Rhythm Control Strategy for Afib

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This treatment strategy can establish and maintain normal heart rhythm. Cardioversion can help achieve normal rhythm, and medications or ablation can help to maintain the rhythm.


There are two types of cardioversion:

Electrical cardioversion: Pads placed over the chest deliver an electrical shock to the chest. The shock causes the electrical impulses to stop and reorganize back into normal rhythm. You receive sedation and anesthesia during this procedure to prevent you from being aware of the shock.

Chemical (drug) cardioversion: Medications are used to restore the heart's normal rhythm.

Maintaining Normal Rhythm

Once your heart resumes its normal rhythm, you will need follow-up treatment to maintain that rhythm. Treatments may include medical therapy with anti-arrhythmic medications or a procedure like catheter ablation, surgical ablation or device implantation.

Medical Therapy

Anti-arrhythmic medications act on heart tissues at a cellular level to stop or prevent atrial fibrillation. These medications can help keep your heart in normal rhythm, and you may need to take them once or several times a day.

Each of the drugs has side effects, but they're usually rare. Side effects may include:

  • Headache
  • Constipation
  • Shortness of breath
  • Possible arrhythmias

For some medications, you'll have to be admitted to the hospital for 48-72 hours to start them. They may require periodic blood tests to monitor the level of the medication in your blood or to monitor kidney, liver or thyroid function.


At UVA, we perform both catheter-based ablation procedures and surgical ablations.