How Atrial Fibrillation (AFib) Is Treated

Table of ContentsView AllTable of ContentsTargeting the CauseMedicationsSurgery and ProceduresComplementary TreatmentsLifestyle ChangesCan AFib Be Cured?Next in Atrial Fibrillation GuideHow Treatment Improves Atrial Fibrillation Life Expectancy

Table of ContentsView All

View All

Table of Contents

Targeting the Cause

Medications

Surgery and Procedures

Complementary Treatments

Lifestyle Changes

Can AFib Be Cured?

Next in Atrial Fibrillation Guide

Atrialfibrillation(AFib) is an irregular, frequently rapid heart rhythm originating in the atria (the heart’s upper chambers). During a normal heartbeat, the atria pump blood into the ventricles (lower heart chambers). However, in AFib, the atria quiver (fibrillate), so blood is not pumped as efficiently or powerfully into the ventricles.

Symptoms likepalpitationsorchest discomfortmay arise with atrial fibrillation, andblood clotscan develop within the atria and cause astroke.

Atrial fibrillation has no definite cure, although its symptoms can be reduced and blood clots may be prevented. This article will review the various treatments for atrial fibrillation, including lifestyle changes, medications, and surgical procedures.

Atrial Fibrillation

Atrial Fibrillation Treatments Target the Cause

Atrial fibrillation is common, affecting an estimated 3 to 6 million adults in the United States.AFib increases with age and typically develops in people with underlying heart problems like high blood pressure (hypertension),coronary artery disease,heart failure, orheart valve disease.

Other triggers or risk factors for AFib are:

Numerous strategies exist for managing atrial fibrillation, including lifestyle behaviors, medications, and procedures. These strategies aim to reduce AFib symptoms and help prevent blood clots. Addressing the underlying cause of your AFib is another critical component of a person’s treatment plan.

For example, a healthcare provider may prescribe medication to lower blood pressure, manage diabetes, or help a person quit smoking. Likewise, medication combined with a nutrition and exercise program may be advised to help a person lose weight.

In some cases, treating a specific condition (e.g., hyperthyroidism) or eliminating a trigger (e.g., alcohol) can result in the reversal of AFib.

How to Identify Atrial Fibrillation (AFib)

Atrial Fibrillation Medications

Three types of medications are used to manage AFib:

Heart Rhythm Control Medications

Drugs used to rest or maintain a normal heart rhythm (sinus rhythm) and decrease AFib-related symptoms are calledantiarrhythmics.

Antiarrhythmics commonly used to treat AFib include:

The downside of antiarrhythmics is that rates of recurrent atrial fibrillation are still reasonably high. Moreover, these drugs are associated with potentially serious side effects and complications.

For example, the commonly used antiarrhythmic amiodarone is associated with lung and thyroid gland toxicity, nerve and eye problems, and unpleasant gastrointestinal side effects like nausea and constipation.

How Long Does Amiodarone Stay In Your System?

Lastly, while rare, antiarrhythmic drugs can trigger the onset of dangerousventricular arrhythmias.

Specialized Care

Heart-Rate-Control Medications

Medications to control heart rate slow the heartbeat. Compared to antiarrhythmics, heart rate control medications are associated with a lower rate of hospitalization and significant adverse events.That said, it can be challenging to lower the heart rate enough to relieve AFib symptoms.

Medications used in the rate control strategy include:

Medicines to Prevent Blood Clots

Since the atria cannot strongly pump blood into the ventricles in AFib, blood pools and may form clots. If a blood clot travels to the brain, it can lead to a stroke.

Anticoagulants used in AFib include:

Selecting an AFib Medication StrategyChoosing a medication strategy requires considering factors like age, duration of AFib, symptoms, and history of stroke or other health problems. In the end, some people take both heart rate and rhythm control medicines, and many people with AFib take an anticoagulant to help prevent stroke.

