Other names: AF; AFib; PAF; Paroxysmal Atrial Fibrillation
Atrial Fibrillation (AF) is a common heart condition that causes an irregular and often rapid heart rate. Having AF increases a person’s risk of having a stroke or developing heart failure.
AF is a type of arrhythmia. Arrhythmias are disturbances in the way the heart beats and are commonly caused by changes to the electrical impulse within the heart. When your heart is healthy, a steady, electrical signal that originates in the Sino Atrial node in the right upper part of your heart keeps your heart at a regular beat, usually between 60 and 100 beats per minute. This is called sinus rhythm.
The electric signal in people with AF is random and chaotic which causes the two top chambers of your heart (the left and right atrium) to quiver and twitch. It becomes difficult for your heart to fill or empty itself of blood when it is quivering so much and out of sync with the two lower chambers (the ventricles), and blood may pool in the heart chambers and start clotting. Clots can dislodge from the heart and travel to vessels leading to the brain, kidneys, eyes, or peripherally in the arms or legs. The clot can block blood and oxygen flow to the brain or other organs.
There are three types of AF:
Paroxysmal AF: Episodes of AF come and go, sometimes in relation to exercise or stress. Episodes may last for minutes or hours but no longer than one week
Persistent AF: Episodes last for longer than one week
Long-standing persistent or permanent AF: AF episode has lasted longer than one year.
What Causes AF
Experts aren’t sure exactly what causes AF; however, they have identified several risk factors that make some people more likely to develop the condition. These include
Older age (particularly over 65 years)
Congenital heart disease
Coronary artery disease
Diabetes
Excessive alcohol intake
Exercise: Healthy middle-aged males who have been engaged in strenuous endurance training for more than 10 years have the highest risk of developing AF caused by exercise
Genetics: AF can sometimes run in families
Heart attack
Heart disease or damage
High blood pressure
High thyroid hormone levels or other metabolic imbalance
Kidney disease
Lung infections (eg, pneumonia)
Medications such as adenosine, dobutamine, ondansetron, paclitaxel, and anthracyclines
Obesity
Sleep apnea
Stress.
What are the Symptoms of AF?
Some people with AF have no symptoms and only get a diagnosis after a routine physical examination or an examination for an unrelated reason. Some people are not diagnosed until they have a stroke or mini-stroke.
Other people experience symptoms daily or only mild symptoms once in a while. Symptoms may include:
Heart flutters or palpitations
feel dizzy, weak or faint
Nausea
Shortness of breath
Chest pain, discomfort, or tightness
Fatigue
Having difficulty exercising.
How is AF Diagnosed?
See your doctor if you are experiencing symptoms of AF.
Your doctor will ask about your family history of heart disease and check your heart rhythm, heart rate, and pulse. The diagnosis of atrial fibrillation is usually confirmed with an electrocardiogram (ECG), a test that records the heart's electrical activity.
Sometimes a portable ECG called a Holter monitor, may need to be worn at home for 24 hours, if a person's AF is not consistent. Monitors are also available that can be used for longer than 24 hours if needed.
How is AF Treated?
Treatment varies depends on the type of AF but may include:
Anticoagulants (blood thinners)
Antiarrhythmics
Beta-blockers
Calcium channel blockers
Digoxin
Pacemakers
Radiofrequency ablation.
Drugs used to treat Atrial Fibrillation
The medications listed below are related to or used in the treatment of this condition.
For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Activity
Activity is based on recent site visitor activity relative to other medications in the list.
Rx
Prescription only.
OTC
Over-the-counter.
Rx/OTC
Prescription or Over-the-counter.
Off-label
This medication may not be approved by the FDA for the treatment of this condition.
EUA
An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives.
Expanded Access
Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.
Pregnancy Category
A
Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N
FDA has not classified the drug.
Controlled Substances Act (CSA) Schedule
M
The drug has multiple schedules. The schedule may depend on the exact dosage form or strength of the medication.
U
CSA Schedule is unknown.
N
Is not subject to the Controlled Substances Act.
1
Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2
Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3
Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4
Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5
Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.
Alcohol
X
Interacts with Alcohol.
Further information
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