What is atrial fibrillation treatment?

Dr Syed Ahsan

Atrial fibrillation (AF or Afib) is a heart rhythm disorder that causes an irregular and sometimes fast heartbeat. You may experience no, mild, or severe symptoms, requiring treatments that target your various symptoms individually.

How do we treat atrial fibrillation?

Once we confirm your diagnosis and know the cause of your condition, we can recommend the most appropriate treatment. It’s also vital to manage any co-existing health conditions contributing to atrial fibrillation – such as diabetes or high blood pressure.

Atrial fibrillation treatments range from lifestyle changes and medications to cardiac devices and surgical procedures.

With treatment, we aim to:

  • Maintain a steady heart rate
  • Restore your heart rhythm
  • Reduce your stroke risk by preventing blood clots

We usually start your treatment plan with lifestyle changes and medications. However, we may recommend cardioversion, ablation, or a pacemaker if these are ineffective.

Dr Syed Ahsan is one of London’s most experienced AF specialists – with a proven track record treating atrial fibrillation at every stage. The sooner AF is diagnosed, the better your outcomes. Book your consultation today. Keep reading to learn more about atrial fibrillation treatments.

Lifestyle factors

While it is unlikely you can treat atrial fibrillation with lifestyle changes alone, they could help you manage your condition better alongside other treatments. A healthy diet, regular exercise, and quitting unhealthy habits, such as smoking and drinking alcohol excessively, can benefit people with Afib significantly. We also recommend limiting stimulants, such as coffee, tea, and chocolate. Nicotine itself is also a stimulant.

Your diet should be low in salt and fat and include many fresh fruits and vegetables. Adopting a Mediterranean diet may allow you more control over your blood pressure and blood sugar levels. We recommend monitoring your blood sugar, as people with atrial fibrillation are more likely to develop diabetes.

Our blog – Lifestyle changes to help manage arrhythmia & Managing Atrial Fibrillation Without Medication – covers how these changes may help you in more detail.

Medications

Heart rate and rhythm control

We may prescribe beta blockers or an anti-arrhythmic to prevent your heart from:

  • Beating fast
  • Beating out of rhythm

You usually take these in tablet form and we’ll let you know whether you should take them with or without food. Though, there are a few side effects to note: worsening arrhythmia, nausea, cold hands/feet, low blood pressure, fatigue, constipation and nightmares.

 

Preventing blood clots

Blood clots are a common complication of AF and strokes are five times more likely as a result. To avoid stroke we often prescribe:

  • Blood thinners (such as warfarin) or
  • NOACs (non-vitamin K oral anticoagulants) (more commonly)

You won’t need to watch your vitamin K intake with NOACs, as you would with medications such as warfarin.

Side effects of blood thinners include: indigestion, dizziness, heavy periods, easier bruising, muscle weakness and bleeding, such as bleeding gums

Cardioversion

You may be suitable for cardioversion if your atrial fibrillation is persistent or you do not respond to medications.

If you experience an abnormal heart rhythm, cardioversion can assist in restoring it with a small electrical shock. We do this via pads on the chest or back under a light general anaesthetic.

The procedure is fast and safe, taking only a few minutes. Though, you may have a temporary rash on your skin caused by the pads. However, it isn’t a long-term treatment, and most patients will revert to atrial fibrillation eventually.

We do not recommend cardioversion for patients with a blood clot in their heart. Cardioversion can cause these clots to loosen, leading to a stroke.

 

Catheter Ablation

When symptoms are severe or medication isn’t sufficient or suitable, catheter ablation may be a feasible treatment. This is a minimally invasive surgical procedure that can noticeably improve atrial fibrillation symptoms, sometimes permanently.

We pass very fine catheters (wires) through a vein at the top of your leg and into the heart. You may experience some bleeding in these areas or bruising in the leg after the procedure. Electrodes at the tip of the wires then measure electrical signals within the heart and identify problematic areas.

We then use radio-frequency waves transmitted via the wires to administer heat to the target area, stopping it from sending further atrial fibrillation signals to the heart. Watch our information video to learn more: What is catheter ablation?

Some people with atrial fibrillation also develop atrial flutter. Catheter ablation is the recommended treatment for atrial flutter.

 

Cryoballoon

An alternative to catheter (radio-frequency) ablation is the cryoballoon procedure. The procedure is performed similarly to catheter ablation. But, rather than delivering heat, it involves a ‘freezing balloon’ technology to prevent the signals that trigger atrial fibrillation from entering the heart.

You may experience bruising and bleeding after the procedure, similar to catheter ablation. You may also experience blood vessel or heart valve damage. To learn more about the differences, watch our video: What is the difference between cryoablation and radiofrequency ablation?

