Table of ContentsView AllTable of ContentsA-Fib MedicationsOther InterventionsComplications of Atrial FibrillationNutrition ConsiderationsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
A-Fib Medications
Other Interventions
Complications of Atrial Fibrillation
Nutrition Considerations
Frequently Asked Questions
Treatment of AFib may involve drugs to control heart rate or rhythm, blood thinners to prevent blood clots, electrical cardioversion (shock therapy) to restore rhythm, and surgeries or procedures to block irregular electrical signals in the heart.
Here’s what you need to know about the medications commonly used to treat atrial fibrillation.
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What Medications Are Available for Atrial Fibrillation?
Along with treating AFib, conditions that cause atrial fibrillation, including high blood pressure, diabetes, and sleep apnea, also should be treated. The American Heart Association recommends the following lifestyle modifications for managing AFib:
The main treatments for AFib aim to control heart rate and rhythm and decrease stroke risk.
Types of medications most often used for AFib are:
An older anticoagulant option iswarfarin, which carries the risk of more interactions compared to other medications in this drug class and requires frequent monitoring. It may be used as an alternative option for some people or a first-choice anticoagulant for certain groups.
Rate-control medications: These types of medications decrease theheart ratewith a target of less than 100 to 110 beats per minute (bpm).Several drugs fall into this group, such as the following:
Of these drugs, beta-blockers are associated with the lowest risk of death, so they are typically used as a first-line treatment.
Rhythm-control medications: These drugs are also called antiarrhythmic medications. They restore anormal (sinus) heart rhythm. They are recommended for select people with AFib, such as those with bothersome symptoms, heart failure, or a recent diagnosis.There are two main types of rhythm control medications:
Nexterone or Pacerone (amiodarone) is another option that is reserved for use when other rhythm control medications aren’t effective or can’t be used, due to its serious side effects and drug interactions. It may also be given intravenously (IV) to restore rhythm in emergencies.
What Causes AFib?Anything that causes stress or damage to the heart can cause AFib, including the following:Older ageHigh blood pressureHeart diseaseLung diseaseHigh amounts ofalcoholDiabetesStrokeObstructive sleep apneaStress oranxiety
What Causes AFib?
Anything that causes stress or damage to the heart can cause AFib, including the following:Older ageHigh blood pressureHeart diseaseLung diseaseHigh amounts ofalcoholDiabetesStrokeObstructive sleep apneaStress oranxiety
Anything that causes stress or damage to the heart can cause AFib, including the following:
Side Effects
Medications used to treat AFib can cause side effects that may be mild or severe. Here are some important ones to watch out for in each drug class:
Precautions
Blood thinners are not recommended for people at risk of severe bleeding due to untreatable causes.
People taking anticoagulants like warfarin should stop them five or six days beforescheduled surgeriesto decrease the risk of bleeding.Supplements that impact blood clotting should also be stopped two weeks prior to surgery,
Some medications can increase bleeding risk and cause interactions with blood thinners. These include the following:
Medications for heart rate and rhythm control have precautions that vary from drug to drug. To select the best drug for you, your healthcare provider will consider the following:
For some people, AFib will persist despite treatment with medications. When this happens, more invasive interventions may be needed. These procedures include:
Atrial Fibrillation SymptomsSome people with AFib will have no symptoms at all, while others may experiencesymptomslike the following:DizzinessChest painShortness of breathSwelling of the legsStroke
Atrial Fibrillation Symptoms
Some people with AFib will have no symptoms at all, while others may experiencesymptomslike the following:DizzinessChest painShortness of breathSwelling of the legsStroke
Some people with AFib will have no symptoms at all, while others may experiencesymptomslike the following:
AFib, especially if untreated, can cause serious complications, such as the following:
If you suspect you have AFib, seek medical attention immediately to minimize the risk of complications. It’s also important to follow your treatment plan closely if you have AFib and discuss any questions or concerns with your healthcare provider or pharmacist.
Lifestyle changes like increasing exercise and maintaining a healthy weight help lower the risk of AFib.Studies show that for people who are overweight, losing at least 10% of their body weight can slash the odds of AFib.
Moderate physical activity is also essential in lessening the chances of developing AFib. Consistent, moderate-intensity aerobic exercise (cardio) lowers the risk for AFib, while inactivity and extreme exercise increase the risk.
Having even one alcoholic drink a day can raise your risk for AFib.Binge drinkingmakes you 3 times more likely to develop AFib than someone who drinks occasionally.Abstaining from alcoholcan lower the risk of AFib or future episodes.
