Breaking News
March 24, 2019 - Enzyme inhibitor stops inflammation and neurodevelopmental disorders in mouse models
March 24, 2019 - Walk, Dance, Clean: Even a Little Activity Helps You Live Longer
March 24, 2019 - Americans used less eye care in 2014 versus 2008
March 24, 2019 - Study finds link between depression in 20s linked to memory loss in 50s
March 24, 2019 - New tool helps physiotherapy students to master complex fine motor skills
March 24, 2019 - The AMR Centre secures £2.3m funding boost
March 24, 2019 - Study examines effects of taking ondansetron during first trimester of pregnancy
March 24, 2019 - Researchers identify a more effective treatment for cancer
March 24, 2019 - Open-source solution for multiparametric optical mapping of the heart’s electrical activity
March 24, 2019 - New nanotechnology approach shows promise in treating triple negative breast cancer
March 24, 2019 - Trevena Announces Publication of APOLLO-1 Results in The Journal of Pain Research Highlighting Oliceridine’s Potential for Management of Moderate-to-Severe Acute Pain
March 24, 2019 - Maternal deaths following C-section 50 times higher in Africa compared to high-income countries
March 24, 2019 - Apple watch could detect irregular heart beat says study
March 24, 2019 - Queen Mary University of London’s BCI boosts radionuclide imaging capabilities with MILabs VECTor technology
March 24, 2019 - Girls should be encouraged to gain more ball skills, shows study
March 24, 2019 - Acute doses of synthetic cannabinoid can impair critical thinking and memory
March 24, 2019 - Presence of bacteria in urine does not always point to infection, shows study
March 24, 2019 - Scientists identify a new role for nerve-supporting cells
March 24, 2019 - Hidden differences between pathology of CTE and Alzheimer’s disease discovered
March 24, 2019 - Knowing causative genes of osteoporosis may open door to more effective treatments
March 24, 2019 - Toilet-seat based cardiovascular monitoring system getting ready to begin commercialization
March 24, 2019 - New model for intensive care identifies factors that send ill patients to ICU
March 24, 2019 - Recommendations Issued for HSCT in Multiple Myeloma
March 24, 2019 - Deep brain stimulation provides sustained relief for severe depression
March 24, 2019 - “Statistical significance” may soon be a thing of past?
March 24, 2019 - Researchers track effects of epigenetic marks carried by sperm chromosomes
March 24, 2019 - AHA News: Family Adopts Three Children With Three Different Heart Conditions
March 24, 2019 - Research into opioid painkillers could provide clues for safer drug development
March 23, 2019 - Lung cancer survivor recounts her lifetime struggles
March 23, 2019 - Radial and femoral approach for PCI achieve similar results in terms of survival
March 23, 2019 - Study sheds light on the optimal timing of coronary angiography in NSTEMI patients
March 23, 2019 - Excess hormones could cause a condition that can lead to blindness in women, study finds
March 23, 2019 - Dramatic shifts in first-time opioid prescriptions bring hope, concern
March 23, 2019 - Antidepressant drugs may not work when neurons are out of shape
March 23, 2019 - TTUHSC El Paso to establish endowed chair in neurology through a major grant
March 23, 2019 - New device approved by FDA for treating patients with moderate-to-severe heart failure
March 23, 2019 - People with peripheral artery disease have lower Omega-3 Index, shows research
March 23, 2019 - Trigger warnings have minimal impact on how people respond to content, shows research
March 23, 2019 - Gilead Announces Data From Two Studies Supporting Further Development of GS-6207, a Novel, Investigational HIV-1 Capsid Inhibitor as a Component of Future Long-Acting HIV Therapies
March 23, 2019 - Selfish genetic elements amplify inflammation and age-related diseases
March 23, 2019 - Study provides new understanding of how the brain recovers from damage caused by stroke
March 23, 2019 - CRISPR/Cas libraries could revolutionize drug discovery
March 23, 2019 - Allergic reaction during pregnancy may alter sexual-development in offspring’s brain
March 23, 2019 - Seeing through a robot’s eyes helps those with profound motor impairments
March 23, 2019 - Recent research shows that ease of breastfeeding after C-section differs culturally
March 23, 2019 - Newly discovered parameters offer more control over efficient release of drugs
March 23, 2019 - ‘De-tabooing’ of abortion- Women would like more support from health care community
March 23, 2019 - Anti-TB drugs can increase susceptibility to Mtb reinfection
March 23, 2019 - New survey indicates need of attention to neglected tropical diseases
March 23, 2019 - Innovative in vitro method to develop easy-to-swallow medicine for children and older people
March 23, 2019 - Sugary drinks could raise risk of early deaths finds study
March 23, 2019 - Lian wins ENGINE grant for stem-cell-based therapy to treat Type 1 diabetes
March 23, 2019 - Overall, Physicians Are Happy and Enjoy Their Lives
March 23, 2019 - Researchers discover how blood vessels protect the brain during inflammation
March 23, 2019 - CDC study shows modest improvement in optimal hospital breastfeeding policy
March 23, 2019 - Family-based prevention program to reduce alcohol use among older teens
March 23, 2019 - Remote monitoring of implanted defibrillators in heart failure patients prevents hospitalizations
March 23, 2019 - Appropriate doffing of personal protective equipment may reduce healthcare worker contamination
March 23, 2019 - Window screens can suppress mosquito populations, reduce malaria in Tanzania
March 23, 2019 - Researchers discover new biomarker for postoperative liver dysfunction
March 23, 2019 - Pregnancy history may be linked to cognitive function in older women, finds study
March 23, 2019 - Study shows ticagrelor is equally safe and effective as clopidogrel after heart attack
March 23, 2019 - FDA Approves First Drug for Postpartum Depression, Zulresso (brexanolone)
March 23, 2019 - New guidelines outline new treatment management for psoriasis
March 23, 2019 - Thermally abused cooking oil may promote progression of breast cancer
March 23, 2019 - High-fructose corn syrup fuels growth of colon tumors in mice
March 23, 2019 - Partnership aims at establishing best practices to promote diversity in clinical trials
March 23, 2019 - New study examines presence of microbes in tap water from residences, office buildings
March 23, 2019 - Early life trauma may affect brain structure, contribute to major depressive disorder
March 23, 2019 - NIH starts clinical trial of drug to treat cravings associated with opioid use disorder
March 23, 2019 - Cervix bacteria, immune factors could be a warning signal of premature birth, reports new research
March 23, 2019 - Worst-ever emergency care performance figures underscore the need to focus on staffing
March 23, 2019 - The Current issue of “The view from here” is concerned with Cancer
March 23, 2019 - Mouse model validates how ‘good’ and ‘bad’ bacteria affect acne
March 23, 2019 - Individual amygdala neurons respond to touch, imagery and sounds
March 23, 2019 - Combination of two topical creams can prevent cancer
March 23, 2019 - Study suggests depression screening when assessing African-Americans for schizophrenia
March 23, 2019 - New electronic support system for choosing drug treatment based on patient’s genotype
March 23, 2019 - First-of-its-kind study provides pregnancy statistics of imprisoned U.S. women
March 23, 2019 - Marinus Pharmaceuticals Initiates Phase 3 Study in Children with PCDH19-Related Epilepsy
Understanding AFib: Drugs and procedures to help restore a normal rhythm

