Atrial fibrillation (AFib) is the most common heart arrhythmia (abnormal heart rhythm) that requires treatment. According to the Centers for Disease Control, it is estimated that AFib will affect 12.1 million Americans by 2030. Many people with AFib experience symptoms like palpitations, chest pain, shortness of breath, or weakness and an atrial fibrillation attack can result in an emergency room visit or hospitalization.
Atrial fibrillation treatment can require medications and procedures and people often ask what the best alternative treatments for AFib are. Because an arrhythmia, like atrial fibrillation, is complex there is no simple or easy fix. The best alternative treatments for AFib focus on risk factor modification through healthy living. A healthy lifestyle not only benefits atrial fibrillation, it also positively impacts AFib risk factors like obesity, high blood pressure, diabetes, heart disease, and sleep apnea.
Can atrial fibrillation be cured permanently?
There is currently no cure for atrial fibrillation. That being said, there are many effective treatments and many people are able to live for long periods while being AFib free. If you have atrial fibrillation, aggressive risk factor modification, stroke prevention and early rhythm control can improve your outcomes.
What is the most effective treatment for atrial fibrillation?
There is no one-size-fits-all treatment for atrial fibrillation. The circumstances surrounding each person’s AFib are unique and therefore require a personalized treatment plan. One person’s AFib may have been triggered by excessive alcohol intake while another’s was caused by high blood pressure; both will require different treatment approaches.
Identifying and treating modifiable AFib triggers and risk factors is an important part of AFib treatment. Apart from this very important aspect of atrial fibrillation management, atrial fibrillation ablation is the most effective treatment for atrial fibrillation. When catheter ablation is done early in the disease process (i.e. when atrial fibrillation is still intermittent) it has up to an 80% success rate. People who have a successful AFib catheter ablation can go for many years before having a recurrence of AFib. The success of AFib ablation is influenced by the continued management of AFib risk factors and avoidance of AFib triggers.
Ablation success rates are even higher for the similar, but distinct arrhythmia, atrial flutter. Atrial flutter can occur on its own or in conjunction with atrial fibrillation. If you have atrial flutter alone, an atrial flutter ablation has success rates approaching 95%.
Can homeopathy cure AFib?
According to the National Center for Complementary and Integrative Health there is little evidence to support that homeopathy is an effective treatment for any specific health condition. Homeopathy has two primary tenets:
Like cures like. A substance that causes symptoms in healthy people can be used to cure a disease that causes similar symptoms.
Law of minimum dose. This is the idea that the lower the dose of a medication, the greater its effectiveness. Because of this principle, many homeopathic remedies are so dilute that they actually have no remaining molecules of the original substance. Opponents of homeopathy argue that a substance that no longer contains an active ingredient cannot help cure disease. However, you cannot safely assume that homeopathic remedies do not contain active ingredients because sometimes products that are labeled as homeopathic actually contain large amounts of active ingredients which could cause side effects or drug interactions.
An example of homeopathic treatment principles can be seen with red onions. Red onions produce eye watering in a healthy subject. Thus, according to homeopathy, a diluted preparation of onion can be used to treat allergies (which also causes watery eyes). Homeopathy is different from herbal supplements or Chinese medicine.
Atrial fibrillation is a complex disease that often requires a multi-faceted treatment approach. Successful AFib treatment can include atrial fibrillation medications or procedures, risk factor modification, and stroke prevention. While homeopathy cannot effectively treat atrial fibrillation, living a healthy lifestyle can make a significant impact. Lifestyle optimizations that can help manage your AFib include:
- Move more, sit less. Aim for at least 150 minutes of moderate-intensity physical activity per week. You gain even more benefits by being active for 300 minutes per week. Moderate-intensity physical activity does not have to mean going for a jog. Pickleball, dancing, gardening, water aerobics, or riding a bike are just a few examples of moderate-intensity activity. A good way to tell if you are working at a ‘moderate-intensity’ level during your activity is if your heart rate and work of breathing increase but you are still able to carry on a conversation.
- Eat a healthy diet. A diet that is rich in fruits, vegetables, lean protein, whole grains, nuts, legumes (beans), and seeds will provide your body with the nutrients and vitamins it needs. Minimize saturated and trans fats, processed food, and sugar. Feeding your body a colorful, nutrient packed diet is a small gift you can give yourself every day.
- Maintain a healthy body weight. Moving more and eating a healthy diet will help you maintain a healthy body weight. Overweight and obesity can directly increase the risk of AFib by increasing levels of stress hormones and systemic inflammation. They also increase the incidence of high blood pressure, diabetes, heart disease, and sleep apnea. Each of these health conditions individually increases the risk of developing atrial fibrillation. The presence of obesity or other AFib risk factors not only increases your risk of atrial fibrillation, it also makes atrial fibrillation treatments less effective.
- Don’t smoke or use tobacco products. Smoking or chewing tobacco has toxic effects on the heart and increases the risk of atrial fibrillation. It also increases AFib risk by increasing the risk of diabetes, high blood pressure, heart disease, and COPD. Talk to your healthcare provider if you use tobacco and want to quit. There are many effective smoking cessation aids available.
