Medications for A fib Options advice and side effects
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Many prescription medications are available to help manage this condition. The drugs may have different effects, which can include controlling the heart rate, preventing blood clots, and normalizing the rhythm of the heart. Also known as A-fib, this condition is a type of arrhythmia, meaning that a person has an irregular heart rhythm. The beating of the upper two chambers of the heart, known as the atria, is irregular. It occurs after damage to heart tissue or a problem with electrical signaling, typically as a result of other conditions. Due to this irregular beating, the heart is unable to pump blood efficiently, which can lead to blood collecting in the heart and an increased risk of clots. A-fib is the most common clinical arrhythmia. Although it can occur at any stage of life, the risk of developing A-fib increases with age. The treatment options include medications that help control the heart’s rhythm and rate and drugs that prevent blood clots from forming. In this article, we discuss the different types of medications that can help manage atrial fibrillation. Preventing clots Share on PinterestImage credit: Matt Cardy/Getty Image.Due to the irregular heartbeat that may occur with A-fib, blood can pool in the heart and increase the risk of blood clots. If these blood clots enter the bloodstream, they can lead to a stroke. As such, people may receive drugs known as blood thinners to prevent blood clot formation or to treat an existing blood clot. Examples of drugs that help prevent blood clots include: Anticoagulants Anticoagulants are a group of medications that reduce the body’s ability to form blood clots by interrupting the blood clotting process. The formation of a blood clot relies on substances called clotting factors undergoing a coagulation cascade. By preventing these substances from working correctly, anticoagulants can help reduce the formation of blood clots. Possible side effects of anticoagulants include:excessive bleedingdizzinessheadacheschanges in bowel movements Examples of anticoagulants include:warfarindabigatran etexilaterivaroxabanedoxaban tosylateapixaban Antiplatelets Antiplatelet drugs describe medications that prevent platelets, also known as thrombocytes, from sticking together. Platelets are small fragments of cells, and their main function is to stick to the lining of blood vessels and form a blood clot to help stop or prevent bleeding. However, a high number of platelets can result in unnecessary clotting, which can increase the risk of a stroke. As such, a doctor may only recommend antiplatelets for individuals with a high risk of A-fib or other cardiovascular events. A person should not start or stop aspirin without first consulting a doctor. Possible side effects of antiplatelets include:bleeding more easily stomach paindiarrheaindigestion or heartburn Examples of antiplatelets include clopidogrel bisulfate and aspirin. Heart rate control These medications, which are known as anti-arrhythmic drugs, help control heart rate. Typically, they slow the heart rate by blocking irregular electrical signals in the atria, which prevents their transmission to the ventricles. Examples of heart rate-controlling medications include: Beta-blockers Beta-blockers, also known as beta-adrenergic blocking agents, are a group of drugs that block the action of certain hormones that can affect the heart rate. They can block the release of epinephrine and norepinephrine, which would otherwise cause a rapid heartbeat and heart palpitations. Beta-blockers can also reduce the production of angiotensin II. In doing so, they help blood vessels relax, easing the passage of blood. Generally, people are able to tolerate beta-blockers well. However, some individuals may still experience side effects, such as:cold hands and feetslow heartbeatfatiguelow blood pressureerectile dysfunction Examples of beta-blockers include:atenololbisoprololcarvedilol phosphatemetoprolol succinatenadololpropranolol hydrochloride Calcium channel blockers Calcium channel blockers (CCBs) can increase blood flow and oxygen to the heart. Calcium plays a vital role in enabling muscle contraction and allowing the heart to pump blood around the body. CCBs reduce the amount of calcium that can enter cardiac muscle cells and blood vessel walls, which helps lower blood pressure and slow a person’s heart rate. Side effects from CCBs are rare, but they can include:constipationslow heart ratelow blood pressuredizziness Examples of calcium channel blockers include diltiazem hydrochloride and verapamil hydrochloride. Digoxin Digoxin is a drug that can help manage heart rate. It influences the electrical activity in the heart, increasing the force of contraction while slowing conduction to decrease heart rate. A doctor may prescribe digoxin if a person is unable to tolerate beta-blockers or CCBs. Alternatively, they may suggest using digoxin in addition to these drugs if a person requires a further reduction in their heart rate. Potential side effects of digoxin include:confusiondizzinessnauseadiarrheablurry visionskin rashes Heart rhythm control These types of drugs attempt to restore the heart rhythm to normal. Experts may also refer to this as pharmacological or chemical cardioversion. Electrical signals help the heart contract in a coordinated way. A-fib disrupts this signaling pathway, leading to an abnormal heart rhythm. These drugs allow the heart to reset into a normal rhythm. Examples of heart rhythm controlling medications include: Sodium channel