Treating Arrhythmia

Written by the Healthline Editorial Team | Published on July 7, 2014
Medically Reviewed by Kenneth R. Hirsch, MD on July 7, 2014

Treating Arrhythmia

If your doctor thinks your arrhythmia is clinically significant, he or she will prescribe a treatment plan. The goal of treatment is to reduce your symptoms and decrease the risk of the condition becoming worse or more dangerous.

Many arrhythmias are considered harmless and do not require treatment. If you do need treatment, the least invasive treatment that also corrects the condition is preferred. Here are a few possible treatments to control arrhythmias:

Lifestyle Changes

Various factors, such as diet, exercise, lifestyle habits, and pre-existing medical conditions, can contribute to a person developing arrhythmia. The following lifestyle changes might improve your condition:

  • quit smoking
  • reduce your consumption of alcohol, caffeine, and other drugs, including many over-the-counter cold remedies
  • talk to your doctor about changing the medications you take
  • lose any excess weight
  • exercise regularly
  • get plenty of sleep
  • eat a balanced diet
  • keep your diabetes and blood pressure under control
  • stay hydrated and keep your electrolytes in balance

Medications

If lifestyle changes aren’t enough, your doctor may prescribe one of the following medications for your arrhythmia:

Antiarrhythmic Drugs

Antiarrhythmic drugs can treat both symptomatic tachycardia (rapid heartbeat) and premature heartbeats. They suppress abnormal electrical impulses or slow down the transmission of these impulses.

These meds can be delivered intravenously or taken orally. In many cases, they are needed daily and indefinitely, especially for long-term care and treatment of the condition.

Some commonly prescribed antiarrhythmic drugs include:

  • amiodarone (Cordarone, Pacerone)
  • disopyramide (Norpace)
  • dronedarone (Multaq)
  • flecainide (Tambocor)
  • propafenone (Rythmol)
  • tocainide (Tonocarid)

A potential side effect of this class of medication is proarrhythmia: the development of new arrhythmias or recurrence of preexisting arrhythmias. Certain types of antiarrhythmic drugs are more likely to induce other arrhythmias, but all of them have this proarrhythmic potential. These new arrhythmias can make treatment more difficult. In some cases, the new arrhythmias may be worse than the one you’re trying to treat with the medicine.

Calcium Channel Blockers

Calcium channel blockers, or “calcium antagonists,” help slow a rapid heart rate. Calcium channel blockers are also prescribed for the treatment of high blood pressure and angina (chest pain).

Some calcium channel blockers commonly prescribed for arrhythmia include:

  • diltiazem (Cardizem, Cartia, Dilacor, Diltia, Tiazac)
  • verapamil (Calan, Covera, Isoptin, Verelan)

Calcium channel blockers prescribed for high blood pressure include:

  • amlodipine (Norvasc)
  • nicardipine (Cardene)

Beta Blockers>

Beta blockers slow the heart rate and cardiac output of patients with atrial fibrillation. These medicines also lower blood pressure by reducing the effects of adrenaline on the body.

Some commonly prescribed beta blockers include:

  • atenolol (Tenormin)
  • metoprolol (Lopressor, Toprol)
  • carvedilol (Coreg)
  • propranolol (Inderal)

Anticoagulants

Anticoagulants and blood thinners make it more difficult for blood to clot (coagulate). They do not dissolve existing blood clots. They can prevent new clots from forming, and existing clots from becoming larger. This is important because blood clots can break loose and travel through the body to the brain, where they can block blood flow. This may cause a stroke, which might leave portions of the brain damaged or destroyed.

People with atrial fibrillation are often prescribed anticoagulants or blood thinners because they have an elevated risk of developing clots. When the atria quiver chaotically, blood can pool in the atria instead of flowing into the ventricles. Blood that sits can form clots.

Some commonly prescribed anticoagulants and blood thinners include:

  • aspirin
  • heparin
  • warfarin (Coumadin)

Medication to Treat Related Conditions

If you have high blood pressure, coronary artery disease, heart failure, or any condition that puts you at greater risk for arrhythmia, your doctor may prescribe a medicine to treat this underlying cause.

Noninvasive Treatments

Vagal Maneuvers

Some episodes of arrhythmia can be stopped by certain actions called vagal maneuvers. These include holding your breath, straining, coughing, or putting your face in ice water. These maneuvers affect the vagus nerve and can cause your heart rate to slow.

Cardioversion

If your arrhythmia begins in the upper half of your heart (the atria) and includes fibrillating (quivering), your doctor may use cardioversion. This is an electric shock treatment that resets your heart’s rhythm. This treatment is noninvasive and relatively painless. You may be given a sedative to help you relax.

Invasive Treatments

Cardiac Ablation

A thin, flexible tube (called a catheter) is directed into your heart through your arm, groin, or neck with the help of a special X-ray. Once there, the catheter delivers a burst of energy that destroys very small areas of tissue and muscle where your doctor believes your arrhythmia begins. This creates a block in the pathway that is causing the arrhythmia.

Pacemaker

Pacemakers regulate bradycardias (slow heart rates). These battery-powered devices are placed under the skin of the chest or abdomen. Some pacemakers work continuously to ensure your heart beats at a normal rate. Others monitor your heart rate and turn on only if your heart rate slows too much.

Implanted Cardioverter Defibrillators (ICDs)

These devices are highly effective at stopping life-threatening arrhythmias such as atrial fibrillation with rapid heart rate, ventricular tachycardia, or ventricular fibrillation. ICDs continuously monitor your heart rate. If it dips too low, the ICD acts as a pacemaker to restore a normal, healthy rhythm. If your heart rate goes too fast, it sends out shocks of energy to reset the natural rhythm.

Surgery

Surgery can treat underlying causes of arrhythmia, such as coronary artery disease and some types of heart failure. If a doctor is performing a surgery for one of these conditions, he or she might also do something called the maze procedure—making small cuts or burns in the atria. These wounds heal to form scar tissue that creates boundaries to direct the flow of electrical impulses.

If the cause of your arrhythmia is an aneurysm (a bulge in a blood vessel) in or near your heart, a ventricular aneurysm surgery can remove the aneurysm.

If your coronary artery disease is in an advanced stage and you have frequent ventricular tachycardia—a very life-threatening arrhythmia—you may undergo coronary bypass surgery. This surgery uses veins or arteries from other parts of your body to “bypass” veins and arteries in the heart that are narrow or clogged. This will improve your heart’s blood supply and reduce the frequency of arrhythmias.

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