Atrial Fibrillation Treatment
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 AF – 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, our Consultant Cardiologist, has a wealth of experience in AF treatment. To discuss which treatment may benefit you, book an initial consultation today. Keep reading to learn more about AF treatments.
While it is unlikely you can treat AF 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 AF are more likely to develop diabetes.
Our blog – Lifestyle changes to help manage arrhythmia – covers how these changes may help you in more detail.
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
You may be suitable for cardioversion if your AF 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 AF 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.
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 AF 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 AF 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.
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 AF 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 AF symptoms. Cryoballoon is especially effective for these patients.
If medications and other treatments for atrial fibrillation do not successfully maintain your heart rate, we may recommend a pacemaker. Some AF 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 AF 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 AF. These people often benefit from anti-arrhythmics.
Elderly patients are more likely to experience conditions that contribute to AF, 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.
Book an appointment
This page offers a brief overview of how we treat atrial fibrillation and what each treatment involves. For a more in-depth view of AF treatments, read our patient guide: What is the treatment for atrial fibrillation?
If you suspect or are experiencing atrial fibrillation, our Consultant Cardiologist, Dr Syed Ahsan, can recommend the most appropriate treatment. Book a private consultation today to get started.
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…”
NORTH MIDDLESEX HOSPITAL
“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…”
ANTHONY BARTRAM – ST BARTHOLOMEW’S HOSPITAL