Drug Therapy for Arrhythmias & Atrial Fibrillation (Afib)
If you or someone you know has been diagnosed with atrial fibrillation or Afib, they may have been put on a regimen of drugs as a first-line defense against the condition. Prescription medications are often a primary treatment for many arrhythmias when lifestyle change alone has not yielded any significant changes in arrhythmic episodes. Medical therapy can be very effective and, much like procedural options, are typically more effective at earlier stages of the condition.
There are two main medications that an Afib patient may be prescribed:
Antiarrhythmic or rate control medications help the heart beat appropriately by suppressing problematic electrical signals from the sinus node or targeting areas of the heart that may alter or block the electrical signal’s normal path. Generally speaking, calcium channel blockers and beta blockers are used for this purpose.
On the other hand, anticoagulants do not control or normalize the heart rate but address the significantly increased risk of stroke in patients with arrhythmias, especially Afib. This stroke risk may be over five times greater in Afib patients than in those with a normal heart rhythm. Anticoagulants are often colloquially called blood thinners, but this is not an accurate term. Rather than thinning the blood, anticoagulants reduce the ability of platelets to stick together and form clots. In doing so, they reduce the risk of clot formation in the heart’s left atrial appendage. If a clot were to dislodge, enter the bloodstream, and travel to the brain, it would cause an ischemic stroke.
Of course, while medications are easy to prescribe and take, they do not address the underlying cause of the arrhythmia. They, therefore, must be taken daily to remain effective. Unfortunately, these medications also come with side effects. Over 50% of patients eventually stop taking their medication because the medicines are no longer effective, or the side effects are too significant. A procedural solution like cardiac catheter ablation or cryoablation is often an excellent next step for these patients. For patients who cannot tolerate their anticoagulant medication, left atrial appendage occlusion, such as the Watchman device, can be a good option to reduce stroke risk.