When lifestyle changes alone are not enough to control atrial fibrillation (AFib) or atrial flutter, cardiac electrophysiologists at NYU Langone’s Heart Rhythm Center may prescribe medication to slow your heart rate, control its rhythm, and prevent a life-threatening stroke. If medication therapy is not effective, your doctor may recommend cardioversion or catheter ablation.
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Your cardiologist may prescribe antiarrhythmic medications, beta blockers, or calcium channel blockers to control the heart’s rhythm and rate.
Antiarrhythmic medications can control electrical impulses to the heart, thus encouraging a healthy rate and rhythm. Medications such as amiodarone, flecainide, Multaq®, and sotalol are commonly used for these purposes.
If you regularly take over-the-counter medications or herbal supplements, please let your doctor know. These can trigger arrhythmias and interfere with the effectiveness of antiarrhythmic medications.
Beta blockers can lower your heart rate by inhibiting the effects of stress hormones, such as adrenaline, on the heart and blood vessels. These hormones are responsible for the “fight or flight” response to stress, which can trigger an arrhythmia.
Calcium channel blockers, such as verapamil, relax the walls of blood vessels and slow your heart rate. This can help lower the fast heart rate associated with AFib.
In AFib and atrial flutter, the backup of blood in the heart’s upper chambers can cause blood clots and microclots to form. The pumping action of the heart can move these clots to the brain, causing a stroke.
Anticoagulants or antiplatelet medications may be prescribed to prevent these clots. Anticoagulants, such as Coumadin®, Eliquis®, Xarelto®, and Pradaxa®, affect the blood’s ability to clot. Antiplatelet medications prevent platelets—blood cells involved in clot formation—from clumping together. Aspirin is a commonly prescribed antiplatelet medication.
If you are unable to tolerate the side effects of these medications, your doctor might recommend you receive a left atrial appendage occlusion device, which limits the ability of clots to form in the heart.
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