Is It Possible to Correct Atrial Fibrillation After Many Years?

Atrial fibrillation (AFib) that has persisted for many years is generally not recommended for correction. This is because the procedure carries certain risks, and even if successful, maintaining a normal sinus rhythm can be difficult. Long-standing AFib often progresses to a permanent form of the condition. Attempting to restore normal heart rhythm in such cases can increase the risk of blood clots. Additionally, the atria are often enlarged after years of AFib, further reducing the chances of successful rhythm restoration.

Assessing the Feasibility of Rhythm Restoration

Before considering any corrective measures, it is advisable to undergo an echocardiogram to assess the size of the left atrium. If the left atrial diameter is less than 45mm, there may be a chance to restore sinus rhythm. However, if the left atrium measures more than 45mm, the likelihood of successful rhythm conversion diminishes significantly. Even if sinus rhythm is achieved, maintaining it becomes increasingly challenging.

Current Treatment Approaches for Atrial Fibrillation

At present, the primary focus of AFib treatment is on managing symptoms and reducing complications. Anticoagulant therapy is essential to prevent stroke caused by blood clots. Commonly prescribed anticoagulants include warfarin, rivaroxaban, and dabigatran. Patients should be cautious about potential side effects such as gum bleeding when using these medications.

Controlling Heart Rate Effectively

Another key aspect of treatment involves controlling the ventricular rate. When the heart rate is not excessively fast, patients often experience fewer symptoms and complications. Medications used to control rapid ventricular rates in AFib include beta-blockers like metoprolol, non-dihydropyridine calcium channel blockers, digoxin, and amiodarone.

Managing Acute AFib Episodes

During acute episodes of AFib, intravenous medications are typically administered to restore normal heart rhythm quickly and effectively. Once the heart rate is stabilized, oral medications should be introduced promptly to prevent recurrence of rapid ventricular response and maintain rhythm control over the long term.