Appointments

800.659.7822

Request an Appointment

Questions

800.659.7822

Contact us with Questions

Expand Content

Arrhythmia Treatments

Arrhythmia treatment depends on the type and severity of the arrhythmia. In some cases of arrhythmia, no treatment is necessary. Treatment options include: medications, lifestyle changes, invasive therapies, electrical devices or surgery.

A variety of drugs are available to treat arrhythmias. Because everyone is different, it may take trials of several medications and doses to find the one that works best for you. Several types of drugs are used:

  • Anti-arrhythmic drugs – drugs used to convert the arrhythmia to sinus rhythm (normal rhythm) or to prevent an arrhythmia.
  • Heart-rate control drugs – drugs used to control the heart-rate.
  • Anticoagulant or antiplatelet therapy – drugs, such as warfarin (a "blood-thinner") or aspirin, which reduce the risk of clots forming or strokes.
  • Medications used to treat related conditions that may be causing an abnormal heart rhythm.

It is important to know:

  • The names of your medications.
  • What they are for.
  • How often and at what times to take them.

Arrhythmias may be related to certain lifestyle factors. Here are some ways to change these arrhythmia risk factors:

  • If you smoke, stop.
  • Limit your intake of alcohol.
  • Limit or stop using caffeine. Some people are sensitive to caffeine and may notice more symptoms when using caffeinated products (such as tea, coffee, colas and some over-the-counter medications).
  • Avoid ingestion of stimulants. Beware of stimulants used in cough and cold medications and herbal or nutritional supplements. Some such medications contain ingredients that promote irregular heart rhythms. Read the label and ask your doctor or pharmacist what medication would be best for you.
  • Control high blood pressure.
  • If you are obese or overweight, achieve a desirable weight to decrease risk for arrhythmias such as atrial fibrillation.
  • Control blood sugar levels.
  • Treat sleep apnea; treatment may decrease your risk for arrhythmia.
  • If you notice that your irregular heart rhythm occurs more often with certain activities, you should avoid them.
  • Your family may also want to be involved in your care by learning to recognize your symptoms and how to start CPR if needed.

Electrical cardioversion and catheter ablation are invasive therapies used to treat or eliminate irregular heart rhythms. Your doctor will determine the best treatment for you and discuss the benefits and risks of these therapies with you.

Electrical cardioversion

In patients with persistent past or irregular arrhythmias (such as atrial fibrillation), a normal rhythm may not be achieved with drug therapy alone. Cardioversion is performed by the doctor in a special procedure room. After administration of a short-acting anesthesia, an electrical impulse is delivered through your chest wall that synchronizes the heart and allows the normal rhythm to restart.

Surgical treatment of atrial fibrillation
Catheter ablation

During an ablation, high-frequency electrical energy is delivered through a catheter to a small area of tissue inside of the heart that causes the abnormal heart rhythm. This energy "disconnects" the pathway of the abnormal rhythm. Ablation can be used to treat most SVTs, atrial flutter, and some atrial and ventricular tachycardias. It can also be used to disconnect the electrical pathway between the atria and the ventricles, which may be useful in people with atrial fibrillation. Ablation may be combined with other procedures to achieve optimal treatment.

Pulmonary vein isolation

In patients with frequent, paroxysmal or persistent atrial fibrillation, isolation of the pulmonary veins is a type of ablation that targets areas thought to cause atrial fibrillation. The goal is to create rings of scar that isolate the foci responsible for triggering atrial fibrillation.

These devices are inserted by a cardiologist during a procedure in the electrophysiology lab.

Treatments for Arrhythmias - Permanent Pacemaker
Permanent pacemaker

A device that sends small electrical impulses to the heart muscle to maintain a normal heart rate. The pacemaker has a pulse generator (which houses a batter and a tiny computer) and leads (wires) that send impulses from the pulse generator to the heart muscle, as well as sense the heart's electrical activity. Pacemakers are mostly used to prevent the heart from beating too slowly.


Implantable cardioverter-defibrillator (ICD)

A sophisticated device used primarily to treat ventricular tachycardia and ventricular fibrillation, two life-threatening heart rhythms. The ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again. There are several ways the ICD can be used to restore normal heart rhythm:

  • Anti-tachycardia pacing (ATP) – when the heart beats too fast, a series of small electrical impulses may be delivered to the heart muscle to restore a normal heart rate and rhythm.
  • Cardioversion/Defibrillation – when the heart is beating dangerously fast or irregularly, a shock may be delivered to the heart muscle to restore a normal rhythm.
  • Anti-bradycardia pacing – most ICD’s provide back-up pacing to prevent too slow of a heart rhythm.

Biventricular (B-V) pacemakers and defibrillators (also called cardiac resynchronization therapy or CRT)

Biventricular pacemakers and defibrillators are used in patients with heart failure who also have evidence of an uncoordinated or asynchronous contraction of the left ventricle. These devices help to synchronize the contraction of the left ventricle. In addition to the one or two leads used by traditional pacemakers and defibrillators that are placed in the right ventricle and right atrium, bi-ventricular devices utilize an additional lead placed on the back or left side of the left ventricle. To reach this area, the additional lead is typically guided through the coronary sinus, a small vein on the back of the heart.

Patients may require heart surgery for three reasons when treating an arrthythmia:

  • A patient may need heart surgery to treat heart disease that may be causing the arrhythmia (see valve surgery or coronary artery bypass surgery).
  • The Maze and modified Maze procedures are two surgeries used to correct atrial fibrillation not controlled with medications or non-surgical treatment methods. It is often used when other types of heart surgery such as valve surgery are planned, but in some cases can be performed on its own.
  • In some cases, biventricular pacemaker leads may be placed on the heart using minimally invasive or endoscopic techniques.

Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.

Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice,  please review our Miller Family Heart and Vascular Institute Outcomes

Cleveland Clinic Heart and Vascular Institute Cardiologists and Surgeons

Choosing a doctor to treat your abnormal heart rhythm depends on where you are in your diagnosis and treatment.  The following Heart and Vascular Institute Sections and Departments treat patients with Arrhythmias:

The Heart and Vascular Institute also has specialized centers to treat certain populations of patients:

For younger patients with abnormal heart rhythms:

See: About Us to learn more about the Sydell and Arnold Miller Family Heart & Vascular Institute.

Contact

If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

Becoming a Patient

Abnormal Heart Rhythm Conditions

Treatment Guides

Diagnostic Tests

Diagnostic tests are used to diagnose your abnormal heartbeat and the most effective treatment method.

Anatomy

Webchats

Our webchats and video chats give patients and visitors another opportunity to ask questions and interact with our physicians.

View a calendar of events and register for future chats. Check the calendar for topics that interest you!

Videos

Interactive Tools

Resource Links


Why choose Cleveland Clinic for your care?

Our outcomes speak for themselves. Please review our facts and figures and if you have any questions don’t hesitate to ask.

Download

This information is about procedures and may include instructions specific to Cleveland Clinic. Please consult your physician for information pertaining to your specific procedure.

Reviewed: 05/15


Talk to a Nurse: Mon. - Fri., 8:30 a.m. - 4 p.m. (ET)

Call a Heart & Vascular Nurse locally 216.445.9288 or toll-free 866.289.6911.

Schedule an Appointment

Toll-free 800.659.7822

This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

© Copyright 2015 Cleveland Clinic. All rights reserved.