Rate Control Medication for Atrial Fibrillation
Rate control medication slows the heart rate to less than 100 beats per minute by blocking some of the errant electrical signals in the atria and preventing them from being transmitted to the ventricles.
There have been ongoing discussions in the medical community as to which of two medication approaches-rate control or rhythm control-is best for atrial fibrillation patients. Recent studies suggest that rate control, when combined with anticoagulation, is as good as rhythm control, and may be better because rate control medications are considered safer and are good overall for treating heart disease and coronary disease.
Using rate control medication avoids subjecting patients to the riskier rhythm control medications. These studies indicate that unless rate control has not worked, it is less important to aggressively drive patients into a normal sinus rhythm. In either case, anticoagulation is considered critical. 1
Types of Rate Control Drugs
There are three types of rate control medications:
- Beta blockers, which slow the heart rate and relax the blood vessels. Examples include Atenolol (Tenormin®), Carvedilol (Coreg™), Metoprolol (Toprol XL™, Lopressor®), and Sotolol (Betapace®)
- Calcium Channel Blockers, which relax blood vessels and reduce heart workload. Examples includes Diltiazem (Cardizem®, Tiazac®) and Verapamil (Calan®, Covera-HS®, Isoptin®)
- Cardiac Glycosides, which improve cardiac output, but can also be toxic. Digoxin (Lanoxin®) is an example of a cardiac glycoside.
Rate control medications, though less risky than rhythm control, aren't without risks, including:
- Side effects, such as fatigue, shortness of breath, dizziness, and much worse
- Can provoke cardiac arrhythmias
- Some can be toxic, such as cardiac glycosides
Rate control medications don't cure atrial fibrillation, so this medication regimen becomes life-long.
If rate control medication proves unsuccessful for you, then rhythm control medication may restore your heart's normal sinus rhythm. Or your doctor may recommend a catheter ablation or surgical ablation. For more information about these procedures, see Can Afib Be Cured?
1 Wyse, D. George, M.D., "Rate Versus Rhythm Control in the Management of Atrial Fibrillation" <http://www.americanheart.org/presenter.jhtml?identifier=3005618>, American Heart Association [Internet], Copyright, 2006.