- Minimize alcohol intake. Alcohol is irritating to the heart and can cause AFib. Drinking more than 1 alcoholic beverage per day for women or 2 drinks per day for men can increase the risk of atrial fibrillation. Binge drinking, which is defined by drinking more than 4 drinks for women or 5 drinks for men on one occasion, is especially detrimental for AFib. In fact, it is estimated that 30-60% of emergency room evaluations for AFib are due to binge drinking.
- Manage your stress. Physical or emotional stress can trigger atrial fibrillation, possibly through its activation of the sympathetic nervous system and subsequent increase in stress hormones and inflammation. Yoga, tai chi, qigong, acupuncture, meditation, and spending time with your social support network can all help relieve stress.
- Get adequate rest. Getting at least 7-8 hours or sleep per night is important to maintaining overall health and can have a positive impact on atrial fibrillation. Sleep quality also matters. Talk to your healthcare provider about sleep apnea if you struggle with insomnia, awaken frequently, snore, or wake up feeling tired. Untreated sleep apnea increases the risk of Afib and makes AFib treatments less effective.
Which drug is commonly used to treat atrial fibrillation?
Common atrial fibrillation medications can be broken up into two main categories: drugs used to control heart rate and drugs aimed at maintaining a normal heart rhythm, also known as antiarrhythmics. In addition to treatment of the abnormal heart rhythm, stroke prevention is an important part of the treatment plan for people with atrial fibrillation treatment. Anticoagulation (blood thinner medications) or procedures are usually used to address stroke prevention. Drugs commonly used to treat the irregular heartbeat that is atrial fibrillation include:
Rate control medications. In addition to causing an irregular heartbeat, atrial fibrillation often makes the heart beat too fast. AFib symptoms, like palpitations, shortness of breath, chest pain, fatigue, weakness, and dizziness, are directly or indirectly related to the heart beating too fast. In addition, this elevated heart rate can cause or aggravate other heart conditions, like heart failure.
Beta-blockers and calcium channel blockers (i.e. diltiazem and verapamil) are the most commonly used medications for controlling the often fast heart rate that is seen with AFib. Digoxin is another option for controlling heart rate but its use is significantly less common than beta-blockers or calcium channel blockers. Some people have better heart rate control with calcium channel blockers than beta-blockers, and vice versa. Therefore, if your heart rate is not controlled with one class (i.e. beta-blockers) your provider may try a medication in the other class (i.e. calcium channel blockers).
In addition, both medication classes have certain benefits that may influence which one your doctor recommends. For example, if you have had a heart attack or have heart failure, beta-blockers are preferred over calcium channel blockers. Or, if you are an athlete, your doctor may start with a calcium channel blocker because there tends to be less exercise intolerance with these medications compared to beta-blockers.
Rhythm control. Rhythm control can be achieved using medications or atrial fibrillation procedures, such as an AFib ablation. Regardless of method, the goal of rhythm control is to maintain a normal heart rhythm and prevent an atrial flutter or atrial fibrillation attack. Rhythm control is recommended if you have atrial fibrillation and has been shown to be superior to rate control alone. An exception to this is if you have permanent or chronic atrial fibrillation for which your doctor has determined that rhythm control is not an option.
Antiarrhythmics are medications used to treat heart-rhythm abnormalities and include:
- Amiodarone
- Dronedarone
- Flecainide
- Propafenone
- Dofetilide
- Sotalol
Many of these medications also have some rate controlling properties.
What is the best beta-blocker for atrial fibrillation?
Beta-blockers are commonly used to assist with rate control in atrial fibrillation. Beta-receptors are located throughout the body and are central to the regulation of cardiac function. They allow interaction between the sympathetic nervous system and various organs and are imperative for our survival.
Beta-blockers are medications that block the ability of hormones, like adrenaline, from attaching to receptors which blocks their effects. For example, when adrenaline attaches to beta receptors in the heart one effect is for the heart rate to increase so a beta-blocker blocks this action and thus, keeps the heart rate low.
There are two main types of beta-blockers: selective and non-selective. Selective beta-blockers only target beta receptors in the heart and are frequently used in AFib treatment. Examples of selective beta-blockers that are very effective at lowering heart rate are: Metoprolol, bisoprolol (Zabeta), nebivolol (Bystolic), and atenolol.
What is a natural alternative to beta-blockers?
Beta-blockers help keep the heart rate low by blocking the effects of stress hormones. Stress management can help decrease the secretion of stress hormones and could be considered a natural alternative to beta-blockers. Yoga, qigong, tai chi, biofeedback, and meditation can all help reduce stress and lower blood pressure. Studies have found promising results in regards to their utility in AFib treatment.
Another natural alternative for AFib treatment that has shown promise in research is cardiac specific acupuncture. Multiple, albeit small, studies have shown that specific acupuncture techniques are effective at helping the heart revert to a normal rhythm.
There are supplements and herbal remedies that can have antiarrhythmic or rate controlling properties such as hawthorn, barberry, Shensongyangxin, motherwort, and Wenxin Keli. There have been studies evaluating these substances but they have shown mixed results. Another concern with many of these supplements/remedies is the potential for interactions with atrial fibrillation medications and therefore are not generally recommended.
Contact us if you have atrial fibrillation and are seeking alternatives to long-term medication. Our team will work with you to develop a personalized atrial fibrillation treatment plan to help minimize the impact of atrial fibrillation on your life.
