonly used drugs are amiodarone (Cordarone, Pacerone), sotalol (Betapace), propafenone (Rythmol), and flecainide (Tambocor). Overall, these drugs are 50%-70% effective.
- Beta-blockers: These drugs slow the heart rate by decreasing the rate of the SA node and by slowing conduction through the AV node. Therefore, the heart's demand for oxygen is decreased, and the blood pressure is stabilized. Examples include esmolol (Brevibloc), atenolol (Tenormin), propranolol (Inderal), or metoprolol (Lopressor, Toprol XL).
- Calcium channel blockers: These drugs also slow heart rate by mechanisms similar to those of beta-blockers. Verapamil (Calan, Isoptin) and diltiazem (Cardizem) are examples of calcium channel blockers.
- Digoxin (Lanoxin): This drug decreases the conductivity of electrical impulses through the AV node, but onset of action is slower than beta-blockers and calcium blockers. Digoxin is currently used primarily in patients with associated heart disease, such as a poorly functioning left ventricle.
- Dofetilide (Tikosyn): This is an oral antiarrhythmic drug that must be initiated in the hospital over a three-day period. Hospitalization is needed to closely monitor the heart rhythm during the initial dosing period. If the atrial fibrillation responds favorably during the initial dosing, a maintenance dose is established to be continued at home.
- Other medications: There are many other drugs in use and they are prescribed to individualize the treatment of AFib. Other drugs can include Ibutilide (Corvert), Dronedarone (Multaq), and Quinidine (Cardioquin, Quinalan, Quinidex, Quinaglute); others may be used rarely.
- Herbs: Some herbal companies claim cures of atrial fibrillation with their product, but the data to support these claims is questionable and not acceptable to most researchers.
Medically Reviewed by a Doctor on 5/25/2016
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