Medicines used to treat atrial fibrillation work in different ways.

Slow the Heart Rate
Medications, such as beta-blockers and calcium-channel blockers are used to control the ventricular rate while the patient is in atrial fibrillation. The goal is to keep the heart from becoming overtaxed. Medications are effective 30 - 60% of the time, but over time may lose effectiveness. You may need to try several medications before your physician finds the best one.

Restore Normal Heart Rhythm
To restore normal heart rhythm, a drug called an antiarrhythmic may be prescribed. Because of the side effects of antiarrhythmic medications, they are not suitable for all patients. Over the long term, the majority of patients on antiarrhythmia therapy will eventually fail to remain in normal sinus rhythm on any drug.

Prevent Blood Clots
“Blood thinners” or anticoagulants are used to reduce the risk of blood clot formation. If clots form in the heart, they can break loose and cause a stroke. Blood thinning medications have no effect on heart rhythm. The main blood thinning medication used is Coumadin (warfarin), but a group of ‘novel’ agents are also available - Xarelto, Pradaxa, or Eliquis. Coumadin remains the main stay of therapy for several reasons. Generally, it is more economical; practitioners can regulate and reverse its effects, and it’s widely covered by insurances and Medicare.