Selecting an AFib Medication Strategy

Choosing a medication strategy requires considering factors like age, duration of AFib, symptoms, and history of stroke or other health problems. In the end, some people take both heart rate and rhythm control medicines, and many people with AFib take an anticoagulant to help prevent stroke.

Can You Reverse Atrial Fibrillation (AFib) Naturally?

Surgical and Nonsurgical Procedures

Cardioversion,catheter ablation, pacemaker implantation, or various surgical procedures can also be used to manage AFib.

Cardioversion

Cardioversionis restoring the heart’s normal rhythm and may be performed electrically or chemically, as follows:

A significant downside of electrical or chemical cardioversion is its risk of stroke from blood clots lodged in the atria.

As such, cardioversion is typically delayed until a person has been treated with an anticoagulant for three to four weeks. The anticoagulant helps any preformed blood clots stabilize or resolve. Anticoagulation is also given after the cardioversion, for at least four weeks, and often much longer.

Rarely, electrical cardioversion may be performed emergently in people with atrial fibrillation who arehemodynamically unstable, meaning their heart cannot supply their body’s vital organs with adequate blood flow.

Catheter Ablation

During the procedure, catheters (thin, flexible wires) are inserted into a blood vessel, usually in the groin area, and advanced into the heart. Heat (radiofrequency energy) or cold (cryoablation) are then used to ablate (destroy) tissue to create scarring to stop the abnormal signaling pathway.

While catheter ablation has the potential to cure AFib, complications may occur, such as bleeding, blood clots to the lung (pulmonary embolism), stroke, injury to the heart, and, although rarely, death.

Pacemaker Implantation

Pacemakersare implanted devices that send electrical impulses to the heart muscle to prevent the heart from beating too slowly. Pacemakers are typically used in people with AFib who also experience a slow heart rate (bradycardia) during treatment with antiarrhythmic medications or after catheter ablation.

A pacemaker may also be implanted in people with atrial fibrillation who experiencesick sinus syndrome, in which the heart fluctuates between episodes of AFib and a slow heart rate.

Maze Procedure

Traditionally, the maze procedure is performed in a person undergoingopen heart surgeryfor another indication like coronary artery disease or heart valve disease.

The maze procedure can now be performed using minimally invasive techniques, where instead of a large incision (6–8 inches) in the chest, tiny cuts in between the ribs are used to access the heart with surgical tools.

How Successful Is the Maze Procedure?The maze procedure has evolved over the years. The most recent version—the Cox-maze IV procedure—has a success rate (freedom from AFib) of 92% one year after surgery and 77% 10 years after surgery.

How Successful Is the Maze Procedure?

The maze procedure has evolved over the years. The most recent version—the Cox-maze IV procedure—has a success rate (freedom from AFib) of 92% one year after surgery and 77% 10 years after surgery.

Left Atrial Appendage Closure (LAAC)

The left atrial appendage is a small pouch in the left atrium (upper left heart chamber), a common location of blood clots in people with atrial fibrillation.

Closing or sealing off the left atrial appendage surgically or with aFood and Drug Administration (FDA)–approved device(so blood cannot pool within it and clot) is typically performed in people with AFib who are at a high risk of stroke but cannot take blood thinners.

Overall, LAAC devices offer a promising alternative to long-term anticoagulation with a decreased bleeding risk. Still, LAAC is a surgical procedure associated with various complications, such as blood clotting around the device and fluid buildup around the heart sac (pericardial effusion).

Complementary Treatments for AFib

Complementary therapies have shown promise in helping improve symptoms of atrial fibrillation, namely yoga,acupuncture, andbiofeedback.While these therapies can ease the burden of living with AFib and improve quality of life, they are not intended to replace standard AFib treatments.

Dietary supplements likeomega-3 fatty acids, vitamins with antioxidant properties likevitamin Candvitamin E, and herbal supplements, such asberberineorcinchonabark, or the Chinese medicineShensongyangxin,have also been considered for helping manage AFib.

