The underlying cause of any heart rhythm disorder provides the basis for selecting the best treatment plan. In general, the best treatment is the least invasive option that effectively controls the heart rhythm disorder. Treatment options fall into several categories from the least to the most invasive and include the following:
- Lifestyle Changes – Since other heart disorders increase the risk of developing abnormal heart rhythms, lifestyle changes often are recommended. Living a “heart healthy” lifestyle can ease the symptoms experienced with heart rhythm disorders and other heart disorders, and can be beneficial to overall patient health.
- Medications– Many abnormal heart rhythms can be controlled with medications or treat related conditions such as high blood pressure, coronary artery disease, heart failure, and heart attack. Medications are also used to reduce the risk of blood clots in patients with certain types of abnormal heart rhythms.
- Electronic Devices – By delivering a controlled electric shock to the heart, defibrillators or cardioverters “shock” the heart back into a normal heart rhythm. Sometimes the devices are external, such as in an emergency situation. Often, the electronics are implanted in the patient’s chest.
- Implanted cardioverter defibrillators (ICDs) – ICDs continuously monitor the heart rhythm, automatically function as pacemakers for heart rates that are too slow, and deliver life-saving shocks if a dangerously fast heart rhythm is detected. These devices are 99 percent effective in stopping life-threatening abnormal heart rhythms and are the most successful option to treat ventricular fibrillation (VF), the major cause of sudden cardiac arrest (SCA).
- Pacemakers – Devices that “pace” the heart rate when it is too slow (bradycardia) can take over for the heart’s natural pacemaker, the sinoatrial node, when it is not working properly. Pacemakers monitor and regulate the rhythm of the heart and send electrical signals to stimulate the heart if it is beating too slowly.
- Devices for Heart Failure – A cardiac resynchronization therapy (CRT) device is a special type of pacemaker for certain patients with heart failure. The implanted device paces both the left and right ventricles (lower chambers) of the heart at the same time. This helps to resynchronize muscle contractions and improve the efficiency of the weakened heart.
- Cardioversion – During this brief procedure, an electrical shock is delivered to the heart to convert an abnormal heart rhythm back to a normal rhythm.
- Catheter Ablation – During this procedure, one or more flexible, thin tubes (catheters) are guided into the blood vessels and to the heart muscle. A burst of energy heats and destroys very small areas of tissue that cause the abnormal electrical signals.
- Surgery – Although surgery is sometimes used to treat abnormal heart rhythms, it is more commonly used to treat other heart problems, such as coronary artery disease and heart failure. Correcting these conditions may reduce the risk of abnormal heart rhythms.
The first step in treating any abnormal heart rhythm to determine the underlying cause of the problem. With that information, patients and their families, together with their doctors, can discuss all of the options while considering the circumstances of each individual case. The following are some things to consider when selecting the most appropriate treatment option:
- What is the nature and severity of the heart rhythm disorder and its symptoms?
- Are there underlying conditions that contribute to the heart rhythm disorder or impact the patient’s health or quality of life?
- How does age, overall health, and personal and family medical history factor into the treatment decision?
- What, if any, medications are being taken to treat any other medical conditions?
- Are there concerns about end-of-life issues?