Tobacco usealso increases the risk of AFib and stroke.Quitting smokingis essential in optimizing health.
Though more research is needed, plant-based diets (like theMediterranean diet) may help control AFib or its risk factors.On the other hand, diets high in fats and low in carbs (like theketogenic diet) can increase the risk for AFib, especially in people with diabetes.
Supplements can also play a role in AFib. Some studies show thatvitamin Candvitamin D supplementsmay reduce the risk of AFib after heart surgery.
However, a review of five studies concluded that high amounts of another antioxidant,omega-3 fatty acids, can contribute to AFib.If you have AFib, discuss the use of any supplements with your healthcare provider before taking them.
Many types of supplements can interfere with blood clotting and increase bleeding risk. Some supplements that shouldn’t be taken with anticoagulants are:
Of note,vitamin Kincreases blood clots. Be aware of taking the following with anticoagulants:
Warfarin and other anticoagulants deplete clotting factors that depend on vitamin K to form. Sudden changes in vitamin K intake could change the blood-thinning effect of anticoagulant medications. If you are prescribed warfarin or other anticoagulants, it’s essential that you keep your vitamin K intake consistent.
Summary
AFib is a common irregular heartbeat that can cause stroke, dementia, or heart attacks if not corrected.
Often, AFib is linked to several health conditions, including diabetes, high blood pressure, and sleep apnea. Lifestyle changes like exercise and abstaining from tobacco and alcohol can help prevent or allow you to manage AFib.
Several medications may be used to treat or prevent recurrent episodes of AFib. These include medicines that help control heart rate or rhythm. Blood thinners may also be used to prevent strokes. The best drug for you will depend on your symptoms, age, and underlying conditions.
Discuss how you are supposed to take your medication with your healthcare provider and pharmacist to optimize therapy. Keep an eye out for side effects since all the medicines used for AFib can cause serious ones.
Frequently Asked QuestionsFlecainide, metoprolol, and apixaban are a few drugs that may be used for AFib, but there are many choices.Your healthcare provider can help you determine the best medicine to optimize your therapy.Managing stress may help protect against AFib episodes. A few evidence-based strategies arecognitive behavioral therapyand mindfulness exercises. These have been shown to improve the quality of life of people with AFib.In one study, about 75% of people with short-term (paroxysmal) AFib experienced triggers.Some common triggers of AFib episodes are alcohol, caffeine, strenuous exercise, and sleep deprivation.Mindfulness rituals likedeep breathing exercises, tai chi, and restorative yoga are beneficial for healthy heart functioning and may improve symptoms of AFib.No. Quitting your heart medication could be dangerous. Please do not change your medication regime. Instead, discuss your questions and concerns about your medication or supplements with your healthcare provider.
Flecainide, metoprolol, and apixaban are a few drugs that may be used for AFib, but there are many choices.Your healthcare provider can help you determine the best medicine to optimize your therapy.
Managing stress may help protect against AFib episodes. A few evidence-based strategies arecognitive behavioral therapyand mindfulness exercises. These have been shown to improve the quality of life of people with AFib.
In one study, about 75% of people with short-term (paroxysmal) AFib experienced triggers.Some common triggers of AFib episodes are alcohol, caffeine, strenuous exercise, and sleep deprivation.
In one study, about 75% of people with short-term (paroxysmal) AFib experienced triggers.
Some common triggers of AFib episodes are alcohol, caffeine, strenuous exercise, and sleep deprivation.
Mindfulness rituals likedeep breathing exercises, tai chi, and restorative yoga are beneficial for healthy heart functioning and may improve symptoms of AFib.
No. Quitting your heart medication could be dangerous. Please do not change your medication regime. Instead, discuss your questions and concerns about your medication or supplements with your healthcare provider.