blockers The heart features many different ion channels, including sodium channels, which help create an electrical action potential that promotes rhythmic contraction of the heart. Therefore, sodium channel blockers help restore the heart’s rhythm by slowing its ability to conduct electricity. Potential side effects of sodium channel blockers include:vision problemsdizzinessheadacheschanges in bowel movements Examples of sodium channel blockers include:flecainide acetatepropafenone hydrochloridequinidine gluconate Potassium channel blockers Potassium is an essential macromineral that plays a role in heart function. High levels of potassium, known as hyperkalemia, can result in an abnormal heart rhythm. As such, potassium channel blockers can help restore heart rhythm by slowing electrical signals that can cause A-fib. Possible side effects of potassium channel blockers include:headachesdizzinessabdominal paininsomnia Examples of potassium channel blockers include:amiodarone hydrochloridesotalol hydrochloridedofetilide When to use A-fib medications There are three basic types of A-fib:Paroxysmal: This is more common in the early stages of the condition, wherein episodes occur intermittently but not frequently.Persistent: This develops when an irregular heartbeat lasts for longer than 7 days.Long standing persistent (formerly known as permanent): A doctor will describe A-fib as long standing persistent when it is not possible to bring the heart back to a regular rhythm. Most people with A-fib will need to take medication to manage their symptoms and reduce their risk of stroke. For some people, medication alone is not enough to control A-fib. In these cases, a doctor may recommend more intensive treatment options, such as catheter ablation, surgical maze procedures, or electrical stimulation. Learn more about the surgical options for treating A-fib. Which drugs are best for which people Doctors look at various factors before developing a treatment plan. These include:the person’s agethe severity of their symptomshow often the symptoms occurtheir heart ratetheir risk of strokeany underlying heart disease or other health conditions Many doctors use the CHA₂DS₂-VASc score to assess a person’s risk of stroke and to determine which A-fib medications would best meet their needs. This approach calculates a person’s risk of stroke by awarding points based on whether the person:has congestive heart failurehas high blood pressureis aged 65–74 years or olderhas diabeteshas previously had a stroke or blood clothas underlying vascular disease, such as having had a heart attack in the pastwas assigned female at birth Summary Several medications are available to treat or manage the various effects of A-fib. The type and severity of A-fib will dictate which medications are best. A doctor will monitor the person’s response to the drug over time, checking regularly for any adverse effects and any changes in symptoms. As with any drug, some people may experience side effects when taking A-fib medications. These may include a risk of excessive bleeding, hypotension, and a slow heart rate. If medications do not resolve the irregular heart rhythms, a doctor may suggest surgical options to help treat the condition. Last medically reviewed on July 24, 2022Heart DiseaseCardiovascular / CardiologyPharmacy / PharmacistDrugsCat 1afib 56 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Anticoagulant medicines: Side effects. (2021). https://www.nhs.uk/conditions/anticoagulants/side-effects/Anticoagulants. (n.d.). https://www.hopkinslupus.org/lupus-treatment/common-medications-conditions/anticoagulants/Appropriate aspirin or anticoagulant use. (2022). https://millionhearts.hhs.gov/about-million-hearts/optimizing-care/aspirin-anticoagulant-use.htmlAtrial fibrillation. (2022). https://www.cdc.gov/heartdisease/atrial_fibrillation.htmAtrial fibrillation. (2022). https://www.nhlbi.nih.gov/health/atrial-fibrillationAtrial fibrillation medications. (n.d.). https://www.heart.org/en/health-topics/atrial-fibrillation/treatment-and-prevention-of-atrial-fibrillation/atrial-fibrillation-medicationsAtrial fibrillation. (n.d.). https://www.stoptheclot.org/about-clots/afib-2/Atrial fibrillation: Treatment. (2021). https://www.nhs.uk/conditions/atrial-fibrillation/treatment/Barmore, W., et al. (2022). Biochemistry, clotting factors. https://www.ncbi.nlm.nih.gov/books/NBK507850/Blood basics. (n.d.). https://www.hematology.org/education/patients/blood-basicsBlood components. (n.d.). https://www.redcrossblood.org/donate-blood/how-to-donate/types-of-blood-donations/blood-components.htmlBrandes, A., et al. (2018). Risk factor management in atrial fibrillation. https://www.aerjournal.com/articles/risk-factor-management-atrial-fibrillationChemical cardioversion. (n.d.). https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/chemical-cardioversionClopidogrel. (2021). https://www.nhs.uk/medicines/clopidogrel/Clopidogrel bisulfate tablet, film coated. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=52902cfe-2863-490a-b700-3f47dfe3cf50David, M. N. V., et al. (2022). Digoxin. https://www.ncbi.nlm.nih.gov/books/NBK556025/Digoxin. (n.d.). https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/drug-cabinet/digoxinDrug cabinet: Anti-arrhythmics. (n.d.). https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/drug-cabinet/anti-arrhythmicsDrug cabinet: Calcium channel blockers. (n.d.). https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/drug-cabinet/calcium-channel-blockersFarzam, K., et al. (2021). Beta blockers. https://www.ncbi.nlm.nih.gov/books/NBK532906/Goyal, A., et al. (2021). Pharmacological cardioversion. https://www.ncbi.nlm.nih.gov/books/NBK470536/Hyperkalemia (high potassium). (2016). https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/hyperkalemia-high-potassiumIqbal, A. M., et al. (2022). Antiplatelet medications. https://www.ncbi.nlm.nih.gov/books/NBK537062/Jiang, D., et al. (2019). Structure of the cardiac sodium channel. