Atrial Fibrillation Treatment and management
Goal of Atrial Fibrillation treatment at the Arizona Heart Rhythm Center in Phoenix (Arizona) is to reduce risks of stroke, eliminate symptoms, and improve overall quality of life.
Anticoagulants for stroke prevention
Preventing Clots with Medication (antiplatelets and anticoagulants)
Drugs such as blood thinners are given to patients to prevent blood clot formation or to treat an existing blood clot. Examples include:
- Other FDA approved anticoagulants that do not require the monthly blood test, but care must be taken to take them as directed so that you receive the maximum benefit for stroke prevention.
- rivaroxaban, and
Overview of Side Effects
Antiplatelets can increase your risk of bleeding. Even though aspirin can be purchased over the counter, it is important that you do not take more than the dose prescribed by your doctor. Report any of the symptoms stated below to your healthcare provider.
Anticoagulants increase risk of bleeding. If you are prescribed warfarin, there is a monthly blood test that is necessary to monitor and achieve optimal dosing. Read our patient’s guide to taking warfarin.
Important Precautions when taking anti-clotting medications
- Call your healthcare provider right away if you have any unusual bleeding or bruising
- If you forget to take your daily anticoagulant dose, don’t take an extra one to catch up! Follow your healthcare provider’s directions about what to do if you miss a dose.
- Always talk to your healthcare provider about switching from one anticoagulant to another (including changing to a generic version). Even small variations in the amount of the dose of a medication can cause problems.
- Always tell you doctor, dentist and pharmacist that you take one of these medicines. This is especially important before you start taking a new medication or have any procedure that can cause bleeding.
- If you are taking warfarin, discuss any new medications with your healthcare providers.
- It is also wise to take extra care with contact sports or any other situation that might risk unnecessary trauma.
- Here are some things to watch for or report to your physician:
- If you have an accident of any kind
- If you often find bruises or blood blisters
- If you feel sick, weak, faint or dizzy
- If you think you are pregnant
- If you notice red, dark brown or black urine or stools
- If you bleed more with periods
- Bleeding gums
- Bad headache or stomach ache that won’t go away
Medications for heart-rate control during atrial fibrillation
- Beta blockers. These are drugs used to slow the heart rate. Most people can function and feel better if their heart rate is controlled. Read more about beta blockers.
Some examples may include:
- Calcium channel blockers. These medications have multiple effects on the heart. They are used to slow the heart rate in patients with AFib and to reduce the strength of the muscle cell’s contraction.
Some examples are:
- Digoxin. This medication slows the rate at which electrical currents are conducted from the atria to the ventricle.
Antiarrhythmic medications for prevention of atrial fibrillation
If you have severe symptoms from atrial fibrillation and restoring regular rhythm should be attempted. AF can be treated with medications to restore the heart rhythm to normal. Significant side effects may occur, and your healthcare provider will most likely want to monitor progress closely.
- Sodium channel blockers which help the heart’s rhythm by slowing the heart’s ability to conduct electricity.
Examples may include
- Flecainide (Tambocor®),
- Propafenone (Rythmol®)
- Quinidine (Various).
- Potassium channel blockers help the heart’s rhythm by slowing down the electrical signals that cause AFib.
Examples may include:
- Amiodarone (Cordarone® or Pacerone®)
- Sotalol (Betapace®)Dofetilide
Catheter ablation is a minimally invasive procedure that aims to restore the normal heart rhythm by inactivating the tissue that triggers and perpetuates atrial fibrillation and other arrhythmias.
Our team of experts has made important contributions that have helped advance the field of catheter ablation using radiofrequency (heat) energy.
Types of catheter ablations:
- Pulmonary vein isolation (PVI) is a minimally invasive procedure in which a flexible catheter is inserted into the heart via a vein in the leg to electrically isolate the pulmonary veins from the rest of the heart. This procedure can eliminate or significantly reduce the severity and frequency of atrial fibrillation episodes in the majority of patients. Our practice is one of the first sites to offer investigational nMarQ catheter as a part of a research trial.
- AF rotor ablation using rhythm view system (Topera, Inc). Rotors are considered sustaining mechanism for persistent or permanent atrial fibrillation. Our practice has been in the forefront of rotor site ablation and was one of the first sites in the country to offer this ablation in the country.
- Atrial flutter ablation is a minimally invasive procedure where the physician targets the area in which the circuit for atrial flutter is located. By inactivating this tissue, the atrial flutter can be eliminated.
- AV node ablation is reserved for patients who have advanced heart disease in addition to having atrial fibrillation and/or atrial flutter. The AV node is ablated and a permanent pacemaker with or without a defibrillator is inserted. This procedure eliminates the arrhythmias and helps maintain a normal heart rate.
Left atrial appendage closure:
- LEFT ATRIAL APPENDAGE OCCLUSION DEVICES: The WATCHMAN device, a left atrial appendage closure device designed to replace blood-thinning medications such as warfarin to prevent strokes in patients with atrial fibrillation. Our physicians pioneered the use of this device.
- LARIAT suture ligation procedure of left atrial appendage
The MAZE procedure
reserved for patients who have atrial fibrillation and need open heart surgery for a heart valve repair/replacement and/or a coronary artery bypass. This procedure is performed by cardiothoracic surgeons in close collaboration with the electrophysiologists