Treatment of atrial fibrillation

Atrial fibrillation (AF) is a long-term disease (LTD). Doctors need to know how to deal with patients affected by this heart disease.

AF, which is a severe chronic disorder of the heart rhythm, affects 1% of the population, but from the age of 80, the figure reaches 8%. As the population is growing old, this pathology is affecting more and more patients.


  • Very frequent diseaseatrial fibrillation is an anarchistic contraction of the atria, parts of the heart which receive blood.
  • Several types of atrial fibrillation:
    • Paroxystic: ends in one week, often within 48 hours, repeating;
    • Persistent: recurring and requiring a treatment;
    • Permanent.

Initial check-up

  • To determine an atrial fibrillation, here are this pathology's associated symptoms :
    • Difficulty of breathing (dyspnea),
    • Palpitations,
    • Malaise,
    • Fainting,
    • Tiredness,
    • Thoracic disturbance,
    • Cerebral vascular accident (CVA),
    • Transient ischemic attack (TIA).
  • Questions to be asked to a suffering patient of AF:
    • Former episodes,
    • Starting factors of AF,
    • Frequency of AF,
    • Its duration,
    • The way in which the attacks end
    • Effects of the treatment,
    • Signs of hemodynamic instability (often requiring an emergency hospitalisation),
    • Type of AF.
  • Examinations are recommended, inter alia:
    • ECG (electrocardiogram),
      • Confirms the arrhythmia
      • Measures the heart rate (HR)
      • Searches for another heart pathology
    • Thyreostimuline (TSH),
    • Transthoracic Echocardiogram (TTE) (if subjacent heart disease suspected or within the framework of a cardioversion),
    • Hematologic and biochemical examinations
      • Glycemia,
      • Creatinin,
      • Complete blood count.
    • Depending on the cases, combine with:
      • Chest radiography,
      • Transesophageal Echocardiography (TEE),
      • Holter ECG,
      • Cardiac stress test.


  • The goal of therapeutic management:
    • To decrease functional disturbance,
    • To prevent thromboembolic events,
    • To avoid the aggravation of a possible latent heart disease,
    • To work out a strategy of management.

Prevent thromboembolic accidents with a antithrombotic treatment

  • In case of AF:
    • AVK: high-risk patients,
    • Aspirin: low-risk patients,
    • AVK or aspirin according to the case: patients with risk moderate.
  • In case of a cardioversion:
    • Patient in AF for more than 48 H: 3 weeks before and one month afterwards, AVK;
    • Patient in AF for less than 48 H: anticoagulant treatment, according to the risks.

Treating the rhythm disorder

  • To control HR, for permanent or persistent AF: beta-blockers and/or calcium antagonists bradycardia .
  • To control the heart rhythm:
    • Cardioversion (persistant AF)
      • Electric
      • Pharmacological
    • Drug treatment to maintain the sinus rhythm (amiodarone, flecainide, propafenone, sotalol, even cibenzoline, disopyramide and Quinidine )
    • Other treatments
      • Endocavitary ablation of the AF
      • Operative treatments

Follow-up of a patient suffering from AF

  • Follow-up allows assessing :
    • Thromboembolic risks
    • Benefit and risks of anticoagulant treatment
    • Benefit and risks of antiarythmic treatment.

A consultation every 6 months is recommended, questioning the patient (life, symptoms, treatment...). Complementary examinations can be carried out.


Atrial Fibrillation Association (AFA)
Photographic copyright: Cudazi |
Ask a question
CCM is a leading international tech website. Our content is written in collaboration with IT experts, under the direction of Jeff Pillou, founder of CCM reaches more than 50 million unique visitors per month and is available in 11 languages.


This document, titled « Treatment of atrial fibrillation », is available under the Creative Commons license. Any copy, reuse, or modification of the content should be sufficiently credited to CCM Health (