Atrial fibrillation: treatment, pills

Atrial fibrillation is a disease that with proper compliance with the lifestyle and the implementation of the recommendations of the doctor may not disturb the patient. Otherwise, you may develop complications, life-threatening, and then to help the patient more difficult. The main objectives in the treatment of this disease be to maintain a normal state of health of the patient and prevention of complications, and not the restoration of normal values of heart rate.

The main directions in the treatment of atrial fibrillation is a technique of restoring and maintaining normal sinus rhythm or slowing of the heart rate to 80 – 100 per minute with the preservation of the scintillation of the Atria. The first method is successful in rare bouts of the disease and normal heart size. If the patient has frequent seizures, increased heart size and there are changes in the structure of the myocardium, the therapeutic strategy will focus on the second method. Regardless of tactics of treatment the patient is assigned antithrombotic drugs that thin the blood and reduce the likelihood of one of the worst complications of a stroke.

Group of drugs used in atrial fibrillation of the heart

You need to understand that antiarrhythmic medications will not cure the arrhythmia, they only reduce heart rate and prevent the development of recurrent exacerbations and complications.

Before starting drug treatment of atrial fibrillation, you need to find out its cause – the underlying disease which led to it. It is necessary to get rid of this reason. If the rhythm is not restored, it is necessary to resort to antiarrhythmic and antithrombotic therapy. All antiarrhythmic drugs are divided into several groups:

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  • The first class of drugs include sodium channel blockers (Procainamide, Lidocaine, Kinidin the drug hofitol, Allapinin, Etatsizin, Rytmonorm). Procainamide and Lidocaine are drugs an ambulance, they have an immediate (within a few minutes) antiarrhythmic action, are administered intravenously. The use of this class of drugs should be limited in patients with organic lesions of the heart (increased chamber size, heart defects, myocarditis and myocardial infarction).
  • The second class of drugs is beta-blockers (Atenolol, Metoprolol, Esmolol, Bisoprolol) – drugs that have an effect due to blockade of beta-receptors, which reduces effects of the sympathetic nervous system on the heart muscle. That is why this group of drugs are used in so-called sympathoadrenal arrhythmias that occur most often after stress, psycho-emotional overload, or physical stress. This class is one of the safest antiarrhythmics. They are often prescribed in combination with other classes of drugs.
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  • The third class of blockers of potassium channels. One of the first drugs from this group are Amiodarone and Sotalex (sotalol). Amiodarone is a tool with a complex effect, combining antiarrhythmic and antioxidant effects. Noticeable results from taking this drug not come immediately, must go through a period of saturation. After reaching stabilization of heart rhythm, the dose is reduced to minimally effective. Sotalex, as well as new preparations of this group (Dofetilide, Ibutilide, Nibentan) shall be appointed solely with atrial fibrillation. Given the high risk of ventricular tachycardia type «pirouette» immediately after the start of administration, tablets and intravenous injection of drugs of the third class to start taking in the hospital under medical supervision and ECG (to monitor heart rhythm). Tachycardia type «pirouette» is accompanied by sharp jumps in blood pressure and without proper care can lead to the death of the patient.
  • The fourth class of drugs – calcium channel blockers (Verapamil, Diltiazem). The mechanism of action of these drugs is to block the absorption of calcium to the heart muscle, which reduces the energy needs of the myocardium and its contractility, thereby decreasing heart rate. This class of drugs are widely used for the relief of paroxysmal (paroxysmal) atrial fibrillation.
  • Other funds, which include cardiac glycosides (Digoxin, strophanthin, Korglikon). This group of drugs is prescribed when atrial fibrillation occurs with severe heart failure (breathlessness and oedema). Dose picked individually for each patient.
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    Anticoagulants are appointed to prevent blood clots in the Atria (due to the accumulation of blood in them), and to prevent separation of already existing clots. Today the preference is given to preparations of warfarin (Warfarex, Marevan and Warfarin Nycomed). Treatment should be strictly prescribed by the doctor doses, otherwise there is a high risk of bleeding.

    The choice of drugs based on evidence about effectiveness, side effects and contraindications. In patients without organic lesions of the heart muscle therapy you can start with any class of drugs. In organic lesions of the heart it is better to start treatment with the second or third grade. In case of inefficiency it is possible to combine these two classes. Good therapeutic effect has the combination of Amiodarone with any beta-blocker.