The cryoballoon technique may be more beneficial as it has a lower risk of re-ablation. It also involves a shorter procedure time. Paroxysmal atrial fibrillation, or PAF, causes intermittent atrial fibrillation symptoms. Cryoballoon is especially effective for these patients.

Pacemaker

If medications and other treatments for atrial fibrillation do not successfully maintain your heart rate, we may recommend a pacemaker. Some atrial fibrillation treatments may also cause a slow heart rate, such as ablation, requiring pacemaker treatment.

A pacemaker procedure involves fitting a small implanted device close to your heart to regulate the heartbeat. Most people who need a pacemaker for atrial fibrillation are over 80. It is a safe procedure with a low complication rate, though there are some risks. These include blot clots in the arm on the same side of the pacemaker, a pacemaker infection, and an air leak.

There is also a minor chance that your pacemaker will malfunction. Signs of this include dizziness, feeling faint or fainting, and hiccups. Call your cardiologist if you think your pacemaker has malfunctioned.

 

Hybrid Convergent Procedure

If you have persistent AF or have previously had an ablation that didn’t work, a hybrid convergent procedure might help you. You can learn more about treatment options with this short video: What are my options if I’ve had atrial fibrillation for a long time?

The hybrid convergent procedure combines catheter ablation with surgery. This means that ablation can be performed on the inside and outside of the target area. It also allows the heart specialist to treat areas which are hard to reach with catheters.

The procedure can be completed in one go. Your surgeon might also suggest treating you in two sessions, at least a month apart. Dr Ahsan helped develop this technique and is a leading expert in performing it. To learn more, and find out if it’s right for you, contact the London Heart Clinic today.

 

Treating Atrial Fibrillation in the elderly

Atrial fibrillation risk increases with age, particularly after 65. For elderly patients, our first focus is controlling the heart rate. Many older patients experience no symptoms of atrial fibrillation. These people often benefit from anti-arrhythmics.

Elderly patients are more likely to experience conditions that contribute to atrial fibrillation, which we need to manage. We will likely recommend blood-thinning medications as stroke risk also increases with age. The catheter ablation procedure involves more risk, though it is still possible.

Atrial Fibrillation Treatment FAQs

What are the treatment options for atrial fibrillation?
Dr Syed Ahsan

What are the treatment options for atrial fibrillation?

0:42
Title

What are the treatment options for atrial fibrillation?

Duration

0:42

Featuring

Dr Syed Ahsan

Video Description

In this video. Dr. Syed Ahsan, our Consultant Cardiologist, discusses atrial fibrillation (AF) management. Initially, blood thinners are prescribed to prevent stroke risk. Your medications are then tailored to either maintain a normal heart rhythm or control your heart rate. Catheter ablation, a modern minimally invasive procedure, corrects heart irregularities as a day case procedure. To understand which of these treatment options is most appropriate to your unique needs, contact us today.
Atrial Fibrillation Treatment

Is there a cure for atrial fibrillation?
Dr Syed Ahsan

Is there a cure for atrial fibrillation?

0:20
Title

Is there a cure for atrial fibrillation?

Duration

0:20

Featuring

Dr Syed Ahsan

Video Description

Dr Syed Ahsan advises that while there is no cure for atrial fibrillation, there are plenty of treatments, such as medications and ablation, that can treat the problem.
Atrial Fibrillation Treatment

What are the treatments available for atrial fibrillation?
Dr Syed Ahsan

What are the treatments available for atrial fibrillation?

0:59
Title

What are the treatments available for atrial fibrillation?

Duration

0:59

Featuring

Dr Syed Ahsan

Video Description

Dr Syed Ahsan, Consultant Cardiologist explains the different types of treatments available for atrial fibrillation. These include catheter ablation and convergent ablation. There is another hybrid procedure called the conversion procedure which is currently being trialled.
Atrial Fibrillation Treatment

How manageable is atrial fibrillation?
Dr Syed Ahsan

How manageable is atrial fibrillation?

0:37
Title

How manageable is atrial fibrillation?

Duration

0:37

Featuring

Dr Syed Ahsan

Video Description

Are you experiencing atrial fibrillation (AF) and concerned about what it means for your health? AF is totally manageable, but it is important that you keep taking your medications and contacting a healthcare provide if you’re worried about anything. The key is to stay calm, as there are many effective strategies to address and treat atrial fibrillation. Dr. Syed Ahsan is a world-leading expert in heart rhythm disorders, treating many people like you with AF every day. Contact us today to book your consultation with him.
Atrial Fibrillation Treatment

Video Transcript

If you are having an episode of atrial fibrillation, first thing to say is don’t worry. It’s not going to be life threatening, and almost always we can control this and manage this. The first thing to do is make sure you’re taking your medications regularly. If you’re worried about that, contact us and we can advise you further. It may be that we need to do some more tests or some more investigations to establish whether you are in AF, how fast it’s going, and then we can advise you further on changing your medications or doing other treatments to get your heart back into a normal rhythm. But the key thing is not to panic.

