Different modalities of treatment are used depending on the patient’s conditions:a) If the patient is in critical condition, such as being hemodynamically unstable (fluctuations in blood pressure), complaining of angina (chest pain) or has heart failure (inability if the ventricles to pump adequate blood, manifest as shortness of breath, swollen legs), immediate synchronous cardioversion (shocking) is indicated.
b) If the patient is stable, the physician should first focus on ventricular response to the atrial fibrillation, while simultaneously treating the underline cause of the arrhythmia. The rate or the ventricular response can be controlled by medications such as digitalis or digoxin, verapamil, or timolol.
c) Once the ventricular response has been controlled, the normal heart rate may return or it can be also restored by administration of medication such Quinidine or by DC synchronous cardioversion.
d) Many authorities advocate anticoagulants therapy for patients who are at risk for stroke, due to the likelihood of thrombus formation in the left atrium. This approach has been debated for many years. There are evidence suggesting that patients with chronic atrial fibrillation should be anticoagualted in the absence of any contraindication; the risk of an embolic stroke appears to outweigh the risk posed by chronic anticoagulant therapy.
You should contact a doctor if you experience the symptoms of AF. It can be hard to detect since the attacks come and go. If an ECG is insufficient, the physician may have you wear a portable (Holter) ECG for a period of time.
