02: Medical management basics

AFib treatment includes blood thinners, rate and rhythm control medications, careful monitoring for side effects, and sometimes procedures, with urgent care needed for severe or sudden symptoms.

Medication Categories 

Blood Thinners (Anticoagulants): 

  • Prevent stroke by preventing clots 
  • Examples: Warfarin, Eliquis, Xarelto, Pradaxa 
  • Most critical medication - never skip 
  • Take exactly as prescribed, same time daily 

Rate Control Medications: 

  • Slow heart rate during AFib 
  • Examples: Beta-blockers, calcium channel blockers, digoxin 
  • Help reduce symptoms 

Rhythm Control Medications: 

  • Try to maintain normal rhythm 
  • Examples: Flecainide, propafenone, amiodarone, sotalol 
  • Not for everyone 

Taking Medications Safely 

Never miss blood thinner doses: 

  • Set phone alarms 
  • Use pill organizer 
  • Keep backup supply 
  • Refill before running out 

Track side effects: 

  • Unusual bleeding or bruising 
  • Excessive fatigue 
  • Dizziness 
  • Shortness of breath 
  • Report to doctor immediately 

Drug interactions: 

  • Tell ALL doctors about ALL medications 
  • Check with pharmacist before OTC drugs 
  • Avoid grapefruit juice with some meds 
  • Limit vitamin K foods if on warfarin 

Procedures You May Hear About 

Cardioversion: Shock or medication to reset rhythm 
Ablation: Destroy tissue causing irregular signals 
Pacemaker: Regulate heart rate if needed 
Left Atrial Appendage Closure: Alternative to blood thinners for some 

Discuss options with your cardiologist - not everyone needs procedures 

When to Seek Immediate Help 

Call 911 if: 

  • Chest pain or pressure 
  • Severe shortness of breath 
  • Sudden weakness or numbness (stroke symptoms) 
  • Fainting or near-fainting 
  • Heart rate >150 or <40 bpm with symptoms 

Call doctor same day if: 

  • New or worsening symptoms 
  • Heart rate consistently >100 at rest 
  • Unusual bleeding 
  • Medication side effects