Unfortunately, the scientific evidence supporting their benefit in managing atrial fibrillation is scant. Moreover, supplements, especially herbal products, may interact with AFib and other heart medications.

Avoid HarmTo avoid adverse reactions, do not take any supplement, vitamin, or herbal medicine without discussing it with a healthcare provider first.

Avoid Harm

To avoid adverse reactions, do not take any supplement, vitamin, or herbal medicine without discussing it with a healthcare provider first.

AFib Lifestyle Changes

Healthy lifestyle behaviors play a crucial role in living with atrial fibrillation, as they can help reduce AFib episodes and unpleasant symptoms.

Lifestyle behaviors found to be beneficial in AFib care include:

With some exceptions (e.g., reversible AFib triggers like alcohol), atrial fibrillation is typically a recurrent and lifelong condition. The good news is that despite the lack of a definite cure, AFib can be managed well, so many people experience long, happy, and active lives.

If you or a loved one has atrial fibrillation, it’s normal to feel worried or overwhelmed, especially when first diagnosed.

Consider these valuable coping strategies as you navigate a diagnosis of atrial fibrillation:

Atrial Fibrillation: Deciding to Go to the Hospital

Summary

Atrial fibrillation (AFib) is an irregular, usually rapid heart rhythm originating in the atria (the heart’s upper chambers). It causes the atria to quiver, or fibrillate, preventing blood from being strongly pumped into the ventricles (the heart’s lower chambers).

Treatment of AFib involves multiple components, including cardioversion to restore the heart’s normal rhythm and long-term medications to slow the heart’s speed, maintain the heart’s normal rhythm (antiarrhythmic), and prevent blood clots (anticoagulants).

Catheter ablation (to scar the heart to disrupt abnormal signaling pathways), the use of a pacemaker (a device to prevent the heart from beating too slowly), and the maze procedure (where a pattern of scar tissue is created within the atria) are additional ways to manage AFib.

15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Salih M, Abdel-Hafez O, Ibrahim R, Nair R.Atrial fibrillation in the elderly population: Challenges and management considerations.J Arrhythm. 2021 Jun 24;37(4):912-921. doi:10.1002/joa3.12580Joglar JA, Chung MK, Armbruster AL, et al.2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[published correction appears in Circulation. 2024 Jan 2;149(1):e167].Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193Bunch TJ, Steinberg BA.Revisiting rate versus rhythm control in atrial fibrillation - timing matters.N Engl J Med. 2020;383(14):1383-1384. doi:10.1056/NEJMe2027180Istratoaie S, Sabin O, Vesa ŞC, Cismaru G, Donca VI, Buzoianu AD.Efficacy of amiodarone for the prevention of atrial fibrillation recurrence after cardioversion.Cardiovasc J Afr. 2021;32(6):327-338. doi:10.5830/CVJA-2020-060Alobaida M, Alrumayh A.Rate control strategies for atrial fibrillation.Ann Med. 2021;53(1):682-692. doi:10.1080/07853890.2021.1930137Amin A, Houmsse A, Ishola A, Tyler J, Houmsse M.The current approach of atrial fibrillation management.Avicenna J Med. 2016;6(1):8-16. doi:10.4103/2231-0770.173580Benali K, Khairy P, Hammache N, et al.Procedure-related complications of catheter ablation for atrial fibrillation.J Am Coll Cardiol. 2023;81(21):2089-2099. doi:10.1016/j.jacc.2023.03.418Semmler V, von Krogh F, Haller B, et al.The incidence, indications and predictors of acute pacemaker implantation after ablation of persistent atrial fibrillation.Clin Res Cardiol. 2019;108(6):651-659. doi:10.1007/s00392-018-1393-1Chang W, Li G.Clinical review of sick sinus syndrome and atrial fibrillation.Herz. 2022 Jun;47(3):244-250. doi: 10.1007/s00059-021-05046-xKhiabani AJ, MacGregor RM, Bakir NH, et al.The long-term outcomes and durability of the Cox-Maze IV procedure for atrial fibrillation.J Thorac Cardiovasc Surg. 2022;163(2):629-641.e7. doi:10.1016/j.jtcvs.2020.04.100Khan F, Ramirez FD, Hibbert B.Percutaneous left atrial appendage closure for managing thromboembolic risk in atrial fibrillation.CMAJ. 2018;190(41):E1227-E1230. doi:10.1503/cmaj.180470Abdul-Aziz AA, Altawil M, Lyon A, et al.Lifestyle therapy for the management of atrial fibrillation.Am J Cardiol. 2018;121(9):1112-1117. doi:10.1016/j.amjcard.2018.01.023Kanmanthareddy A, Reddy M, Ponnaganti G, et al.Alternative medicine in atrial fibrillation treatment-yoga, acupuncture, biofeedback and more.J Thorac Dis. 2015;7(2):185-92. doi:10.3978/j.issn.2072-1439.2015.01.13Wingerter R, Steiger N, Burrows A, Estes NAM 3rd.Impact of lifestyle modification on atrial fibrillation.Am J Cardiol. 2020;125(2):289-297. doi:10.1016/j.amjcard.2019.10.018Rosenstrøm S, Risom SS, Hove JD, Brødsgaard A.Living with atrial fibrillation: a family perspective.Nurs Res Pract. 2022;2022:7394445. doi:10.1155/2022/7394445

