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
procedures. These procedures can cure atrial fibrillation, but are not always successful and not all people are good candidates.