Atrial fibrillation/flutter

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Anterior heart arteries

Heart, front view

Heart, section through the middle

Posterior heart arteries

Auricular fibrillation; A-fib

In certain cases, atrial fibrillation may require emergency treatment to convert the arrhythmia to normal (sinus) rhythm. This treatment may involve either with electrical cardioversion or intravenous (IV) drugs such as dofetilide, amiodarone, or ibutilide.

Long-term treatment varies depending on the cause of the atrial fibrillation or flutter. Medication may include beta-blockers, calcium channel blockers, digitalis or other medications (such as anti-arrhythmic drugs), which slow the heartbeat or the conduction of the impulse from the atria to the ventricles.

Blood thinners, such as heparin or Coumadin, may be given to reduce the risk of a thromboembolic event such as a stroke.

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

For some patients with atrial flutter, radiofrequency ablation is the current 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 (i.e., 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.

The disorder is usually controllable with treatment. The natural tendency of atrial fibrillation, however, is to become a chronic condition.

• A pulse that is too rapid or too slow may reduce the amount of blood the heart can pump and lead to syncope (fainting).
• Emboli to the brain ( stroke ) or elsewhere -- rare, but often treated with anticoagulation to reduce this risk.

Call your health care provider if symptoms indicate atrial fibrillation or flutter may be present.

Review Date: 05/31/2006
Reviewed By: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY. Review provided by VeriMed Healthcare Network.