19 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.Lau DH, Linz D, Sanders P.New findings in atrial fibrillation mechanisms.Card Electrophysiol Clin. 2019;11(4):563-571. doi:10.1016/j.ccep.2019.08.007Joglar 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.0000000000001193Brundel BJJM, Ai X, Hills MT, et al.Atrial fibrillation.Nat Rev Dis Primers. 2022;8(1):21. doi:10.1038/s41572-022-00347-9Li J, Gao M, Zhang M, et al.Treatment of atrial fibrillation: a comprehensive review and practice guide.Cardiovasc J Afr. 2020;31(3):153-158. doi:10.5830/CVJA-2019-064Alobaida M, Alrumayh A.Rate control strategies for atrial fibrillation.Ann Med. 2021 Dec;53(1):682-692. doi: 10.1080/07853890.2021.1930137Reiffel JA, Capucci A.“Pill in the pocket” antiarrhythmic drugs for orally administered pharmacologic cardioversion of atrial fibrillation.Am J Cardiol. 2021;140:55-61. doi:10.1016/j.amjcard.2020.10.063Gutierrez C, Blanchard DG.Diagnosis and treatment of atrial fibrillation.Am Fam Physician. 2016;94(6):442-452.Dorian P, Angaran P.β-Blockers and atrial fibrillation: hypertension and other medical conditions influencing their use.Can J Cardiol. 2014;30(5 Suppl):S38-S41. doi:10.1016/j.cjca.2013.09.029National Library of Medicine.Calcium channel blockers.National Library of Medicine.Antiarrhythmic medications.Miller CAS, Maron MS, Estes NAM III,, et al.Safety, side effects and relative efficacy of medications for rhythm control of atrial fibrillation in hypertrophic cardiomyopathy.Am J Cardiol. 2019;123(11):1859-1862. doi:10.1016/j.amjcard.2019.02.051Markman TM, Jarrah AA, Tian Y, et al.Safety of pill-in-the-pocket class 1C antiarrhythmic drugs for atrial fibrillation.JACC Clin Electrophysiol. 2022;8(12):1515-1520. doi:10.1016/j.jacep.2022.07.010De Vecchis R, Di Maio M, Noutsias M, et al.High prevalence of proarrhythmic events in patients with history of atrial fibrillation undergoing a rhythm control strategy: A retrospective study.J Clin Med Res. 2019;11(5):345-352. doi:10.14740/jocmr3805Amaraneni A, Chippa V, Rettew AC.Anticoagulation safety.In:StatPearls. Treasure Island (FL): StatPearls Publishing; April 17, 2023.Chung MK, Eckhardt LL, Chen LY, et al.Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American Heart Association.Circulation. 2020;141(16):e750-e772. doi:10.1161/CIR.0000000000000748O’Keefe EL, Sturgess JE, O’Keefe JH, et al.Prevention and treatment of atrial fibrillation via risk factor modification.Am J Cardiol. 2021;160:46-52. doi:10.1016/j.amjcard.2021.08.042Lombardi M, Carbone S, Del Buono MG, et al.Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials.Eur Heart J Cardiovasc Pharmacother. 2021;7(4):e69-e70. doi:10.1093/ehjcvp/pvab008Abebe W.Review of herbal medications with the potential to cause bleeding: dental implications, and risk prediction and prevention avenues.EPMA J. 2019;10(1):51-64. doi:10.1007/s13167-018-0158-2NIH Office of Dietary Supplements.Vitamin K.
19 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.Lau DH, Linz D, Sanders P.New findings in atrial fibrillation mechanisms.Card Electrophysiol Clin. 2019;11(4):563-571. doi:10.1016/j.ccep.2019.08.007Joglar 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.0000000000001193Brundel BJJM, Ai X, Hills MT, et al.Atrial fibrillation.Nat Rev Dis Primers. 2022;8(1):21. doi:10.1038/s41572-022-00347-9Li J, Gao M, Zhang M, et al.Treatment of atrial fibrillation: a comprehensive review and practice guide.Cardiovasc J Afr. 2020;31(3):153-158. doi:10.5830/CVJA-2019-064Alobaida M, Alrumayh A.Rate control strategies for atrial fibrillation.Ann Med. 2021 Dec;53(1):682-692. doi: 10.1080/07853890.2021.1930137Reiffel JA, Capucci A.“Pill in the pocket” antiarrhythmic drugs for orally administered pharmacologic cardioversion of atrial fibrillation.Am J Cardiol. 2021;140:55-61. doi:10.1016/j.amjcard.2020.10.063Gutierrez C, Blanchard DG.Diagnosis and treatment of atrial fibrillation.Am Fam Physician. 2016;94(6):442-452.Dorian P, Angaran P.β-Blockers and atrial fibrillation: hypertension and other medical conditions influencing their use.Can J Cardiol. 2014;30(5 Suppl):S38-S41. doi:10.1016/j.cjca.2013.09.029National Library of Medicine.Calcium channel blockers.National Library of Medicine.Antiarrhythmic medications.Miller CAS, Maron MS, Estes NAM III,, et al.Safety, side effects and relative efficacy of medications for rhythm control of atrial fibrillation in hypertrophic cardiomyopathy.Am J Cardiol. 