If you’re elderly, sedentary, or experiencing relatively few symptoms, your doctor may prescribe rate control medications to manage your atrial fibrillation. Rate control slows down your heart rate (the ventricular beats only) by blocking the erratic electrical signals that the atria are generating.
It’s important to note that these medications DO NOT cure or treat atrial fibrillation. In fact, these medications allow afib to continue. By allowing the afib to continue, the heart is overworked over time and that can lead to remodeling and fibrosis which increases the risk of stroke. While these drugs may reduce the severity of the symptoms of atrial fibrillation, they do not address the risk of stroke and death associated with afib.
Anti-arrhythmic drugs, on the other hand, aim to actually stop the atrial fibrillation (not just slow it down like rate control medications do).
The other unfortunate aspect of rate control drugs is that they come with serious side effects including:
- Shortness of breath
- Arrhythmia (irregular heartbeat)
- Loss of sex drive
- Atrial enlargement
Mellanie True Hills, Speaker and CEO of StopAfib.org, wrote an excellent article about the awful side effects of rate control medications and how this drug therapy should be questioned given the alternatives that exist today to treat atrial fibrillation.
There are three types of rate control medications. They are beta-blockers, calcium channel blockers, and cardiac glycosides.
Beta-blockers “block” the effects of adrenaline on your heart. They make the AV Node in the heart less sensitive to the erratic electrical impulses that your afib is generating. These types of rate control meds are usually prescribed to young and/or active people because exercise reduces the effectiveness of the other two types of rate control drugs.
Beta-blockers include: atenolol (Tenormin), metoprolol (Lopressor, Toprol-XL), esmolol HCI (Brevibloc, propranolol), (Inderal), timolol, nadolol, and pindolol and the newer drugs carvedilol (Coreg) and nebivolol (Bystolic).source
Calcium-channel blockers prevent or slow the flow of calcium into the heart. Drugs in this category include: diltiazem (Dilt, Cardizem, Tilazem, Cartia XT) and verapamil (Calan, Isoptin).source
Cardiac glycosides slow down and control the heart rate by blocking the electrical conduction between the atria and ventricles. The most widely prescribed Glycoside is digoxin (a Digitalis compound, brand names Lanoxin, Digitek), but medical authorities consider it the least effective.source
A study in 2013 found that afib patients, “taking the heart drug digoxin were 35% more likely to suffer a cardiovascular-related death and 61% more likely to die due to an arrhythmia (irregular heartbeat) than afib patients not taking digoxin.”source If your doctor recommends you take it, or you are already on it, I would strongly advise you ask your doctor to consider other rate control medications.
Sadly, none of these medications cure afib and as you can see they can have a serious impact on your quality of life. Furthermore, they may put you at greater risk of stroke and premature death over the long-term since they don’t address the afib itself.