Treatment for arrhythmia is only required if the condition is putting the patient at risk of a more serious arrhythmia or a complication, or if the symptoms are very severe.
A doctor may recommend a pacemaker to treat bradycardia. If bradycardia is caused by an underlying condition, that condition needs to be treated first. If no underlying problem is found, the doctor may advise implanting a pacemaker. A pacemaker is a small device that is placed under the skin of the chest or abdomen to help control abnormal heart rhythms. Pacemakers use electrical pulses to prompt the heart to beat at a normal minimum rate.
There are several different treatments for tachycardia:
Certain movements that the patient can do themselves might stop some types of arrhythmia that start above the lower half of the heart.
These will not cure the patient, but are usually effective in reducing episodes of tachycardia and can help with proper electrical conduction of the heart.
The doctor may use an electric shock or medication to reset the heart to its regular rhythm.
One or more catheters go through blood vessels into the inner heart. They are placed in areas of the heart that are thought to be the source of the arrhythmia and destroy small sections of those tissues.
The device is implanted near the left collarbone and monitors heart rhythm; if it detects an abnormally fast rhythm, it stimulates the heart to return to a normal rhythm.
A series of surgical incisions are made in the heart. They then heal into scars and form blocks. These blocks guide the electrical impulses, helping the heart to beat efficiently.
Sometimes, an aneurysm (bulge) in a blood vessel that leads to the heart causes an arrhythmia. If other treatments do not work, a surgeon may remove the aneurysm.
Arteries or veins from elsewhere in the patient's body are grafted to the coronary arteries to bypass any regions that have become narrow, and improve the blood supply to the heart muscle (myocardium).
The strategy you and your doctor choose depends on many factors, including whether you have other problems with your heart and if you're able to take medications that can control your heart rhythm. In some cases, you may need a more invasive treatment, such as medical procedures using catheters or surgery.
In some people, a specific event or an underlying condition, such as a thyroid disorder, may trigger atrial fibrillation. Treating the condition causing atrial fibrillation may help relieve your heart rhythm problems. If your symptoms are bothersome or if this is your first episode of atrial fibrillation, your doctor may attempt to reset the rhythm.
Ideally, to treat atrial fibrillation, the heart rate and rhythm are reset to normal. To correct your condition, doctors may be able to reset your heart to its regular rhythm (sinus rhythm) using a procedure called cardioversion, depending on the underlying cause of atrial fibrillation and how long you've had it.
Cardioversion can be done in two ways:
In this brief procedure, an electrical shock is delivered to your heart through paddles or patches placed on your chest. The shock stops your heart's electrical activity for a short moment. The goal is to reset your heart's normal rhythm. You will be given a sedative before the procedure, so you shouldn't feel the electric shock. You may also receive medications to help restore a normal heartbeat (anti-arrhythmics) before the procedure.
This form of cardioversion uses medications called anti-arrhythmics to help restore normal sinus rhythm. Depending on your heart condition, you may receive medications through an IV or by mouth to help return your heart to normal rhythm.
This is often done in the hospital with continuous monitoring of your heart rate. If your heart rhythm returns to normal, your doctor often will prescribe the same anti-arrhythmic medication or a similar one to try to prevent more spells of atrial fibrillation.
Before cardioversion, you may be given warfarin or another blood-thinning medication for several weeks to reduce the risk of blood clots and strokes. If your episode of atrial fibrillation lasted more than 48 hours, you may need to take this type of medication for at least a month after the procedure to prevent blood clots in the heart.
After electrical cardioversion, your doctor may prescribe anti-arrhythmic medications to help prevent future episodes of atrial fibrillation. Medications may include:
Although these drugs may help maintain a normal heart rhythm, they can cause side effects, including:
Rarely, they may cause ventricular arrhythmias — life-threatening rhythm disturbances originating in the heart's lower chambers. These medications may be needed indefinitely. Even with medications, there is a chance of another episode of atrial fibrillation.
Eliminating common PVC triggers — such as caffeine or tobacco — can decrease the frequency and severity of your symptoms.
Beta blockers — which are often used to treat high blood pressure and heart disease — can suppress premature contractions.
Other medications, such as calcium channel blockers, or anti-arrhythmic drugs, such as amiodarone (Pacerone) or flecainide (Tambocor), also might be used if you have ventricular tachycardia or frequent PVCs that interfere with your heart's function.
For PVCs that don't respond to lifestyle changes or medications, your doctor might recommend ablation therapy. This procedure uses radiofrequency energy to destroy the area of heart tissue that is causing your irregular contractions.