Some arrhythmias may just need periodic monitoring. Others may need lifestyle changes (for example, consuming less alcohol or increasing physical activity), medications, or treatment of another medical condition that is causing the arrhythmia.
Occasionally, a procedure might be performed to treat certain serious arrhythmias if they don’t respond to medications.
The first step in treating atrial fibrillation is to find out other medical conditions that can cause it. These conditions include:
The most common medications used to keep the heart from beating too fast in atrial fibrillation are:
Medications called blood thinners reduce the risk of stroke in people with atrial fibrillation. They include:
The main risk of blood thinners is bleeding. This most often happens from the stomach or bowels, but also in the brain. Bleeding in the brain, or intracranial hemorrhage, is a serious complication.
Using blood thinners for older adults with atrial fibrillation can increase falls that cause intracranial hemorrhage. In most cases, preventing a stroke outweighs the risk of falls-related bleeding in the brain.
Anti-arrhythmic medications can restore the heart’s normal rhythm. However, they have many potentially dangerous side effects. So, people take them only when the atrial fibrillation causes uncomfortable symptoms despite.
Many people with bradycardia do not need treatment. Treatment may be needed if the slow heart rate is causing symptoms, such as fainting spells, dizziness, or shortness of breath.
The first step is to find and treat the cause, which might involve changing medications. Or, adjusting the levels of minerals (such as potassium) in the body.
If the problem continues, a cardiologist might implant an internal electronic pacemaker that sends electrical signals to the heart, to keep it beating at a faster rate.
Ventricular arrhythmias often happen because of other heart conditions, like heart failure (the heart cannot pump enough blood) or a heart attack (blood flow to part of the heart is blocked).
These arrhythmias can cause death. Treatment can include:
Ventricular arrhythmias can lead to ventricular tachycardia or ventricular fibrillation. These are life-threatening emergencies, including loss of consciousness and heart attack.
Immediately stopping the abnormal heart rhythm is needed. Defibrillators can do this. To use a defibrillator, emergency personnel place pads or paddles that deliver an electric shock to the chest. This can help “reset” the heart back into a normal rhythm.
Automated defibrillators are available in many public places and the general public with some training can operate them. Involve emergency personnel and call 911 if activating a defibrillator.
If a defibrillator is not available and the person is unconscious, call 911 and start chest compressions (CPR) immediately. Good chest compressions are critical to keep blood circulating until emergency personnel arrive.
A healthcare professional may recommend implanting a small defibrillator, if the person has periodic life-threatening ventricular arrhythmias, or has a high risk for developing them.
Sometimes arrhythmias cannot be managed with medications or lifestyle changes alone. A number of procedures are performed by cardiologists to treat arrhythmias that might be concerning and do not respond to medications or when the patient is very sick.
This procedure involves a cardiologist inserting a catheter into a blood vessel in the thigh, groin, neck, or elbow, and uses X-rays to guide the catheter through the blood vessel and up into the heart. A wire in the catheter sends out heat or freezing cold and destroys the tissue in the heart that is causing the irregular heartbeat.
The parts of heart tissue that are destroyed are very small, so this procedure does not stop the heart from being able to do its job.
An electric current resets the heart's rhythm back to its normal pattern. It is similar to defibrillation, but the “dose” of electricity delivered to the heart is much lower.
Pacemakers can be used to control arrhythmias and their symptoms, most often those which lower heart rate or block transmission of electric activity from upper to lower chambers.
A pacemaker is a small, flat device inserted just under the skin beneath the collarbone during a minor surgical procedure. Thin wires attached to the pacemaker go through small blood vessels into your heart.
The pacemaker contains a computer chip that sends electrical signals to the heart to control the heartbeat. The pacemaker's computer chip also records the heartbeat’s rate and rhythm.
Analysis of these recordings allows the healthcare provider to check and adjust the pacemaker as needed. Adjustment can happen in the office, over the telephone, or online.
An implantable cardioverter defibrillator may be needed if a person has had a ventricular arrhythmia or is at risk for developing this arrhythmia. An ICD looks similar to a pacemaker but is a little larger. An ICD senses an abnormal heart rhythm and delivers an electrical shock to reset the heart to a normal rhythm.
Some people may need both a pacemaker and an ICD. Many devices combine these in a single unit.
Last Updated February 2023
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