Medications to control heart rate and heart rhythm in atrial fibrillation

By Mayo Clinic Staff

Treatment for atrial fibrillation, a common heart rhythm disorder, will depend on how long you've had atrial fibrillation, how bothersome your symptoms are and the underlying cause of your atrial fibrillation. Generally, the treatment goals for atrial fibrillation are to:

  • Reset the rhythm or control the rate
  • Prevent blood clots

The strategy you and your doctor choose depends on many factors, including whether you have other problems with your heart and if you're able to take medications that can control your heart rhythm.

Doctors may prescribe medications to control your heart rate or to help maintain a normal heart rhythm. In some cases, if medications aren't effective, you may need a more invasive procedure to control your heart rate.

Heart rate control

You may be prescribed medications to control your heart rate and restore it to a normal rate. Heart rate control can be achieved through several medications.

The medication digoxin (Lanoxin) may control heart rate at rest, but not as well during activity. Most people require additional or alternative medications, such as calcium channel blockers or beta blockers.

Beta blockers may cause side effects such as worsening of heart failure and low blood pressure (hypotension). Calcium channel blockers also can cause side effects and may need to be avoided if you have heart failure or low blood pressure.

Maintaining a normal heart rhythm

Your doctor may prescribe anti-arrhythmic medications to help prevent future episodes of atrial fibrillation. Medications may include:

  • Dofetilide (Tikosyn)
  • Flecainide
  • Propafenone (Rythmol)
  • Amiodarone (Cordarone, Pacerone)

Although these drugs may help maintain a normal heart rhythm, they can cause side effects, including:

  • Nausea
  • Dizziness
  • Fatigue

Rarely, they may cause ventricular arrhythmias — life-threatening rhythm disturbances originating in the heart's lower chambers. These medications may be needed indefinitely. Even with medications, the chance of another episode of atrial fibrillation is high.

May. 14, 2014 See more In-depth