Treatment for your atrial fibrillation will depend on: 

  • the type of AF you have
  • how long you have had it 
  • most importantly, how it affects you. 

Once we have established your stroke risk and treated it accordingly, we will come to an agreement with you on how to manage your AF. 
There are two treatment options available: 

  • Rate control strategy (helping to control the rate of your AF) 
  • Rhythm control strategy (helping your heart to stay in normal rhythm)

In most cases, medication will be prescribed to assist you in managing your AF. Medication is taken regularly or sometimes only when you are in AF, which is called 'pill in the pocket'. 

The main aim of the above two treatments is to alleviate the symptoms you experience – they are not treatments to change your life expectancy. This may change in the future as more evidence from ongoing trials becomes available. 

Rate control

Rate control is when we do not attempt to restore sinus rhythm, but instead ensure that your heart does not beat too quickly. 

The heart rate can be controlled through the use of  anti-arrhythmic medications that act on the AV-node to slow and partially prevent the transmission of electrical impulses from the atria to the ventricles. 

This means the heart pumps slower and more effectively so that some of the symptoms of AF may be relieved.  

Medications for rate control are:

  • Beta blockers
  • Calcium channel blockers (diltiazem, verapamil)
  • Digoxin. 

Rhythm control

This is when we attempt to get your heart back into sinus (normal) rhythm. This can be achieved by either: 

  • anti-arrhythmic medications
  • electrical cardioversion 
  • catheter ablations. 

Medications can help to keep your heart in sinus rhythm and help to reduce the number of episodes of AF that you experience. They include:

  • beta blockers (including sotalol)
  • flecainide
  • amiodarone
  • dronedarone.


Anti-arrhythmic medications work by helping to stabilise electrical impulses within the heart.

The type of medication used to treat AF will vary in every individual according to symptoms and heart function.

You may be asked to take your medication on a when-needed basis ('pill in the pocket approach'), or we may want you take it regularly. We will sometimes look at combining more than one medication to ensure your heart rate and/or rhythm is well controlled.

Regardless of your treatment strategy (rate or rhythm control), it is still important that you continue your anticoagulation medication to reduce your risk of stroke. 

Learn more about medications for atrial fibrillation.

Atrial tachycardia is an abnormal heart rhythm which is usually seen in patients that have undergone heart surgery, have congenital heart defects or have undergone previous ablation procedures.

Atrial fibrillation is an abnormal heart rhythm. It is the most common heart rhythm disorder in the UK.

Contact the AF team

Harefield Hospital
01895 828979

Royal Brompton Hospital
020  7351 8364