Treatments for Heart Rhythm Disorders

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The heart usually beats in a steady, predictable rhythm. If your heartbeat is occasionally (or often) irregular, you may have a heart rhythm disorder. Healthcare providers also use the term “arrhythmia” to describe irregular heart rhythms.

Because the heart supplies blood and oxygen to the rest of the body, an irregular heartbeat can affect your overall health. Doctors carefully assess and monitor people with heart rhythm disorder symptoms, such as a fluttering sensation in the chest; notably fast, slow or irregular heartbeat; chest pain; or shortness of breath. Some heart rhythm disorders don’t have any noticeable symptoms.

Common heart rhythm disorders include:

  • Atrial fibrillation: a condition in which the top chambers of the heart—the atria—contract rapidly and ineffectively
  • Sick sinus syndrome: a condition marked by inconsistent functioning of the heart’s natural pacemaker, the sinus node
  • Bigeminy: a heart rhythm in which one normal beat is followed by a premature beat
  • Ventricular tachycardia and fibrillation: two life-threatening arrhythmias that require immediate treatment.

There are a variety of treatments available for heart rhythm disorders.

Medication for heart rhythm disorders

Many heart rhythm disorders can be managed with medication. Doctors use a variety of prescription medications to treat arrhythmias, including:

  • Antiarrhythmic drugs. Some medications are specifically designed to alter the activity of the heart. In an emergency, healthcare professionals may administer antiarrhythmic drugs intravenously, to quickly get the medication into the bloodstream. Oral antiarrhythmic drugs can be taken daily to control some irregular heart rhythms.
  • Anticoagulants (“blood thinners”). Some heart rhythm disorders, specifically atrial fibrillation, increase the risk of stroke and blood clots. That’s because blood can stagnate in the upper chambers of the heart when they contract inefficiently. Blood that remains in one place may clot, and a good contraction of the heart muscle could throw a blood clot into circulation, increasing the risk that it might lodge in a blood vessel. Blood-thinning medication decreases the likelihood of blood clot formation and stroke.
  • Calcium channel blockers. Often used to treat high blood pressure, calcium channel blockers can also treat some arrhythmias.
  • Beta blockers. These medications slow the heart rate and may lower blood pressure.

Cardioversion

If you have persistent atrial flutter or atrial fibrillation, and medication hasn’t been effective in converting your heartbeat back to a healthy rhythm, your doctor may recommend electrical cardioversion, a non-invasive medical procedure that shocks your heart back to a normal rhythm.

Patients are given anesthesia before cardioversion, so they won’t feel the shock. Cardioversion is performed in a hospital or medical clinic, with healthcare professionals monitoring the patient throughout the procedure.

Some patients will need to take antiarrhythmic medication after cardioversion. Others will not.

Catheter ablation

Normally, the sinus node controls the rhythm of the heart; it sends the electrical signal that “tells” the heart muscle cells to contract. Occasionally, another area of the heart will also send out abnormal electrical signals. If medication cannot control an abnormal heart disorder, doctors may recommend catheter ablation, a procedure that uses electrical or laser energy to disrupt the part of the heart that’s sending abnormal signals so the heart’s natural pacemaker can do its work without interference.

Catheter ablation is usually used to treat a condition called supraventricular tachycardia (SVT); it’s also used to treat atrial flutter and fibrillation.

A catheter ablation takes 2 to 4 hours and is performed by specialized doctors who access the heart via a large vein in the groin. (Patients are given numbing medication first). After the procedure, the patient must remain still for a few hours. Nurses will monitor that patient throughout recovery.

Pacemakers and implantable cardioverter defibrillators (ICDs)

Some particularly persistent and dangerous heart rhythm disorders are best treated with an implanted pacemaker or cardioverter defibrillator.

Pacemakers may be used to treat bradycardia, a condition in which the heart beats too slowly. The electrical pacemaker takes over for the heart’s natural pacemaker when needed to keep the heart beating efficiently.

ICDs can detect abnormal heart rhythms and intervene by shocking the heart back to a normal rhythm. According to the American Heart Association, ICDs “are 99% effective in stopping life-threatening abnormal heart rhythms and are the most successful option to treat ventricular fibrillation.”

Discuss your heart rhythm disorder treatment options with your healthcare provider.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Apr 7
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