Persistent AFib does not convert back to normal rhythm on its own. Medical treatment is needed to stop the AFib.
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How Is Atrial Fibrillation Treated?
Treatment for AF depends greatly upon you and your symptoms, how long you have atrial fibrillation and in what stage the atrial fibrillation is in. There are several important features to atrial fibrillation that are important to address:
1. How fast is your atrial fibrillation going? Generally a 24- hour monitor is placed to understand how well your drug therapy is working.
2. How far along is your atrial fibrillation: Curative treatment options are available for the treatment of atrial fibrillation however, this will be determined by a number of issues included in the work-up.
3. How healthy are you otherwise? While all these treatment regimens are available you should be healthy enough to undergo these therapies. In other words the treatment regimen needs to be customized to you.
4. What is your stroke risk? We know that patients with atrial fibrillation are at risk for strokes, however treatment for the prevention of stroke patients maybe on coumadin. Like all medications and medical procedures the risks of side effects needs to be addressed and understood. We will review with every patient what their stroke risk profile is.
Generally, your doctor will focus on treatments that help control your heart rate and reduce the risk of blood clots. Blood thinners, such as aspirin or warfarin, are commonly prescribed. Several antiarrhythmic medications that help control episodes of rapid heart rhythms also are available. The choice of which drug may help you is very individual. Because most of the medications work only some of the time, your doctor may need to try other drugs if you experience continued symptoms or unwanted side effects. It is very important to understand the side effects of these antiarrhythmics medications because they are potentially harmful. Careful monitoring of the medications maybe needed to avoid serious side effects.
Other treatment options for atrial fibrillation include catheter based ablation therapy and AV node ablation with pacemaker insertion. Catheter ablation is a minor surgical procedure similar to angiogram. AV node ablation with permanent pacemaker insertion is a procedure reserved for very ill patients, patients with long standing atrial fibrillation and enlarged atria, or those patients with multiple arrhythmias that can not be controlled with medical therapy or a curative ablation technique. Because heart rate control is important in patients with long standing atrial fibrillation this maybe an option if the heart rate is not well controlled.