Management and evaluation for Afib and flutter

Atrial fibrillation is related to advanced age, high blood pressure, alcohol use and family history. It is a very important heart condition for many reasons. It can be constant or it can come and go. Patient’s have a range of symptoms from this illness from dizziness, palpitations, shortness of breath to inability to function, passing out and overall fatigue. Afib is irregular and atrial flutter is regular and usually fast. Afib can be slow to the point that it requires pacemaker implantation or so fast that it might need a cardiac procedure known as ablation for it to resolve.

Temporarily both rhythms can be shocked under supervision in the hospital back into normal rhythm under sedation. Most afib and flutter can be managed with medications to control the rate or convert the irregularity in rhythm back to normal. Afib increases the risk of stroke and therefore many older afib patients will be placed on blood thinners such as Xarelto, Eliquis or Coumadin.

Newer technologies are constantly emerging for treatment of atrial fibrillation and also lowering its risk of stroke. Most recently, WATCHMAN procedure has been introduced which allows for the patients to be taken off blood thinners. This procedure is performed at the moment at Glendale Adventist Hospital and is available to our patients that would be appropriate candidates.

Commonly used drugs to treat afib are amiodarone, Multaq, Digoxin, Metoprolol and Sotalol. Patients can be on medications that control the rate such as metoprolol and digoxin and Diltiazem. They can also be on medications that attempt to keep them in normal rhythm such as Amiodarone, Multaq and Sotatolol. Often patients are on a combination of such medications as well.