Treatment for atrial fibrillation can vary, depending on what’s causing it. If your GP or cardiologist is able to find the cause of this condition they may be able to treat you for the cause alone. This may cure your AF. If they can’t find the cause they will treat you for AF.
Because people with AF are at an increased risk of stroke, part of their treatment involves reducing their stroke risk. Anticoagulants do this by slowing down the process of blood clotting.
Warfarin is the oldest of the anticoagulants and has been used to slow blood clotting for many years. Warfarin works with our body’s vitamin K to prevent clotting. However, as the amounts of vitamin K change, people on warfarin need to have regular –often-weekly – blood tests. This is to make sure that they are having the right amount of Warfarin for their vitamin K levels.
Three new, or novel anticoagulants (NOACs) have been approved for use in the UK in the last few years. These are dabigatran, rivaroxaban and apixaban. Because these work in a different way to warfarin, the daily dose you take is more likely to be the same each time.
If you can’t take anticoagulants because of other medical issues, and alternative is the left atrial appendage occlusion (LAAO). This is also known as the Transcatheter Closure of the left atrial appendage (LAA). The LAA is a small pouch off the heart where clots can form, and this procedure can close it partially or completely, reducing the risk of clotting to a similar degree as anticoagulation therapy.
If you are taking anticoagulant therapy, the Atrial Fibrillation Association recommend that you always carry an ‘anticoagulant alert card’ is case you need urgent medical treatment. You can download this from the AF Association website.
You can also download the Clinical Governance Resource Pack, with information on self-monitoring for patients on long-term warfarin from the AF Association website.
Other treatments for atrial fibrillation
Other medicines, anti-arrhythmics, can treat AF by returning your heart to its normal rhythm, and controlling the rate at which it beats. The anti-arrhythmic that is best for you will depend on a variety of factors. These include the type of AF you have, any other medical conditions you’ve been diagnosed with, and how well the medicine affects your AF.
Your specialist may change your medication if it isn’t effective, of results in unpleasant side effects. The treatment to control your heart rate is likely to include beta-blockers, or calcium channel blockers.
Depending on your circumstances you may be offered a procedure to help bring your heart rate under control. Cardioversion involves giving you a controlled electric shock, to trigger a return to normal heart rhythm. This is carried out in hospital.
Catheter ablation involves finding the area of your heart that is causing the problem. This is done by guiding catheters, very thin wires, through one of your veins and into your heart. Once your specialists find the source of the problem they destroy that area of tissue with heat, via the catheter. You are likely to have a general anaesthetic for this procedure.
Another option is to have a pacemaker fitted, near your collarbone. This may help your heart beat return to normal. This procedure is usually used for people over 80.