2019;123(11):1859-1862. doi:10.1016/j.amjcard.2019.02.051Markman TM, Jarrah AA, Tian Y, et al.Safety of pill-in-the-pocket class 1C antiarrhythmic drugs for atrial fibrillation.JACC Clin Electrophysiol. 2022;8(12):1515-1520. doi:10.1016/j.jacep.2022.07.010De Vecchis R, Di Maio M, Noutsias M, et al.High prevalence of proarrhythmic events in patients with history of atrial fibrillation undergoing a rhythm control strategy: A retrospective study.J Clin Med Res. 2019;11(5):345-352. doi:10.14740/jocmr3805Amaraneni A, Chippa V, Rettew AC.Anticoagulation safety.In:StatPearls. Treasure Island (FL): StatPearls Publishing; April 17, 2023.Chung MK, Eckhardt LL, Chen LY, et al.Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American Heart Association.Circulation. 2020;141(16):e750-e772. doi:10.1161/CIR.0000000000000748O’Keefe EL, Sturgess JE, O’Keefe JH, et al.Prevention and treatment of atrial fibrillation via risk factor modification.Am J Cardiol. 2021;160:46-52. doi:10.1016/j.amjcard.2021.08.042Lombardi M, Carbone S, Del Buono MG, et al.Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials.Eur Heart J Cardiovasc Pharmacother. 2021;7(4):e69-e70. doi:10.1093/ehjcvp/pvab008Abebe W.Review of herbal medications with the potential to cause bleeding: dental implications, and risk prediction and prevention avenues.EPMA J. 2019;10(1):51-64. doi:10.1007/s13167-018-0158-2NIH Office of Dietary Supplements.Vitamin K.
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.
Lau DH, Linz D, Sanders P.New findings in atrial fibrillation mechanisms.Card Electrophysiol Clin. 2019;11(4):563-571. doi:10.1016/j.ccep.2019.08.007Joglar 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.0000000000001193Brundel BJJM, Ai X, Hills MT, et al.Atrial fibrillation.Nat Rev Dis Primers. 2022;8(1):21. doi:10.1038/s41572-022-00347-9Li J, Gao M, Zhang M, et al.Treatment of atrial fibrillation: a comprehensive review and practice guide.Cardiovasc J Afr. 2020;31(3):153-158. doi:10.5830/CVJA-2019-064Alobaida M, Alrumayh A.Rate control strategies for atrial fibrillation.Ann Med. 2021 Dec;53(1):682-692. doi: 10.1080/07853890.2021.1930137Reiffel JA, Capucci A.“Pill in the pocket” antiarrhythmic drugs for orally administered pharmacologic cardioversion of atrial fibrillation.Am J Cardiol. 2021;140:55-61. doi:10.1016/j.amjcard.2020.10.063Gutierrez C, Blanchard DG.Diagnosis and treatment of atrial fibrillation.Am Fam Physician. 2016;94(6):442-452.Dorian P, Angaran P.β-Blockers and atrial fibrillation: hypertension and other medical conditions influencing their use.Can J Cardiol. 2014;30(5 Suppl):S38-S41. doi:10.1016/j.cjca.2013.09.029National Library of Medicine.Calcium channel blockers.National Library of Medicine.Antiarrhythmic medications.Miller CAS, Maron MS, Estes NAM III,, et al.Safety, side effects and relative efficacy of medications for rhythm control of atrial fibrillation in hypertrophic cardiomyopathy.Am J Cardiol. 2019;123(11):1859-1862. doi:10.1016/j.amjcard.2019.02.051Markman TM, Jarrah AA, Tian Y, et al.Safety of pill-in-the-pocket class 1C antiarrhythmic drugs for atrial fibrillation.JACC Clin Electrophysiol. 2022;8(12):1515-1520. doi:10.1016/j.jacep.2022.07.010De Vecchis R, Di Maio M, Noutsias M, et al.High prevalence of proarrhythmic events in patients with history of atrial fibrillation undergoing a rhythm control strategy: A retrospective study.J Clin Med Res. 2019;11(5):345-352. doi:10.14740/jocmr3805Amaraneni A, Chippa V, Rettew AC.Anticoagulation safety.In:StatPearls. Treasure Island (FL): StatPearls Publishing; April 17, 2023.Chung MK, Eckhardt LL, Chen LY, et al.Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American Heart Association.Circulation. 2020;141(16):e750-e772. doi:10.1161/CIR.0000000000000748O’Keefe EL, Sturgess JE, O’Keefe JH, et al.Prevention and treatment of atrial fibrillation via risk factor modification.Am J Cardiol. 2021;160:46-52. doi:10.1016/j.amjcard.2021.08.042Lombardi M, Carbone S, Del Buono MG, et al.Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials.Eur Heart J Cardiovasc Pharmacother. 2021;7(4):e69-e70. doi:10.1093/ehjcvp/pvab008Abebe W.Review of herbal medications with the potential to cause bleeding: dental implications, and risk prediction and prevention avenues.EPMA J. 2019;10(1):51-64. doi:10.1007/s13167-018-0158-2NIH Office of Dietary Supplements.Vitamin K.
