These clots may become dislodged, traveling to the brain or other organs. Slowing the heart rate can be achieved by using heart rate controlling drugs such as beta-blockers, calcium channel blockers or digoxin, alone or in combination. Anticoagulation to reduce the risk of stroke has been shown to be best using warfarin. Aspirin is not as effective as warfarin but is often used in patients with contraindications to warfarin. The decision to try to convert the heart rhythm to normal must be individualized.
Antiarrhythmic drugs can be expensive and side effects are frequent.
In patients that have heart rates that are difficult to control or experience side effects to the medicine, catheter ablation of the electric connection between the atria and ventricles with pacemaker placement may be an option. Newer therapies for atrial fibrillation include small implantable atrial defibrillators which continuously monitor the heart rhythm for atrial fibrillation and, when detected, deliver a small shock to convert the heart rhythm to normal.