15 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Salih M, Abdel-Hafez O, Ibrahim R, Nair R.Atrial fibrillation in the elderly population: Challenges and management considerations.J Arrhythm. 2021 Jun 24;37(4):912-921. doi:10.1002/joa3.12580Joglar JA, Chung MK, Armbruster AL, et al.2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[published correction appears in Circulation. 2024 Jan 2;149(1):e167].Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193Bunch TJ, Steinberg BA.Revisiting rate versus rhythm control in atrial fibrillation - timing matters.N Engl J Med. 2020;383(14):1383-1384. doi:10.1056/NEJMe2027180Istratoaie S, Sabin O, Vesa ŞC, Cismaru G, Donca VI, Buzoianu AD.Efficacy of amiodarone for the prevention of atrial fibrillation recurrence after cardioversion.Cardiovasc J Afr. 2021;32(6):327-338. doi:10.5830/CVJA-2020-060Alobaida M, Alrumayh A.Rate control strategies for atrial fibrillation.Ann Med. 2021;53(1):682-692. doi:10.1080/07853890.2021.1930137Amin A, Houmsse A, Ishola A, Tyler J, Houmsse M.The current approach of atrial fibrillation management.Avicenna J Med. 2016;6(1):8-16. doi:10.4103/2231-0770.173580Benali K, Khairy P, Hammache N, et al.Procedure-related complications of catheter ablation for atrial fibrillation.J Am Coll Cardiol. 2023;81(21):2089-2099. doi:10.1016/j.jacc.2023.03.418Semmler V, von Krogh F, Haller B, et al.The incidence, indications and predictors of acute pacemaker implantation after ablation of persistent atrial fibrillation.Clin Res Cardiol. 2019;108(6):651-659. doi:10.1007/s00392-018-1393-1Chang W, Li G.Clinical review of sick sinus syndrome and atrial fibrillation.Herz. 2022 Jun;47(3):244-250. doi: 10.1007/s00059-021-05046-xKhiabani AJ, MacGregor RM, Bakir NH, et al.The long-term outcomes and durability of the Cox-Maze IV procedure for atrial fibrillation.J Thorac Cardiovasc Surg. 2022;163(2):629-641.e7. doi:10.1016/j.jtcvs.2020.04.100Khan F, Ramirez FD, Hibbert B.Percutaneous left atrial appendage closure for managing thromboembolic risk in atrial fibrillation.CMAJ. 2018;190(41):E1227-E1230. doi:10.1503/cmaj.180470Abdul-Aziz AA, Altawil M, Lyon A, et al.Lifestyle therapy for the management of atrial fibrillation.Am J Cardiol. 2018;121(9):1112-1117. doi:10.1016/j.amjcard.2018.01.023Kanmanthareddy A, Reddy M, Ponnaganti G, et al.Alternative medicine in atrial fibrillation treatment-yoga, acupuncture, biofeedback and more.J Thorac Dis. 2015;7(2):185-92. doi:10.3978/j.issn.2072-1439.2015.01.13Wingerter R, Steiger N, Burrows A, Estes NAM 3rd.Impact of lifestyle modification on atrial fibrillation.Am J Cardiol. 2020;125(2):289-297. doi:10.1016/j.amjcard.2019.10.018Rosenstrøm S, Risom SS, Hove JD, Brødsgaard A.Living with atrial fibrillation: a family perspective.Nurs Res Pract. 2022;2022:7394445. doi:10.1155/2022/7394445

