Atrial Fibrillation Treatment: medical therapy, stroke prevention, electrical cardioversion, electrophysiology study – Doctor

Atrial Fibrillation - Treatments

There are two main targets of atrial fibrillation (AF) treatment: rate or rhythm control and stroke prevention.

A) Heart Rate or Heart Rhythm Control

Heart rate or heart rhythm can be controlled via medications or procedures.

1) Medications

Medical therapy with drugs can be given to slow down the heart rate or convert AF back to the normal sinus rhythm.

2) Procedures

Electrical cardioversion: An electric shock will be delivered to the heart to convert an irregular or rapid heart rhythm (arrhythmia) back to a normal heart rhythm.
Catheter ablation: A thin tube called an electrode catheter is used to conduct an electrophysiology study (EPS) which locates the site causing the abnormal heart rhythm. A radiofrequency energy is then delivered to ablate (or destroy) areas of abnormal electrical activity.

B) Stroke Prevention

Stroke prevention is achieved by anticoagulation with strong blood thinning agents. There are two types of anti-clotting medications in Singapore: Warfarin and Direct-acting Oral Anti-Coagulants (DOACs). Both medications effectively reduce the risk of stroke though they might slightly increase the risk of both external and internal bleeding. Patients taking Warfarin will need to go for regular blood tests to ensure that they are taking an appropriate dose that is unique to them.

Alternatively, treatment for the heart’s left atrial appendage is also available in the form of the WATCHMAN® left atrial appendage device, which is a permanent implant designed to keep harmful sized blood clots from entering your blood stream. This is typically recommended in patients who have had significant bleeding issues with anticoagulation.

Your doctor will assess and evaluate the extent of your condition, before recommending the most suitable treatment. Some factors that will be considered include: