After electrical cardioversion, anti-arrhythmics often are prescribed to help prevent future episodes of atrial fibrillation. Commonly used medications include amiodarone (Cordarone, Pacerone), propafenone (Rythmol), procainamide (Procanbid) and dofetilide (Tikosyn). Although these drugs can help maintain sinus rhythm in many people, they can cause side effects, such as nausea, dizziness and fatigue. In rare instances, they may cause ventricular arrhythmias — life-threatening rhythm disturbances originating in the heart's lower chambers. These medications may be needed indefinitely. Unfortunately, even with medications, the chance of another episode of atrial fibrillation is high.

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