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Salih M, Abdel-Hafez O, Ibrahim R, Nair R.Atrial fibrillation in the elderly population: Challenges and management considerations.J Arrhythm. 2021 Jun 24;37(4):912-921. doi:10.1002/joa3.12580Joglar JA, Chung MK, Armbruster AL, et al.2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[published correction appears in Circulation. 2024 Jan 2;149(1):e167].Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193Bunch TJ, Steinberg BA.Revisiting rate versus rhythm control in atrial fibrillation - timing matters.N Engl J Med. 2020;383(14):1383-1384. doi:10.1056/NEJMe2027180Istratoaie S, Sabin O, Vesa ŞC, Cismaru G, Donca VI, Buzoianu AD.Efficacy of amiodarone for the prevention of atrial fibrillation recurrence after cardioversion.Cardiovasc J Afr. 2021;32(6):327-338. doi:10.5830/CVJA-2020-060Alobaida M, Alrumayh A.Rate control strategies for atrial fibrillation.Ann Med. 2021;53(1):682-692. doi:10.1080/07853890.2021.1930137Amin A, Houmsse A, Ishola A, Tyler J, Houmsse M.The current approach of atrial fibrillation management.Avicenna J Med. 2016;6(1):8-16. doi:10.4103/2231-0770.173580Benali K, Khairy P, Hammache N, et al.Procedure-related complications of catheter ablation for atrial fibrillation.J Am Coll Cardiol. 2023;81(21):2089-2099. doi:10.1016/j.jacc.2023.03.418Semmler V, von Krogh F, Haller B, et al.The incidence, indications and predictors of acute pacemaker implantation after ablation of persistent atrial fibrillation.Clin Res Cardiol. 2019;108(6):651-659. doi:10.1007/s00392-018-1393-1Chang W, Li G.Clinical review of sick sinus syndrome and atrial fibrillation.Herz. 2022 Jun;47(3):244-250. doi: 10.1007/s00059-021-05046-xKhiabani AJ, MacGregor RM, Bakir NH, et al.The long-term outcomes and durability of the Cox-Maze IV procedure for atrial fibrillation.J Thorac Cardiovasc Surg. 2022;163(2):629-641.e7. doi:10.1016/j.jtcvs.2020.04.100Khan F, Ramirez FD, Hibbert B.Percutaneous left atrial appendage closure for managing thromboembolic risk in atrial fibrillation.CMAJ. 2018;190(41):E1227-E1230. doi:10.1503/cmaj.180470Abdul-Aziz AA, Altawil M, Lyon A, et al.Lifestyle therapy for the management of atrial fibrillation.Am J Cardiol. 2018;121(9):1112-1117. doi:10.1016/j.amjcard.2018.01.023Kanmanthareddy A, Reddy M, Ponnaganti G, et al.Alternative medicine in atrial fibrillation treatment-yoga, acupuncture, biofeedback and more.J Thorac Dis. 2015;7(2):185-92. doi:10.3978/j.issn.2072-1439.2015.01.13Wingerter R, Steiger N, Burrows A, Estes NAM 3rd.Impact of lifestyle modification on atrial fibrillation.Am J Cardiol. 2020;125(2):289-297. doi:10.1016/j.amjcard.2019.10.018Rosenstrøm S, Risom SS, Hove JD, Brødsgaard A.Living with atrial fibrillation: a family perspective.Nurs Res Pract. 2022;2022:7394445. doi:10.1155/2022/7394445