Understanding AFib: Drugs and procedures to help restore a normal rhythm

image_pdfDownload PDFimage_print

As we have learned in earlier posts in the Understanding AFib series, atrial fibrillation is a serious heart condition where the heart beats rapidly without a regular beat, like dancing without rhythm.

A typical approach is to slow down the heart rate with medications, such as beta blockers. If the heart is weak to begin with, however, slowing down the heart may not be an adequate solution. If this is the case, special drugs, pacemakers, and procedures may help keep the heart in a normal rhythm, rather than in AFib.

Medications

Several drugs, called anti-arrhythmic drugs, may be useful in keeping the heart from going into AFib. In many instances, they have proven successful in maintaining the normal rhythm of the heart.

My colleague Paul Wang, MD, who specializes in arrhythmias like atrial fibrillation, explained:

Anti-arrhythmic medications are often used if a patient continues to have symptoms from AFib (like dizziness or fatigue) even after starting medications to lower their heart rate. These drugs can increase the time spent in a normal rhythm, which improves quality of life… The problem with anti-arrhythmic drugs is that they often have side-effects that make them difficult to take long-term.

National data show that the most commonly used anti-arrhythmic drugs are amiodarone (used by 5 percent of AFib patients), sotalol (4 percent), and flecainide (3 percent).

Pacemakers

In addition to medications, some patients with AFib may also need to have a pacemaker. A pacemaker is a small device placed under the skin of the chest that delivers an electrical signal to the heart that forces the heart to beat.

Some of the drugs that keep patients in a normal rhythm also slow down the heart to the point where it would beat too slowly. A pacemaker provides a back-up system so that the pacemaker fires when the heart slows down too much. Many modern pacemakers are also small computers that can perform multiple functions, including recording recent heart activity.

Procedures

Several procedures can be performed on the heart that force it to remain in a normal rhythm. Many of these procedures are done through a catheter, a thin tube that is threaded through a blood vessel up to the heart.

Once in the heart, small areas of the heart can be burned or frozen so that the chaotic electrical impulses in the heart’s upper chambers are interrupted and no longer continue firing. By destroying some of the tissue in the atria, these ablation procedures disrupt the heart’s faulty electrical impulses.

It is also possible to destroy the electrical connection between the heart’s upper (atria) and lower chambers (ventricles), known as the atrioventricular (AV) node. By destroying the AV node, no electrical signals can make it into the ventricles. A pacemaker is then required to keep the heart beating.

Other options, such as a Cox Maze procedure, may require open-heart surgery. Like ablation, they disrupt the electrical circuits in the heart’s upper chambers by creating a pattern (like a maze) of scar tissue using a scalpel or other device. These procedures are generally not recommended early in AFib because they carry their own risks and potential complications. It’s also possible the surgery may not work, especially long-term.

For some patients, however, these types of procedures offer a chance for a cure for Afib, allowing for greater health and well-being.

This is the sixth post in the Understanding AFib series to help patients with atrial fibrillation live healthier lives. George H. is an actual patient with some details altered to protect his confidentiality. Estimates of drugs used for rhythm control in AFib come from IQVIA’s National Disease and Therapeutic Index.

Randall Stafford, MD, PhD, is a professor of medicine at Stanford and practices primary care internal medicine. Stafford and Stanford cardiologist Paul Wang, MD, lead an American Heart Association effort to improve stroke prevention decision-making in atrial fibrillation.

Photo by ulleo

Tagged with:

About author

Related Articles