The Importance of AFib Medications
With contributions from Krystina Ostermeyer.
So, your physician diagnosed with atrial fibrillation (AFib). You are probably a bit nervous to know there's something wrong with your heart.
How dangerous is atrial fibrillation, and how will it affect the rest of my life? You undoubtedly have a million questions and have no idea where to begin.
Your physician most likely discussed AFib treatment options, but maybe you do not remember the medication options – it is all so overwhelming!
Here, we will discuss why it is important to take medication when you have AFib and what your medication options are.
The Dangers of AFib: Complications
The most severe complications of AFib are stroke, cardiomyopathy, heart failure, and cognitive loss.
Almost 20% of ischemic strokes, which result from a blood clot in the brain, are linked to AFib. For people who are aged 80 and older, this number increases to 33%.
AFib causes the atria (the upper chambers of the heart) to quiver. When they vibrate, they are unable to contract regularly. When they cannot pump correctly, the contractions (the "lub-dub" that your physician listens to with a stethoscope) fail to pump blood effectively into circulation.
The blood that is supposed to flow into the lungs pools in the atria. This pooled blood can clot. This clot, if it ever gets out of the atria, can cause a stroke.
Cardiomyopathy and Heart Failure
The second significant complication of AFib is cardiomyopathy, which occurs when a person is in AFib for a prolonged period. The long-duration of irregular heartbeats cause the heart muscle to become weak and interferes with its ability to move enough blood to the rest of the body.
Over time, this weakened state can lead to heart failure.
How Does Heart Failure Happen?
Heart failure happens because your heart becomes so weak that it can't pump strongly enough to move the usual amount of blood to the other areas of the body. As a result, blood backs up in the lungs veins and causes fluid to build up.
The fluid will also build up around the heart, making it hard to breathe, and it starts to pool in the legs.
A cognitive loss means that there is a decrease in brain function. The Journal of the American Heart Association included a study showing that people with AFib have a higher risk of cognitive problems and dementia.
The Good News
Fortunately, knowing how to control your AFib can help you avoid experiencing a stroke. For people with AFib, almost 80% of strokes are preventable.
Medication is one of the primary methods used for controlling AFib. The drugs your physician prescribes for you play a crucial role in helping you reduce your risk for stroke as well as managing your symptoms.
Keeping your AFib under good control will also reduce your chances of developing cardiomyopathy, heart failure, and experiencing cognitive loss and as with stroke, taking medication is a vital part of helping you to avoid developing any of these conditions.
AFib Medication Options
Because of the stroke risk, it is important to take medications if your doctor recommends it. Several drugs can be used to treat AFib, such as heart rate control, anticoagulants, and antiarrhythmic medications.
These medications may be used singly or in conjunction, depending on what your physician recommends.
However, drug therapy by itself isn't a guarantee that your heart rate and rhythm will stay under control. Your physician will evaluate your specific type of AFib and recommend a procedure if he feels it is the best choice for you.
Antiarrhythmic medications will help to convert the heart into sinus rhythm (a normal heart rhythm) or may be used after a procedure called a cardioversion.
Antiarrhythmic drugs fall into two distinct categories: sodium channel blockers and results in potassium channel blockers.
Sodium channel blockers change the way sodium flows into the cells of the heart, which alters electrical impulses and slows down your heart rate.
Examples of these medications include:
- Propafenone (Rythmol)
Potassium channel blockers work like sodium channel blockers, except they block potassium's flow into heart muscle cells, which also causes your heart rate to decrease.
The most common potassium channel blockers used today are:
- Amiodarone (Cordarone, Pacerone)
- Sotalol (Betapace, Sorine)
- Dofetilide (Tikosyn)
Antiarrhythmic drugs are often recommended to help stabilize the heart muscle. Sotalol and amiodarone have a dual effect because they decrease the electrical signals sent to the AV node, which reduces the heart rate.
Your physician will prescribe an antiarrhythmic drug if you experience severe AFib symptoms, like shortness of breath and palpitations, or if you have undergone a catheter ablation or cardioversion procedure.
Antiarrhythmic drugs can produce serious side effects, so your physician will keep a close eye on how your body responds to taking them.
Side effects of these medications may include nausea and vomiting, and fatigue. They can also cause ventricular arrhythmias – arrhythmias that originate in ventricles of the heart.
This group of medications can interact with other drugs you are taking and cause additional harmful symptoms. Make sure to tell your physician if you use over-the-counter medicines, vitamins, or herbal supplements.
Eating grapefruit or drinking grapefruit juice can have adverse effects on some antiarrhythmics. In some instances, antiarrhythmics can increase how often or how severe the symptoms occur.