Treatment:

In certain cases, atrial fibrillation may need emergency treatment to to get the heart back into normal rhythm. This treatment may involve electrical cardioversion or intravenous (IV) drugs such as dofetilide, amiodarone, or ibutilide. Drugs are typically needed to keep the pulse from being too fast.

Long-term treatment varies depending on the cause of the atrial fibrillation or flutter. Medications slow the heartbeat or the movement of the electrical impulse from the atria to the ventricles, and may include:

• Beta blockers
• Calcium channel blockers
• Digitalis

Anti-arrhythmic medications may be used to get the heart back into a normal rhythm. These medications may work well in many people, but they can have serious side effects.

Blood thinners, such as heparin, warfarin (Coumadin), or aspirin may help reduce the risk of a blood clot traveling in the body (such as a stroke). Your doctor will consider your age and other medical problems to decide which drug is best.

Some patients with atrial fibrillation, rapid heart rates, and intolerance to medication may need a catheter procedure on the atria called radiofrequency ablation.

For some patients with atrial flutter, radiofrequency ablation can cure the arrhythmia and is the treatment of choice. Some patients with atrial fibrillation and rapid heart rates may need the radiofrequency ablation done not on the atria, but directly on the AV junction (the area that normally filters the impulses coming from the atria before they proceed to the ventricles).

Ablation of the AV junction leads to complete heart block. Treatment for this condition requires a permanent pacemaker.

Expectations (prognosis):

The disorder is usually controllable with treatment. Many people with atrial fibrillation do very well.

Atrial fibrillation tends to become a chronic condition, however. It may come back even wtih treatment.

Complications:

• Fainting (syncope), if atrial fibrillation and atrial flutter cause the pulse to be too quick or slow
• Heart failure
• Stroke, if clots break off and travel to the brain (drugs that thin the blood such as heparin and warfarin can reduce the risk)

Calling your health care provider:

Call your health care provider if you have symptoms of atrial fibrillation or flutter.