There is plenty of debate as to whether Viagra (sildenafil citrate) can be used to treat atrial fibrillation (AF). In this article, we’ll explore the effects of Viagra on AF, how much benefit patients might gain from its use, and the side effects that patients might experience.
What Is Atrial Fibrillation?
Atrial fibrillation is an irregular heartbeat that causes the upper chambers of the heart to quiver. It’s most common in older adults and persons with cardiovascular disease (CVD), and it can be quite stressful for those who experience it. While there is no specific cure for AF, there are various treatments that can help improve the condition.
Older adults who experience AF more frequently are at an increased risk of stroke, heart failure, and death. Untreated AF can lead to complications such as brain damage, dementia, or even death. (1, 2)
Viagra And Atrial Fibrillation
While Viagra is commonly associated with increasing blood pressure and heart rate, evidence suggests that it actually has a suppressive effect on the heart. In one study, 11 out of 24 patients with AF experienced a significant reduction in AF symptoms while taking Viagra. Specifically, 8 out of 24 patients (33%) experienced a 60% or greater reduction in AF symptoms. In addition, there was a greater than 30% reduction in the average number of AF episodes per week in 12 of 24 patients (50%). (3)
Despite these promising results, there is still significant evidence that Viagra is not effective for treating AF. In a multicenter, double-blind trial, 132 patients with AF were randomized to receive either Viagra or a placebo. The results of this trial did not meet its primary end point, and there were no significant differences in the secondary end points, including quality of life measures. (4)
Why Does Viagra Not Affect Atrial Fibrillation?
There are several reasons why Viagra might not be effective for treating AF. First, the dosing regimens and treatment duration used in most of the above studies were suboptimal. Second, many of the patients in these studies had already experienced benefits from other therapies, such as beta blockers, anticoagulants, and calcium channel blockers (CCBs). These agents are more commonly used to treat AF, so it’s possible that some of the patients in these studies were already quite well controlled when they were started on Viagra. (5)
Third, there is the possibility that Viagra does not alter the natural history of AF. In other words, it’s possible that AF will remain controlled even if treatment is stopped after several months of therapy. Fourth, there is a chance that Viagra might aggravate existing cardiovascular disease. Finally, the placebo effect in these studies was quite high, so it’s possible that the patients experienced some psychological benefits from taking the placebo, not realizing that they were actually receiving treatment. (6)
Viagra Side Effects
Side effects are one of the main considerations when contemplating the use of Viagra for treating AF. Fortunately, most of the side effects associated with Viagra are mild and transient. The most common side effect is headaches, which appear in about 30% of patients taking the medication. Other side effects include flushing, tingling, visual disturbances, or dizziness. (5)
The side effects associated with Viagra are generally considered mild and tolerable. However, patients taking higher doses for longer durations might experience more serious side effects. These effects include changes in sexual function, low blood pressure, muscle pain, or nosebleeds. (5)
Does Viagra Affect Other Cardiac Conditions?
There is some evidence that Viagra might be effective for treating other cardiac conditions. In particular, it has been shown to be beneficial for patients with cardiac hypertrophy who also experience erectile dysfunction. In this case, an initial trial of Viagra at a low dose might be beneficial in terms of cardiac hypertrophy, with an eventual increase in dose necessary to achieve maximum therapeutic effect. (7)
In another small study, 12 out of 19 patients (63%) with hypertrophic cardiomyopathy (HCM) experienced a significant improvement in their symptoms while taking Viagra. Specifically, 8 out of 19 patients (42%) experienced a greater than 50% reduction in the number of exercise-induced angina attacks per week. (8)
Unfortunately, the evidence that Viagra is beneficial for treating HCM is still relatively weak. For instance, there is no high-quality, randomized controlled trial that specifically examines the effects of Viagra on HCM. In addition, many of the studies that do exist have fairly low patient numbers, and the dosing regimens and treatment duration used in these studies were suboptimal. More research is needed to determine whether or not Viagra can be used to treat HCM.
Should You Try Viagra To Treat Atrial Fibrillation?
Trying Viagra to treat atrial fibrillation is a questionable strategy, if you are seeking a medical therapy for this condition. First of all, it’s important to note that, as we mentioned above, the majority of the studies that examine the effects of Viagra on AF do not show any significant therapeutic benefit. In addition, the safety and tolerability of Viagra are quite poor, and there are risks associated with using this medication, especially at higher doses. (5)
On the other hand, there are alternative treatments for AF that have been shown to be both effective and safe. For instance, catheter ablation and pacemakers are two commonly used devices that are quite effective at restoring and maintaining normal sinus rhythm. (9)
Based on the evidence available, it’s unlikely that Viagra will be of any benefit to patients with AF. For this reason, it is a poor choice to use this medication in an attempt to treat or prevent this condition. Instead, physicians should choose medications that have been specifically shown to improve the symptoms of AF, such as beta blockers, CCBs, and anticoagulants. In addition, there is some evidence that Viagra might even be harmful to persons with HF, so it’s best to avoid using this medication in patients with this condition. (5)
In summary, Viagra might not be effective for treating atrial fibrillation, but it might be beneficial for certain subpopulations of patients with this condition. Physicians should try to identify the cause of the patient’s AF and then choose an appropriate medication based on the characteristics of the patient’s heart disease. Most importantly, physicians should try to keep their patients well-informed about the risks associated with the use of any medication, including Viagra. (10)