Treatments
There are a handful of treatments for AF that are used depending on several factors, namely the duration and intensity of the case. Basically, there are two goals for treatment: return the heart rate to normal, and prevent blood clots from forming in the heart.
There are two main ways to achieve these goals. If the patient has an irregular rate caused by a thyroid issue, the straightforward method of treatment is to diagnose and fix the underlying cause. However, the second method is not so simple. Physicians can manually reset the heart to it's natural sinoatrial rhythm using a method called cardioversion.
Electrical Cardioversion
Using this method, the physician places the patient on their back in an operating room under sedation, and places two electrical paddles on the patient's chest, similar to those on a external defibrillator. The physician then sends an electrical pulse to the patients heart, also similar to using a defibrillator, but with much less power. The pulse will stop the patient's heart for a very short time, until it starts itself again, hopefully with a fixed rhythm. If the procedure does not work, the physician may try it a couple more times.
Cardioversion with Drugs
With a wide range of anti-arrhythmic drugs, physicians can often restore sinus rhythm without a complicated procedure like electric cardioversion. The drugs can be used either intravenously or orally, and are usually fast-acting. The process is done in the hospital while the patient is hooked up to a heart monitor to track the effectiveness of the medication.During cardioversion, it is very important for physicians to ensure that the patient does not have any blood clots and will not sustain any clots during either electrical cardioversion or cardioversion with drugs. This is done with two measures. The first being screening for already present clots with what is called a transesophageal echocardiography, which will expose any clots the patient currently has. The second is to prevent any clots during the procedures. Blood thinning medication must be taken for several weeks to prevent backup blood in the atria from clotting during any procedures that will be performed.
Maintenance
Should the physician perform electrical cardioversion, the new heart rhythm will need to be maintained with medication. The medication used to maintain a proper rhythm is similar to the medication used during cardioversion with drugs, although typically with lower doses. Although the patient may be taking the proper prescribed medication, there is still a risk of returning episodes of AF. Therefore, patients are also prescribed anticoagulants to use over a long period of time, just like the anticoagulants used before cardioversion.
Overall, the typical AF case is not immediately life-threatening. But over time, the risk of deadly heart failure and atrial blood clotting increases dramatically. Atrial fibrillation is a serious health issue in many patients, particularly older patients, and those who have pre-existing heart conditions.
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