Atrial Fibrillation and the Use of Anticoagulants

Featuring Dr. Frank Halperin, MD, FRCPC, FACC, Cardiologist

Duration: 2 minute, 46 seconds

The most important medications for the treatments of atrial fibrillation are the anticoagulants. 

These are agents such as warfarin or Coumadin and now we have newer anticoagulants that have just come on the market in the last few years. These are by far in a way the most important treatment that one should receive if one has atrial fibrillation. 

There are however other classes of medications which are designed not for stroke prevention, but for the improvement of symptoms which is one of the major issues that patients with atrial fibrillation have.
There are two general classes of medications that we use in this regard.

The first group are the anti-arrhythmics and their job is to try and control the rate of atrial fibrillation by keeping the patient in normal rhythm. The way that these medications work is they adjust the way that electricity travels through the heart and make it less likely for atrial fibrillation to occur.

And if it should occur, it makes it more likely for the patients to revert back into normal rhythm. When they’re in normal rhythm the rate tends to be well controlled and the patient tends to have less symptoms.

The second group of medications are medications whose goal is just to control the patient’s rate. So in other words, they don’t try and put you back in normal rhythm from atrial fibrillation. The patient  typically remains in atrial fibrillation, but the rate is well controlled.  

These are medications like digoxin, beta blockers and some of our calcium channel blockers and these are commonly prescribed by all physicians, including family practitioners. The anti-arrhythmic drugs that I mentioned before, these drugs tend to have more in terms of side effects and they tend typically to be prescribed by specialists.

If one developed symptoms that are suggestive of atrial fibrillation and by that I mean palpitations, or rapid irregular heartbeat, shortness of breath or decreased exercise tolerance. It is very important that you see your medical practitioner about this because there’s risk of complications and other issues down the road that could occur if these issues aren’t appropriately investigated and managed.  

If you feel very unwell with these symptoms, it’s important to go to the emergency department because there are treatments that they can initiate in a rapid manner to help restore a normal rhythm and help prevent complications.

If you’re having general symptoms, symptoms that are not very severe, that’s the time when it’s worthwhile to go see your family, so if you’re feeling minor palpitations, slight decrease in exercise tolerance or mild shortness of breath, this is the time when your family physician can be very helpful.  They can arrange for the appropriate testing other investigations and initiate the appropriate management from there.

Related keywords:

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Presenter: Dr. Frank Halperin, Cardiologist, Kelowna, BC

Local Practitioners: Cardiologist