Discharge Instructions for Atrial Fibrillation

You have been diagnosed with an abnormal heart rhythm called atrial fibrillation. With this condition, your heart’s 2 upper chambers quiver rather than squeeze the blood out in a normal pattern. This leads to an irregular and sometimes rapid heartbeat. Some people will develop associated symptoms such as a flip-flopping heartbeat, chest pain, lightheadedness, or shortness of breath. Other people may have no symptoms at all. Atrial fibrillation is serious because it affects the heart’s ability to fill with blood as it should. Blood clots may form. This increases the risk for stroke. Untreated atrial fibrillation can also lead to heart failure. Atrial fibrillation can be controlled. With treatment, most people with atrial fibrillation lead normal lives.

Treatment options

Recommended treatment for atrial fibrillation depends on your age, symptoms, how long you have had atrial fibrillation, and other factors. You will have a complete evaluation to find out if you have any abnormalities that caused your heart to go into atrial fibrillation. This might be blocked heart arteries or a thyroid problem. Your doctor will assess your particular case and discuss choices with you.

Treatment choices may include:

• Treating an underlying disorder that puts you at risk for atrial fibrillation. For example, correcting an abnormal thyroid or electrolyte problem, or treating a blocked heart artery.

• Restoring a normal heart rhythm with an electrical shock (cardioversion) or with an antiarrhythmic medicine (chemical cardioversion).

• Using medicine to control your heart rate in atrial fibrillation.

• Preventing the risk for blood clot and stroke using blood-thinning medicines. Your doctor will tell you what he or she recommends. Choices may include aspirin, clopidogrel, warfarin, dabigatran, rivaroxaban, apixaban, and edoxaban.

• Doing catheter ablation or a surgical maze procedure. These use different methods to destroy certain areas of heart tissue. This interrupts the electrical signals causing atrial fibrillation. One of these procedures may be a choice when medicines do not work, or as an alternative to long-term medicine.

• Other treatment choices may be recommended for you by your doctor.

Managing risk factors for stroke and preventing heart failure are important parts of any treatment plan for atrial fibrillation.

Home care

• Take your medicines exactly as directed. Don’t skip doses.

• Work with your doctor to find the right medicines and doses for you.

• Learn to take your own pulse. Keep a record of your results. Ask your doctor which pulse rates mean that you need medical attention. Slowing your pulse is often the goal of treatment. Ask your doctor if it’s OK for you to use an automatic machine to check your pulse at home. Sometimes these machines don’t count the pulse correctly when you have atrial fibrillation.

• Limit your intake of coffee, tea, cola, and other beverages with caffeine. Talk with your doctor about whether you should eliminate caffeine.

• Avoid over-the-counter medicines that have caffeine in them.

• Let your doctor know what medicines you take, including prescription and over-the-counter medicines, as well as any supplements. They interfere with some medicines given for atrial fibrillation.

• Ask your doctor about whether you can drink alcohol. Some people need to avoid alcohol to better treat atrial fibrillation. If you are taking blood-thinner medicines, alcohol may interfere with them by increasing their effect.

• Never take stimulants such as amphetamines or cocaine. These drugs can speed up your heart rate and trigger atrial fibrillation.

Follow-up care

Follow up with your doctor, or as advised.