Specialist electrophysiology care
Dr Rohan WijesurendraConsultant Cardiologist & Electrophysiologist
1,500+ ablationsPersonally performed catheter ablation procedures
Oxford-based carePrivate care at Nuffield Health The Manor Hospital
NHS practiceAcademic & researchGMC registrationHospital profile
When AF medication is not enough
Medication can be very effective in treating atrial fibrillation, but it does not work well enough for everyone. You may still have episodes despite treatment, have good rate control without preventing AF, or have side effects that affect your quality of life.
If this is happening, it may be worth reviewing the overall strategy rather than assuming that nothing else can be done.
Why might I still get AF while taking medication?
Different medicines have different purposes. Some slow the heart rate during AF, while others aim to help maintain normal rhythm. No medication prevents every episode, and the balance between benefit and side effects varies considerably between individuals.
Continuing to experience AF does not necessarily mean your treatment has been inappropriate. It may mean that the next treatment decision needs to be reconsidered.
What other options are available?
Depending on your circumstances, these can include:
- adjusting existing medication;
- trying a different rhythm-control medicine;
- cardioversion;
- treating contributing health and lifestyle factors;
- accepting AF while controlling the ventricular rate; or
- catheter ablation.
The right strategy depends on symptoms, AF type, other medical conditions, previous treatment and preferences.
Could catheter ablation be an alternative?
Potentially. Catheter ablation is particularly relevant when AF remains symptomatic despite medication, but this is not the only reason to discuss it. Some people want to understand the relative advantages and disadvantages of medication and ablation before committing to long-term treatment. Should I have an AF ablation? and the detailed AF ablation page can help prepare for that discussion.
A consultation can address that decision without assuming a procedure is the right answer.
Should I stop my medication?
No. Do not stop medication prescribed for AF simply because you are considering other treatment. In particular, anticoagulant medication has a different purpose from medication used to control heart rate or rhythm. Any changes should be discussed with the clinician responsible for your care.
A focused second opinion
If you are already being treated by a GP or cardiologist, you can seek a specialist electrophysiology opinion specifically about your rhythm-management options. This does not require you to change cardiologist.