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How Do You Stop an AFib Attack?

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Ask How Do You Stop an AFib Attack Related Articles

Ask a Doctor

I have chronic atrial fibrillation, and I recently had a frightening attack. Luckily, my Afib attack happened at home when I was with my wife, so everything turned out OK, but I worry about what could happen if I were, for instance, driving. Is there any way to stop an atrial fibrillation attack as it’s happening?

Doctor's Response

There is no effective home treatment for atrial fibrillation while it is occurring.

However, if the doctor recommends lifestyle changes or prescribes medicine, follow his or her recommendations exactly. Lifestyle changes may prevent AFib associated with holiday heart (the layman’s term for AFib attacks brought on by periods of stress and heavy drinking, poor diet, etc.). In addition, careful adherence to medication at home may also prevent many episodes of AFib. This is the only way to see whether the medical treatment works or needs adjustment.

Treatment for atrial fibrillation traditionally seeks three goals: to slow down the heart rate, to restore and maintain normal heart rhythm, and to prevent blood clots that may lead to strokes.

  • Cardiac rate control: The first treatment goal is to slow down the ventricular rate, if it is fast.
    • o If patients experience serious clinical symptoms, such as chest pain or shortness of breath related to the ventricular rate, the health care professional in the emergency department will try to decrease the heart rate rapidly with intravenous (IV) medications.
    • o If patients have no serious symptoms, they may be given medications by mouth.
    • o Sometimes patients may require more than one type of oral medication to control the heart rate.
  • Restore and maintain normal cardiac rhythm: About half of the people with newly diagnosed atrial fibrillation will convert to normal rhythm spontaneously in 24-48 hours. However, atrial fibrillation typically returns in many patients.
    • As already mentioned, not everyone with atrial fibrillation needs to take medication to maintain normal rhythm.
    • The frequency with which arrhythmia returns and the symptoms it causes partly determine whether individuals receive rhythm-controlling medication, which is usually termed anti-arrhythmia medication.
    • Medical professionals tailor each person's anti-arrhythmia medication(s) carefully to produce the desired effect, a normal cardiac rhythm.
    • Most of these medications cause unwanted side effects, which limit their use. These medications should be discussed with a doctor.
  • Prevent clot formation (strokes): Stroke is a devastating complication of atrial fibrillation. Blood clots can form in the atria when their motility is impaired as in AFib. Stroke can occur when a piece of a blood clot formed in the heart breaks off and travels to the brain, where it blocks blood flow.
    • Coexisting medical conditions, such as hypertension, congestive heart failure, heart valve abnormalities, or coronary heart disease, significantly increase the risk of stroke. Age older than 65 years also increases the risk of stroke.
    • Most people with atrial fibrillation take a blood-thinning drug called warfarin (Coumadin) to lower this risk of stroke and heart failure. Warfarin blocks certain factors in the blood that promote clotting. Acutely, the initial blood thinner is IV or subcutaneous heparin to thin a patient's blood rapidly. Then a decision is made whether they need oral warfarin.
    • People at lower risk of stroke and those who cannot take warfarin may use aspirin. It may be used in conjunction with Plavix. Aspirin is not without its own side effects, including bleeding problems and stomach ulcers.
    • Clopidogrel (Plavix) is another medication that is also used by many physicians to prevent clot formation in cardiovascular diseases, including AFib.
    • Other drugs that may be used by some cardiologists include enoxaprin (Lovenox), dabigatran (Pradaxa), and rivroxaban (Xarelto). The choice of these drugs which are used to reduce the chance of clot formation in patients with chronic AFib is often determined by the patient's problems with Coumadin and the preference or experience of the cardiologist with these drugs.

For more information, read our full medical article on atrial fibrillation.

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Reviewed on 9/11/2019
References
"Atrial Fibrillation Fact Sheet." Centers for Disease Control and Prevention (CDC). Feb. 2010. <http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/docs/fs_atrial_fibrillation.pdf>.

"Heart Disease Pictures Slideshow: A Visual Guide to Heart Disease." MedicineNet. 30 Sept. 2009. <https://www.medicinenet.com/heart_disease_pictures_slideshow_visual_guide/article.htm>.

Gage, Brian F., et al. "Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation." The Journal of the American Medical Association 285.22 (2001): 2864-2870.

Rosenthal, Lawrence, et al. "Atrial Fibrillation." Medscape. 30 Jan. 2012. <http://emedicine.medscape.com/article/151066-overview#a0104>.

Rosenthal, Lawrence, et al. "Atrial Fibrillation Medication." Medscape. 15 Mar. 2012. <http://emedicine.medscape.com/article/151066-medication>.



UpToDate. Patient information: Atrial fibrillation (Beyond the Basics).
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