When to seek specialist help for atrial fibrillation?
Dr Syed Ahsan

When to seek specialist help for atrial fibrillation?

0:19
Title

When to seek specialist help for atrial fibrillation?

Duration

0:19

Featuring

Dr Syed Ahsan

Video Description

Wondering when to seek a specialist’s help for atrial fibrillation? Dr. Syed Ahsan explains that anyone with this condition needs to seek medical treatment, even if they have no symptoms. Early intervention can prevent blood clots from forming.
Atrial Fibrillation Treatment

Video Transcript

Anyone with atrial fibrillation should seek medical advice, even if they’re having no symptoms. And the main reason is to assess your risk of stroke and see whether you need to be started on blood thinning medications to prevent blood clots from forming.

Do I need general anaesthetic for my ablation?
Dr Syed Ahsan

Do I need general anaesthetic for my ablation?

0:41
Title

Do I need general anaesthetic for my ablation?

Duration

0:41

Featuring

Dr Syed Ahsan

Video Description

Atrial Fibrillation Treatment

Video Transcript

During the ablation procedure, fine wires called catheters are passed from the vein in your leg called the femoral vein, which runs like a motorway straight into the heart. So we use this vein to access the heart. If you are having an atrial fibrillation ablation, we need to access the top left chamber of the heart, so the vein in the leg goes into the right chamber, and we make a tiny hole using a long needle, uh, so that we can pass the wires into the left chamber.

We then create a three dimensional computer, virtual geometry of the heart chamber, which allows us to see the heart in three dimensions, move it around, tilt it up so we know that we can deliver the treatment, to very specific areas and safely. During the catheter ablation, we also monitor your blood pressure, your breathing. We can see exactly how much force we’re applying inside the hearts to make sure that we’re not pressing too hard and the procedure can be done efficiently and safely. It’s mostly done with a general anaesthetic, so you’ll be asleep and there will be an anaesthetist who will be controlling your breathing. We can do it with sedation and strong pain relief as well.

We also monitor your blood pressure, your breathing. We can see exactly how much force we’re applying inside the hearts to make sure that we’re not pressing too hard and the procedure can be done efficiently and safely. It’s mostly done with a general anaesthetic, so you’ll be asleep and there will be an anaesthetist who will be controlling your breathing. We can do it with sedation and strong pain relief as well.

Occasionally you may also need to have a camera test called a transoesophageal echo at the start of the procedure to make sure that there are no blood clots in the heart. So with ablation, number one is your safety. That’s paramount. So we take all the measures to make sure that you are safe. Uh, we can deliver the treatment safely and effectively. There’ll be various staff members around in the theatre to make sure that you are doing well, and we can perform the procedure as we want. And after the procedure, you’ll go back to the ward, maybe to a recovery bay and a normally discharge home the same day or maybe the following morning.

Do I still need to take medication after an ablation procedure?
Dr Syed Ahsan

Do I still need to take medication after an ablation procedure?

0:32
Title

Do I still need to take medication after an ablation procedure?

Duration

0:32

Featuring

Dr Syed Ahsan

Video Description

Atrial Fibrillation Treatment

Video Transcript

If you’ve had a successful ablation, we’re always keen to try and take you off the medications. Now, you may need to stay on the medications that prevent strokes, but certainly the medications that are controlling your heart rhythm, we, and I’m sure you are keen to come off them, and that’s often the way it happens. Occasionally, we may need to continue on some of those medications after your ablation, but we’ll discuss that with you and we can have a clear understanding of what needs to be done.

Do I need a general anesthetic for an ablation procedure?
Dr Syed Ahsan

Do I need a general anesthetic for an ablation procedure?

0:17
Title

Do I need a general anesthetic for an ablation procedure?

Duration

0:17

Featuring

Dr Syed Ahsan

Video Description

In most patients, we do this procedure under a general anesthetic.
It’s more comfortable for you. We can use a camera during the procedure to help monitoring,
but we do do the procedure with just local anesthetic and sedation in some cases.

Atrial Fibrillation Treatment

What does atrial fibrillation look like on an ECG?
Dr Syed Ahsan

What does atrial fibrillation look like on an ECG?

0:43
Title

What does atrial fibrillation look like on an ECG?

Duration

0:43

Featuring

Dr Syed Ahsan

Video Description

An ECG, or electrocardiogram, is a 12-lead test that records your heart’s electrical activity from different angles. It provides insight into how your heart is functioning electrically. When your heart is in a normal rhythm, the ECG will show a regular pattern.

