How we treat your atrial fibrillation will depend on what type of AF you have, how long you have had it and mainly how it affects you.

We will need to first establish your stroke risk and treat that, then we will agree with you on how best 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, we will prescribe medication to help manage your AF. You will either need to take your medication on a regular basis or as and when you need it, which is known as the 'pill in the pocket' approach.

The main aim of these two treatments is to ease 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, make sure that your heart does not beat too quickly.

We can control your heart rate through antiarrhythmic medications. These act on the AV node to slow and partly prevent electrical impulses transmitting from the atria to the ventricles.

This means the heart pumps slower and more effectively so that some of the symptoms of AF are reduced.

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.

Learn more about the medications used for treating AF by clicking on the 'Information' tab. 

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.

Medications for atrial fibrillation

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

The type of medication used will vary depending on the patient's symptoms and heart function.

You may be asked to take your medication on a when-needed basis ('pill in the pocket approach'), or to take it on a regular basis. 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.

Contact the atrial fibrillation team

Harefield Hospital
01895 828979

Royal Brompton Hospital
0207 351 8364