Atrial Fibrillation: Effective Treatment Options for Rapid Heart Rate

Atrial fibrillation (AFib) is a common heart rhythm disorder that can lead to serious complications if not properly managed. When dealing with rapid AFib, timely and appropriate treatment is crucial to restore normal heart rhythm and prevent further health issues.

Pharmacological Treatment for Rapid AFib

Medication-based rhythm control is often the first line of treatment when symptoms are not immediately life-threatening. Antiarrhythmic drugs such as propafenone and amiodarone are commonly prescribed to restore normal heart rhythm. These medications have shown high efficacy in clinical settings, but they require careful evaluation before administration.

Before initiating drug therapy, it is essential to assess the patient for potential left atrial appendage thrombus formation, which can increase the risk of stroke. Doctors often use echocardiography to rule out blood clots before prescribing rhythm-control medications.

Electrical Cardioversion: A Critical Intervention

When rapid AFib significantly impacts vital organ perfusion, immediate intervention is necessary. This includes symptoms such as dizziness, visual disturbances, and syncope due to reduced cerebral blood flow. In cardiac-related complications, patients may experience chest discomfort or angina due to myocardial ischemia.

In such urgent cases, synchronized electrical cardioversion is the preferred treatment. This procedure uses controlled electrical shocks to restore the heart's normal rhythm. Modern protocols typically employ biphasic defibrillators, starting with an initial energy level of 100 joules. If the first attempt is unsuccessful, the energy can be increased to 200 joules for improved efficacy.

Why Biphasic Defibrillation Is Preferred

Compared to older monophasic devices, biphasic defibrillators offer higher success rates with lower energy levels, reducing the risk of skin burns and myocardial damage. These advanced systems are now standard in most emergency departments and intensive care units due to their effectiveness and safety profile.

Patients undergoing electrical cardioversion are closely monitored before, during, and after the procedure to ensure stability and prevent complications. Post-procedure care often includes continued cardiac monitoring and anticoagulation therapy to reduce stroke risk.