Lau DH, Linz D, Sanders P.New findings in atrial fibrillation mechanisms.Card Electrophysiol Clin. 2019;11(4):563-571. doi:10.1016/j.ccep.2019.08.007
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
Brundel BJJM, Ai X, Hills MT, et al.Atrial fibrillation.Nat Rev Dis Primers. 2022;8(1):21. doi:10.1038/s41572-022-00347-9
Li J, Gao M, Zhang M, et al.Treatment of atrial fibrillation: a comprehensive review and practice guide.Cardiovasc J Afr. 2020;31(3):153-158. doi:10.5830/CVJA-2019-064
Alobaida M, Alrumayh A.Rate control strategies for atrial fibrillation.Ann Med. 2021 Dec;53(1):682-692. doi: 10.1080/07853890.2021.1930137
Reiffel JA, Capucci A.“Pill in the pocket” antiarrhythmic drugs for orally administered pharmacologic cardioversion of atrial fibrillation.Am J Cardiol. 2021;140:55-61. doi:10.1016/j.amjcard.2020.10.063
Gutierrez C, Blanchard DG.Diagnosis and treatment of atrial fibrillation.Am Fam Physician. 2016;94(6):442-452.
Dorian P, Angaran P.β-Blockers and atrial fibrillation: hypertension and other medical conditions influencing their use.Can J Cardiol. 2014;30(5 Suppl):S38-S41. doi:10.1016/j.cjca.2013.09.029
National Library of Medicine.Calcium channel blockers.
National Library of Medicine.Antiarrhythmic medications.
Miller CAS, Maron MS, Estes NAM III,, et al.Safety, side effects and relative efficacy of medications for rhythm control of atrial fibrillation in hypertrophic cardiomyopathy.Am J Cardiol. 2019;123(11):1859-1862. doi:10.1016/j.amjcard.2019.02.051
Markman TM, Jarrah AA, Tian Y, et al.Safety of pill-in-the-pocket class 1C antiarrhythmic drugs for atrial fibrillation.JACC Clin Electrophysiol. 2022;8(12):1515-1520. doi:10.1016/j.jacep.2022.07.010
De Vecchis R, Di Maio M, Noutsias M, et al.High prevalence of proarrhythmic events in patients with history of atrial fibrillation undergoing a rhythm control strategy: A retrospective study.J Clin Med Res. 2019;11(5):345-352. doi:10.14740/jocmr3805
Amaraneni A, Chippa V, Rettew AC.Anticoagulation safety.In:StatPearls. Treasure Island (FL): StatPearls Publishing; April 17, 2023.
Chung MK, Eckhardt LL, Chen LY, et al.Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American Heart Association.Circulation. 2020;141(16):e750-e772. doi:10.1161/CIR.0000000000000748
O’Keefe EL, Sturgess JE, O’Keefe JH, et al.Prevention and treatment of atrial fibrillation via risk factor modification.Am J Cardiol. 2021;160:46-52. doi:10.1016/j.amjcard.2021.08.042
Lombardi M, Carbone S, Del Buono MG, et al.Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials.Eur Heart J Cardiovasc Pharmacother. 2021;7(4):e69-e70. doi:10.1093/ehjcvp/pvab008
Abebe W.Review of herbal medications with the potential to cause bleeding: dental implications, and risk prediction and prevention avenues.EPMA J. 2019;10(1):51-64. doi:10.1007/s13167-018-0158-2
NIH Office of Dietary Supplements.Vitamin K.
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