Diagnosis and treatment of atrial fibrillation

Your doctor may decide to do some tests to diagnose AF and identify any possible underlying causes. These may include:

  • Electrocardiogram (ECG)
  • Echocardiogram (known as 'echo')
  • Chest x-ray
  • Blood tests
ECG of a normal heart rhythm compared to AF © a-fib.com

ECG of a normal heart rhythm compared to AF

Aims of treatment

There are various types of treatment for AF. What, if any, treatment you receive will depend upon your individual circumstances. The aims of treatment are to:

  • Control the heart rate (i.e. how fast it beats)
  • Control the heart rhythm (i.e. how regularly it beats)
  • Prevent blood clots and stroke

Treatment can involve:

  • Drug treatment (see below)
  • Cardioversion
  • Insertion of an artificial pacemaker device
  • Catheter ablation: is a medical procedure used to treat some heart rhythm problems. This requires a thin flexible wire to be guided into the heart. The wire then uses energy to destroy the tissue in the heart which is causing the faulty electrical activity to occur.

Drug treatment of AF

The following groups of drugs can be used to control the heart rate / rhythm in AF:

  • Beta blockers
  • Calcium channel blockers
  • Anti-arrhythmics

If you have AF then you may have an increased risk of blood clots and stroke (a stroke happens when a
blood clot blocks an artery in the brain). Your doctor may prescribe an anticoagulant to reduce the risk of blood clotting and therefore reduce your risk of a stroke.

There are two types of anticoagulants:

  • Warfarin: this is the anticoagulant most commonly used in people with AF.
  • Direct oral anticioagulants (DOACs)  including (dabigatran etexilate, rivaroxaban, apixaban and edoxaban). These drugs may be more suitable for some people with AF.

More information on all of these drugs is available in the treatment section.