Understand medications and why they are helpful. Medications can be a commitment for life and health!

Medications, for most patients, are the most helpful form of treatment. However, many studies show that patients often stop taking medications because of side effects or their own belief that they no longer need it. Discontinuing medications can be very dangerous!

If you have been prescribed heart medications, taking and tracking your medications is one of the best things you can do for your health.

Hear more from Dr. Clyde Yancy.

Tell your healthcare provider about all your other drugs and supplements, including over-the-counter medications and vitamins. Track all your medicines online with Heart360 or download our printable medication log.

Medications for atrial fibrillation (AF)
Medications are often prescribed to prevent and treat blood clots which can lead to a stroke.  Additional drugs may be prescribed to control heart rate and rhythm in the AF patient.  These medications may also be used in conjunction with other treatments. The heart rhythm is more difficult to control. The longer you have untreated AF, the less likely it is that normal rhythm can be reestablished. 

Medication options may include blood thinners, rate controllers, and rhythm controllers.  Lists included here are not intended to be comprehensive, and we encourage you to revisit our page often to keep up with the newest in AF medication options.

Blood thinners and clot prevention (anticoagulants and antiplatelets)
Drugs such as blood thinners are given to patients to prevent blood clot formation or to treat an existing blood clot. Examples of this type of drug are anticoagulants and antiplatelets such as:

• Heparin (or a form of heparin)
• Warfarin
• Aspirin
• Direct thrombin inhibitors and/or factor Xa inhibitors

Most AF patients have to seek other treatments, primarily anticoagulant therapy (Warfarin) and/or radiofrequency catheter ablation.

• Warfarin is a rather high-maintenance drug, and is prescribed in most people with atrial fibrillation.
• Warfarin patients reduce their stroke risk by 65 percent versus patients on no medication.
• Patients taking aspirin reduce their risk by 45 percent in comparison.

“Because Warfarin is such an exacting drug, it requires monthly blood tests and doctor visits to ensure proper dosage," says Dr. Andrea Russo of University of Pennsylvania Health System.

What side effects do anticoagulants and antiplatelets have?

Anticoagulants: Because anticoagulants may increase the risk of bleeding, more frequent monitoring may be needed initially. It is also wise to take extra care with contact sports or any other situation that might risk unneccesary trauma. Here are some things to watch for or report to your physician:

• If you have an accident of any kind
• If you often find bruises or blood blisters
• If you feel sick, weak, faint or dizzy
• If you think you are pregnant
• If you notice red, dark brown or black urine or stools
• If you bleed more with periods
• Bleeding gums
• Bad headache or stomach ache that won’t go away

Antiplatelets also present the risk of bleeding.  Even though aspirin can be purchased over the counter, it is important that you do not take more than the dose prescribed by your doctor.  Report any of the symptoms stated above to your physician.

Rate Controllers

• Beta blockers. These are drugs used to slow the heart rate. Most people can function and feel better if their heart rate is controlled.  Read more about beta blockers.

             Some examples may include:
                     Atenolol 
                     Bisoprolol
                     Carvedilol
                     Metoprolol
                     Nadolol
                     Propranolol
                     Timolol

• Calcium channel blockers. These medications have multiple effects on the heart. They are used to slow the heart rate in patients with AF and to reduce the strength of the muscle cell’s contraction.

             Some examples are:
                    Dilitiazem
                    Verapamil

• Digoxin. This medication slows the rate at which electrical currents are conducted from the atria to the ventricle.
   

Rhythm controllers
Most doctors will treat rhythm problems first with rate controllers or electrical cardioversion. But for some patients, medical cardioversion (a rhythm reset) is preferred. Significant side effects may occur, and your healthcare provider will most likely want to monitor progress closely.

• Sodium channel blockers which help the heart's rhythm by slowing the heart's ability to conduct electricity.

             Examples may include 
                    Flecainide (Tambocor®), 
                    Propafenone (Rythmol®)
                    Quinidine (Various).

• Potassium channel blockers help the heart’s rhythm by slowing down the electrical signals that cause AF.

             Examples may include: 
                    Amiodarone (Cordarone® or Pacerone®)
                    Sotalol (Betapace®)

See Also: Medication Management for Stroke Prevention
Downloadable Patient Information Sheet: How do I manage my medicines? 

This content was last reviewed on 10/11/2011.