In atrial fibrillation, however, the rhythm is chaotic, and the spikes representing heartbeats appear at irregular intervals. This causes the ECG to look uneven. Additionally, we don’t see the typical P waves, which are signals from the top chambers of the heart (the atria) during normal rhythm. In atrial fibrillation, this absence of P waves further indicates the irregularity.

Atrial Fibrillation Treatment

Does a pacemaker control atrial fibrillation?
Dr Syed Ahsan

Does a pacemaker control atrial fibrillation?

0:23
Title

Does a pacemaker control atrial fibrillation?

Duration

0:23

Featuring

Dr Syed Ahsan

Video Description

Atrial Fibrillation Treatment

What medications are there for atrial fibrillation?
Dr Syed Ahsan

What medications are there for atrial fibrillation?

1:00
Title

What medications are there for atrial fibrillation?

Duration

1:00

Featuring

Dr Syed Ahsan

Video Description

Dr Syed Ahsan lists some of the medications available for atrial flutter, including blood thinners and anti-coagulants, as well as rate control medications. The most effective treatment is a catheter ablation.
Atrial Fibrillation Treatment

What is the kardia heart monitoring device?
Dr Syed Ahsan

What is the kardia heart monitoring device?

0:33
Title

What is the kardia heart monitoring device?

Duration

0:33

Featuring

Dr Syed Ahsan

Video Description

If you want to learn more about your heart rhythm, there are tools available to help you monitor it home. For example, the Kardia device is a home monitoring tool for heart rhythm that is available on smartphone or smartwatches. Dr. Syed Ahsan, a specialist expert in heart rhythm disorders, recommends it for accurate and non-invasive at-home heart rhythm monitoring. Recordings can be stored as PDFs and easily shared with your medical team to confirm your diagnosis.
Atrial Fibrillation Treatment

What is the convergent procedure and who is it for?
Dr Syed Ahsan

What is the convergent procedure and who is it for?

0:57
Title

What is the convergent procedure and who is it for?

Duration

0:57

Featuring

Dr Syed Ahsan

Video Description

Dr. Syed Ahsan, a Consultant Cardiologist, explains the convergent procedure, a novel approach to treat atrial fibrillation. It combines internal and external heart treatments in two separate procedures, which take place across a few weeks. Research has shown that you can have better outcomes in maintaining a regular heart rhythm with this combined approach. If standard catheter ablations have failed, or your heart is too large or has been in AF for a long time, the convergent procedure may be more suitable for you. Contact us today to book your appointment with Dr. Ahsan.
Atrial Fibrillation Treatment

My smart device says I have AF what should I do?
Dr Syed Ahsan

My smart device says I have AF what should I do?

0:29
Title

My smart device says I have AF what should I do?

Duration

0:29

Featuring

Dr Syed Ahsan

Video Description

If your watch or phone alerts you about potential atrial fibrillation (AF), it’s crucial to consult with a doctor or a specialist like Dr. Syed Ahsan, a specialist expert in heart rhythm disorders. Further tests and investigations may be necessary, as these modern devices are accurate in detecting AF. Take any alerts seriously and seek professional advice promptly.
Atrial Fibrillation Treatment

How can I monitor my AF after ablation?
Dr Syed Ahsan

How can I monitor my AF after ablation?

0:31
Title

How can I monitor my AF after ablation?

Duration

0:31

Featuring

Dr Syed Ahsan

Video Description

After you’ve had an ablation procedure, you will still need to keep any eye on your atrial fibrillation (AF). Our expert Cardiologist, Dr. Syed Ahsan, may request you to use a smart device, like a phone or watch, to monitor your heart rhythm. This will help you stay informed and on top of your condition, and, if concerned, you can share the data with him to get a professional assessment. The devices are very accurate and will help you feel reassured about your AF.
Atrial Fibrillation Treatment

Book an appointment

Breathlessness can feel uncomfortable and unsettling, but we’re here to help put you at ease.

Our specialist will discuss your treatment in depth so you understand its purpose and how it will work. We are happy to answer any questions to ensure you feel comfortable with our treatment plan.

Call London Heart Clinic on 0203 303 0325 to book an appointment.

What our patients say

After suffering from a heart condition for a number of years I was very happy to meet Dr Ahsan, from the first consultation where he believed there was a solution I have now completed the surgery and had my final consultation with him today…

I am very grateful to have Dr Syed Ahsan as my consultant. Dr Ahsan always greets you warmly on each visit despite his busy workload. Dr Ahsan explains everything clearly and helps you to understand even the most complex medical terms…

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