Harvard Health Letter

Atrial fibrillation: Beyond drug therapies

Medications are the first treatment for atrial fibrillation, but if drugs don't do the job, there are other options.

Atrial fibrillation occurs when the heart's upper chambers (the atria) race or quiver instead of keeping a normal rhythm. The symptoms include lightheadedness, fatigue, and an erratic or racing heartbeat (palpitations). It's the most common form of cardiac arrhythmia, affecting some 2.2 million Americans. Unlike ventricular fibrillation, a dysfunction of the heart's main pumping chambers, atrial fibrillation usually isn't immediately life-threatening. But as doctors learn more about it, they're seeing a greater need for treatment.

An older heart is more likely to develop atrial fibrillation than a younger one. In our 50s, only 1 in 200 of us has atrial fibrillation; by the time we reach our 80s, that ratio is 1 in 12. Atrial fibrillation in younger people often has a fairly benign prognosis. But after about age 60, it's a more serious problem. It can increase the chances of developing heart failure and of having a stroke. If the atria don't contract properly, blood pools inside them, and clots may form. If a clot breaks free and travels to the brain, it can cause a stroke. Clots can also travel to other parts of the body and cause harmful obstructions in blood vessels supplying the bowels and legs.

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