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986426/Kim, T.-H., et al. (2017). CHA2DS2-VASc score for identifying truly low-risk atrial fibrillation for stroke: A Korean nationwide cohort study. https://www.ahajournals.org/doi/10.1161/STROKEAHA.117.018551Label: 365 everyday value aspirin - aspirin tablet, film coated. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3f3fcba9-fdb9-46ce-a1dd-8271d2b3555cLabel: Amiodarone HCL - amiodarone hydrochloride tablet. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d779a746-0bdd-49cc-b0d8-5f9a72524b8cLabel: Atenolol tablet. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1b8a4689-3916-4f4b-b54a-bbb4e322d79bLabel: Bisoprolol - bisoprolol fumarate tablet, film coated. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bba0bc2b-602f-4df1-a761-85bd3c80c7deLabel: Carvedilol phosphate capsule, extended release. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=63065e30-4a50-42b0-9622-a393923c1e98Label: Dabigatran etexilate capsule, coated pellets. (2022). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3a8ec82a-c367-40dc-9302-e1896fcb05eaLabel: Digoxin solution. (2022). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=eda7193a-e139-41d5-a11b-dc6241645995Label: Diltiazem hydrochloride capsule, extended release. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=70293a05-d314-43fa-a2b1-398cfb39edf8Label: Dofetilide capsule. (2022). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0e60aa4b-72c2-4ef4-ab01-c9cf94240ff1Label: Eliquis - apixaban tablet, film coated. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ca70b23e-6f02-43a8-9c88-9550c0d230cfLabel: Flecainide acetate tablet. (2020). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d462d58e-fc3c-4c92-a210-e135eb1f4b77Label: Metoprolol succinate - metoprolol succinate er tablets tablet, film coated, extended release. (2022). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=58441cd3-6043-4bb8-adab-1b32a203bfb2Label: Nadolol tablet. (2022). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e2e24b14-0169-4028-828a-894ad3c2ba55Label: Propafenone hydrochloride capsule, extended release. (2019). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4a8c7594-3576-4e87-9513-8849ef92d509Label: Propranolol hydrochloride capsule, extended release. (2020). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5229b561-287b-463c-8679-cda4c34f440bLabel: Quinidine gluconate - quinidine gluonate tablet, extended release. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4db375a3-0cff-4fa7-af7a-2a49e0b922d0Label: Savaysa - edoxaban tosylate tablet, film coated. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e77d3400-56ad-11e3-949a-0800200c9a66Label: Sotalol hydrochloride AF - sotalol hydrochloride tablet. (2021).https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7c9cc47c-1cb2-405d-8c8a-50226482ede2Label: Verapamil hydrochloride capsule, extended release. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c86084bc-33aa-eece-5a96-6c0dad2d1a32Label: Warfarin sodium - warfarin tablet. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=558b7a0d-5490-4c1b-802e-3ab3f1efe760Label: Xarelto - rivaroxaban tablet, film coated. (2022). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=10db92f9-2300-4a80-836b-673e1ae91610McKeever, R. G., et al. (2022). Calcium channel blockers. https://www.ncbi.nlm.nih.gov/books/NBK482473/Novel anticoagulants. (n.d.). https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/drug-cabinet/novel-anticoagulantsPotassium: Fact sheet for consumers. (2021). https://ods.od.nih.gov/factsheets/Potassium-Consumer/Rate control medication for atrial fibrillation. (2021). https://www.stopafib.org/managing-afib/medication-for-afib/control-afib/rate-control-medication/Rhythm control medication for atrial fibrillation. (2021). https://www.stopafib.org/managing-afib/medication-for-afib/control-afib/rhythm-control-medication/Side effects of digoxin. (2020). https://www.nhs.uk/medicines/digoxin/side-effects-of-digoxin/Sutanto, H., et al. (2019). The role of calcium in the human heart: With great power comes great responsibility. https://kids.frontiersin.org/articles/10.3389/frym.2019.00065Watch: What are beta blockers and what do they do in your body? (n.d.). https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/drug-cabinet/beta-blockersWatch: What are NOACs and what do they do in your body? (n.d.). https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/drug-cabinet/novel-anticoagulantsWhat is Afib? (n.d.).https://www.hopkinsmedicine.org/health/conditions-and-diseases/atrial-fibrillationFEEDBACK:Medically reviewed by Alan Carter, Pharm.D. — By Danielle Dresden — Updated on July 24, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageEverything you need to know about heart diseaseMedically reviewed by Dr. Payal Kohli, M.D., FACC Heart disease is a major cause of death. In this article, learn about the different types, how to recognize the symptoms, and what treatment to expect.READ MOREBlood-thinning foods, drinks, and supplements There are many things people can eat and drink that may help keep the blood thin and reduce the chances of developing dangerous clots. 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