What to do if you're worried your Afib medicines have stopped working
Atrial fibrillation (Afib or AF) is a condition in which the heart sometimes fails to beat at a steady rhythm, causing episodes of irregular and rapid heartbeats. This is caused by faulty signals from the electrical currents that control the heartbeat.
The condition is more common in older adults, says E. Michael Powers, MD, MBA, cardiac electrophysiologist.
“The atria, the heart’s two upper chambers, are supposed to be small and tight. They can start to stretch out as we age, which can contribute to the onset of Afib,” Powers explains.
It’s crucial to detect and treat Afib early because Afib disrupts the normal flow of blood through the heart and the rest of your body, which causes the heart’s upper chambers to quiver instead of beating strongly. When the heart isn’t beating strongly, it can cause blood to pool and clot within the heart, putting people with Afib at greater risk of stroke.
Many medicines prescribed for Afib are designed to prevent strokes.
Common Afib medicines
If you have Afib, learn more about medicines you may be prescribed.
Beta-blockers: These medicines don’t treat irregular heartbeats, but they slow the heart rate down, offering greater comfort and quality of life. Beta-blockers commonly prescribed for Afib include:
- Atenolol (Tenormin)
- Bisoprolol (Cardicor, Congescor)
- Carvedilol (Coreg)
- Metoprolol (Lopressor, Toprol XL)
- Nadolol (Corgard)
- Propranolol (Inderal)
Calcium channel blockers: These medicines are used to slow the heart rate in patients with Afib and help the heart to function better. This type of medicine includes:
- Diltiazem (Cardizem)
- Verapamil
Anticoagulants: These medicines are commonly referred to as blood thinners, but that’s not actually how they work. Instead, they slow the pace at which blood clots form, helping to reduce the risk of stroke. Common anticoagulants for Afib include:
- Apixaban (Eliquis)
- Dabigatran (Pradaxa)
- Edoxaban (Lixiana, Savaysa)
- Rivaroxaban (Xarelto)
- Warfarin (Coumadin)
Digoxin: These medicines interrupt and slow the electrical currents that are sent between the heart’s chambers, reducing their ability to cause an irregular or rapid heartbeat.
Sodium channel blockers: These medicines help keep the heart’s rhythm steady by interrupting the way the heart conducts electricity. Common sodium channel blockers for Afib include:
- Flecainide (Tambocor)
- Propafenone (Rythmol)
Potassium channel blockers: These medicines also slow down the heart’s electrical signals, specifically the ones that cause Afib. These include:
- Amiodarone (Pacerone, Cordarone, Nexterone)
- Sotalol (Betapace)
- Dofetilide (Tikosyn)
- Dronedarone (Multaq)
Get expert care
If you've noticed changes in how your Afib medications are working, it might be time to talk with a doctor.
Signs that your medicines aren't working
It sounds obvious, but the clearest sign that your Afib medicines have stopped working properly is that you’re having more Afib episodes. If you notice that these episodes are increasing in frequency or severity, it’s important to talk to your doctor to reevaluate your medicine and dosage and see if another option might work better for you.
Other signs that may indicate a return of your Afib episodes include:
- Chest pain
- Feeling dizzy or lightheaded
- Fainting
- Feeling fatigued, sluggish, or weak
- Shortness of breath
Other treatments your doctor may suggest
It’s common for an Afib medication that someone has been taking for some time to eventually stop working as it once did. When this happens, your doctor may suggest another medicine that could work for your situation. Your doctor will consider your health concerns, age, and other factors. Your doctor may also recommend a different dosage of your current medicine.
Depending on several health-related factors, your doctor may suggest an Afib ablation—a surgical procedure that changes the way your heart receives electrical signals. This procedure can greatly reduce instances of Afib.
If you have concerns about your Afib or have noticed changes in how your Afib medicines are working, reach out to your provider.