Effective Methods for Rapid Treatment of Atrial Fibrillation

Immediate Rhythm Control for Acute Atrial Fibrillation

If AFib has been present for less than 48 hours, rhythm control is often considered appropriate. This can be achieved through pharmacological therapy or electrical cardioversion. Commonly used medications include intravenous amiodarone or other antiarrhythmic drugs, which may be followed by oral maintenance therapy to stabilize heart rhythm. Electrical cardioversion involves delivering a controlled electric shock to restore the heart's normal sinus rhythm.

Management of Persistent Atrial Fibrillation

When AFib lasts longer than 48 hours, a more advanced procedure such as radiofrequency ablation may be considered. However, this must be preceded by proper anticoagulation therapy for at least three weeks to reduce the risk of thromboembolic events. Prior to the procedure, both transthoracic and transesophageal echocardiography are performed to check for the presence of blood clots in the left atrium, left ventricle, or left atrial appendage. If clots are detected, cardioversion—whether pharmacological or electrical—is contraindicated, and the patient should remain on structured anticoagulant therapy until further evaluation confirms safety.

Emerging Options: Left Atrial Appendage Closure

Left atrial appendage closure is a developing treatment option currently under further research and clinical investigation. This procedure may be considered for patients who are not suitable candidates for long-term anticoagulation or ablation therapy. It aims to reduce the risk of stroke by sealing off the left atrial appendage, where blood clots are most likely to form in patients with AFib.