Salih M, Abdel-Hafez O, Ibrahim R, Nair R.Atrial fibrillation in the elderly population: Challenges and management considerations.J Arrhythm. 2021 Jun 24;37(4):912-921. doi:10.1002/joa3.12580

Joglar JA, Chung MK, Armbruster AL, et al.2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[published correction appears in Circulation. 2024 Jan 2;149(1):e167].Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193

Bunch TJ, Steinberg BA.Revisiting rate versus rhythm control in atrial fibrillation - timing matters.N Engl J Med. 2020;383(14):1383-1384. doi:10.1056/NEJMe2027180

Istratoaie S, Sabin O, Vesa ŞC, Cismaru G, Donca VI, Buzoianu AD.Efficacy of amiodarone for the prevention of atrial fibrillation recurrence after cardioversion.Cardiovasc J Afr. 2021;32(6):327-338. doi:10.5830/CVJA-2020-060

Alobaida M, Alrumayh A.Rate control strategies for atrial fibrillation.Ann Med. 2021;53(1):682-692. doi:10.1080/07853890.2021.1930137

Amin A, Houmsse A, Ishola A, Tyler J, Houmsse M.The current approach of atrial fibrillation management.Avicenna J Med. 2016;6(1):8-16. doi:10.4103/2231-0770.173580

Benali K, Khairy P, Hammache N, et al.Procedure-related complications of catheter ablation for atrial fibrillation.J Am Coll Cardiol. 2023;81(21):2089-2099. doi:10.1016/j.jacc.2023.03.418

Semmler V, von Krogh F, Haller B, et al.The incidence, indications and predictors of acute pacemaker implantation after ablation of persistent atrial fibrillation.Clin Res Cardiol. 2019;108(6):651-659. doi:10.1007/s00392-018-1393-1

Chang W, Li G.Clinical review of sick sinus syndrome and atrial fibrillation.Herz. 2022 Jun;47(3):244-250. doi: 10.1007/s00059-021-05046-x

Khiabani AJ, MacGregor RM, Bakir NH, et al.The long-term outcomes and durability of the Cox-Maze IV procedure for atrial fibrillation.J Thorac Cardiovasc Surg. 2022;163(2):629-641.e7. doi:10.1016/j.jtcvs.2020.04.100

Khan F, Ramirez FD, Hibbert B.Percutaneous left atrial appendage closure for managing thromboembolic risk in atrial fibrillation.CMAJ. 2018;190(41):E1227-E1230. doi:10.1503/cmaj.180470

Abdul-Aziz AA, Altawil M, Lyon A, et al.Lifestyle therapy for the management of atrial fibrillation.Am J Cardiol. 2018;121(9):1112-1117. doi:10.1016/j.amjcard.2018.01.023

Kanmanthareddy A, Reddy M, Ponnaganti G, et al.Alternative medicine in atrial fibrillation treatment-yoga, acupuncture, biofeedback and more.J Thorac Dis. 2015;7(2):185-92. doi:10.3978/j.issn.2072-1439.2015.01.13

Wingerter R, Steiger N, Burrows A, Estes NAM 3rd.Impact of lifestyle modification on atrial fibrillation.Am J Cardiol. 2020;125(2):289-297. doi:10.1016/j.amjcard.2019.10.018

Rosenstrøm S, Risom SS, Hove JD, Brødsgaard A.Living with atrial fibrillation: a family perspective.Nurs Res Pract. 2022;2022:7394445. doi:10.1155/2022/7394445

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