What meds can I use to control my a fib? What are the risks and side effects of medications to control my atrial fibrillation or to reduce the risk of stroke? What are the risks/benefits of other treatment options?

The. The treatment of atrial fibrillation has two important components: 1) treating the rhythm, and 2) preventing stroke. There are two strategies for treating the rhythm. The first is called the rate control strategy, and involves using medicines to prevent the heart rate from going too fast. These medicines do not prevent atrial fibrillation episodes, but are generally effective at preventing fast rhythms and also tend to have few side effects. This is a good strategy for people who do not have severe symptoms from atrial fibrillation, such as older less active people. The second strategy is called the rhythm control strategy, and involves using medications that are designed to maintain normal sinus rhythm and prevent episodes of atrial fibrillation. This strategy may be more desirable for people who are vey symptomatic when in atrial fibrillation such as young, active people. Unfortunately, this strategy tends to be less successful because recurrence of atrial fibrillation is common. The rhythm control medications also tend to have more side effects than the rate control medicines, and in some cases the side effects can be severe. Neither strategy is better than the other at preventing stroke. For stroke prevention, warfarin (also called coumadin) is typically used for people at moderate or high risk. This medication has been shown to be superior in preventing stroke, but it also increases the risk of dangerous bleeding because it is a blood thinner. Patients at lower risk for stroke may just take an Aspirin tablet daily. This has a lower bleeding risk than warfarin. Lastly, some people are candidates for surgical or catheter-based ablation procedures. These procedures can cure atrial fibrillation, but are not always successful and not all people are good candidates.
Too Much. You're asking for the answers it takes me an hour-long office visit to answer for many people. Good questions all, but too much for a 400-character based website. May I suggest a visit with a cardiac electrophysiologist to discuss your particular situation?
Many answers. There is no way to answer all these questions here. Beta blockers and calcium channel blockers will slow heart rate. Digoxin is frequently used for the same things. Discuss with your doctor if you have risk factors for stroke. If yes, blood thinners may be indicated.

Related Questions

What are the risks of atrial fibrillation?

Atrial fibrillation. Afib is a rapid irregular heart rhythm which can decrease heart efficiency as much as 20% in some patients. It can also be associated with clotting and clots travelling around the body to cause stroke or other problems. Some people have atrial fibrillation as their normal rhythm. Talk to your dr. About it if you have it.
Risk factors. Some are: ypertension, alcohol, older age, sleep apnea, diabetes mellitus, hyperthyroidism, valvular heart disease, heart failure, conditions leading to chronic lung disease with pulmonary hypertension, inflammatory conidtions, acute illness especially postoperative state and infections (although the latter ones are more of triggers than causes).

What are the risks of going into atrial fibrillation?

Several. There are several risks associated with atrial fibrillation (af). The first is that af may cause the heart rate to go up which can cause symptoms of dizziness, palpitations and even syncope. Another, more serious risk associated with af is the increased risk of stroke if left untreated. Finally, if the heart rate continues to run high for long periods of time, heart muscle damge can occur.
Feeling bad. The presence of atrial fibrillation increases the overall stroke risk in a patient, however, going into the rhythm is not the time of greatest risk. Any "risk" is thus likely to be related only to the symptoms experienced during the fibrillation.

Beside taking arrhythmia medicines, what are other option for atrial fibrillation? Does a pace maker or defibrillator cure a fib?

Ablation. After assessing the underlying cause of the fibrillation and measuring the size of the two atrial heart chambers, using echocardiography, one can predict the likelihood that the fibrillation will respond to electrical ablation using an intracardiac catheter. Defibrillation of atrial fibrillation might not prevent a recurrence if the underlying cause still exists.
Ablation. Catheter ablation (pulmonary vein isolation) can be curative. Although not curative, an av node ablation in combination with a pacemaker or defibrillator can usually eliminate the symptoms of atrial fibrillation. If you have obstructive sleep apnea using CPAP can greatly improve atrial fibrillation.

What are drug treatments for atrial fibrillation?

See below. All patients with atrial fibrillation should be placed on anticoagulants to decrease the risk of blood clots from the atrium. Drugs like warfarin or the newer drugs such as 10a inhibitors are used. Drugs such as beta blockers or calcium channel blockers are used to control the heart rate. Other drugs such as amiodarone or sotalol are used to try to convert atrial fibrillation back to sinus rhythm.
It Varies. The most important treatment is stroke prevention, which is usually done by medications (aspirin or warfarin). Sometimes rate control medications are used, like metoprolol. If the af is severe enough, stronger anti-arrhythmic medications are used, like propafenone. If these do not work, catheter ablation may be recommended. Pacemaker and av-node ablation may be used as a last resort.

There are drugs for treatment of vagal atrial fibrillation?

Many different. Drugs for treatment of atrial fibrillation but I am confused by the term vagal af.
Yes. Vagal-mediated atrial fibrillation typically occurs at night while people are sleeping or may occur when drinking something cold or going to the bathroom. An antiarrhythmic called norpace, or disopyramide, works well in this situation, as it has anti-vagal properties.

Which drugs are mostly recomended to start therapy for patients with atrial fibrillation. Is quinidine a good chioce?

Atrial fibrillation. Quinidine is only rarely used any more. We older doctors learned years ago that we killed some folks with it. There are more recent and safer drugs that we use now. Talk to your doctor to discuss if you have afib, a cloud doctor shouldn't be advising you without knowing your situation.