Arrhythmia Treatment Options

There are many kinds of arrhythmia treatments a doctor may recommend.

On this page you'll find information on the following:

Rate Control Medication
Rhythm Control Medication
Non-pharmacological Options

You will want to discuss with your doctor(s) the various treatment options in detail, so you understand the potential benefits and risks, as well as costs and other important factors.

Arrhythmia treatments may include one or more of the following:^1A

• Lifestyle changes
• Medicine to prevent and control arrhythmias and to treat related conditions such as high blood pressure, coronary artery disease and heart failure
• Anticoagulant medication to reduce the risk of blood clots and stroke
• A pacemaker that uses batteries to help your heart beat more regularly
• Cardiac defibrillation and implanted cardioverter defibrillators (ICDs)
• Cardiac ablation
• Surgery

There are many factors your doctor(s) may wish to consider in your treatment plan:^2A

• The nature or cause of the arrhythmia (where it starts in the heart)
• The severity of the arrhythmia
• The severity of your symptoms
• If you have other health problems/medications you take
• Your age, overall health, and personal and family medical history

Cardiac Ablation–a safe and effective arrhythmia treatment option

Cardiac ablation offers new advances in medicine with the potential to reduce or eliminate the arrhythmia and the symptoms.

Learn more about cardiac ablation

Medications a Doctor May Prescribe to Treat Cardiac Arrhythmias, Including Atrial Fibrillation

Heart medications have different effects on the body. Some medications act to slow the rate of the heart. These are called "rate control" medicines. Other medications act to help maintain a normal heart rhythm. These are called "rhythm control" medications or antiarrhythmic drugs.

Antiarrhythmic drugs are being used less, with more care and often in conjunction with implantable cardioverter defibrillators (ICDs) or cardiac ablation [anchor link to cardiac ablation para below], explained further on in this section.⁵ Many of the prescription medications reviewed here are also used to treat other kinds of heart-related conditions, including heart failure, high blood pressure, and angina (chest pain).⁴ The choice of medication used is based on the needs of the individual patient.⁶ In the following information you will learn about some of the medications used to treat arrhythmias and the differences between "rate" and "rhythm" control medicines.

Rate and Rhythm Medications

Rate and rhythm medications are often a first course of action in managing atrial fibrillation. Rate control medications are used to slow the heart rate to less than 100 beats per minute. If rate control doesn't work, then a rhythm control medication may be used to try to restore your heart's normal sinus rhythm. Rhythm control medication is also called "drug cardioversion." If rate control medications are unsuccessful, then rhythm control medications are often used to restore the heart's normal sinus rhythm.

Rate Control Heart Medications

Beta blockers:
Beta-blockers slow heart rate, relax the blood vessels and make it easier for the heart to pump blood.

Examples of Beta blockers³:
Acebutolol (Sectral®),Atenolol (Tenormin®),Carvedilol (Coreg®), Metoprolol (Toprol-XL®, Lopressor®),Sotalol (Betapace®

Calcium Channel Blockers:
Calcium channel blockers are also called "calcium antagonists." These medicines work by interrupting the movement of calcium into heart and blood vessel tissue to slow heart rate.⁴

Examples of Calcium Channel Blockers³:
Diltiazem (Cardizem®, Tiazac®) and Verapamil (Calan®, Covera-HS®, Isoptin®)

Rhythm Control Heart Medications

Sodium Channel Blockers:
Sodium channel blockers slow the electrical conductivity of the heart to improve rhythm problems.⁵

Examples of Sodium Channel Blockers³
Flecainide (TambocorTM), Propafenone (Rythmol®) and Quinidine (Cardioquin®, Quinaglute Dura-Tabs®, Quinidex)

Anticoagulants

Anticoagulant medications help to prevent new clots from forming in the blood or existing clots from getting larger. They are often prescribed for patients with atrial fibrillation to help reduce stroke risk. Aspirin also is often recommended for these patients in addition to or instead of prescription anticoagulants.^4E

Talk to Your Doctor About Possible Medication Side Effects and Risks

All medications have potential side effects and risks. Antiarrhythmic drugs must be taken daily and indefinitely. There are also side effects that can be hard to manage. These side effects may include proarrhythmia. Proarrhythmia means that the drug has caused your arrhythmia to actually get worse or you develop a new arrhythmia as bad or worse than the original problem.^4D

When medication proves unsuccessfull, the American College of Cardiology and the American Heart Association suggest catheter (cardiac) ablation or surgical ablation be considered a safe and effective treatment option.

Non-Pharmacological Options

Devices: Implantable cardioverter defibrillator (ICD): This device is inserted into the patient's chest like a pacemaker. When an episode of fast, irregular heartbeat begins, the device delivers a shock to end the tachycardia, preventing the heart from going into ventricular fibrillation, which is frequently fatal.

Cardioversion: This treatment can be chemical (implemented through fast-acting drugs) or electric (implemented through a direct current using paddles over the chest) and is used to restore the heart's normal rhythm. An electrical cardioversion is performed in a hospital setting such as an emergency room, intensive care unit, recovery room, special procedure room, or Electrophysiology Laboratory. This split-second interruption of the abnormal beat allows the heart's electrical system to regain control and restore a normal heartbeat. This method does not provide a permanent solution to the problem.

Cardiac Ablation: A nonsurgical technique that neutralizes parts of the abnormal electrical pathway (tissue) that is causing the arrhythmia. The technique utilizes a variety of imaging and monitoring systems that navigate flexible wires (catheters) to the heart through an artery or vein, locate the precise location of abnormal electric activity (where ablation is needed), and evaluate their progress.

Once in the heart, one or more catheters are used to pinpoint the source of the abnormal electrical signals. When the source of the arrhythmia is located, the catheter delivers bursts of high-energy waves that eliminates the abnormal areas.

Most patients who receive this treatment experience a long-term reduction in the number of episodes of arrhythmia and the severity of symptoms, or a permanent return to normal heart rhythm.

Learn more about cardiac ablation as a safe and effective treatment for arrhythmias. Click here

Cardiac Surgery

Cardiac surgery is an invasive procedure where surgeons will remove abnormal sites (tissue) in the heart that are causing the arrhythmia.

In comparison, cardiac ablation is the most effective treatment option for a range of common cardiac arrhythmias. Learn more

Locate an Arrhythmia Specialist

Could cardiac ablation be right for you? Speak with a specialist near you to learn more about this safe and effective arrhythmia treatment.

Search for an arrhythmia specialist now

1. American Heart Association. "What Is an Arrhythmia?" Copyright, 2007. [10/07LS1466] (PDF attached.)
2. Heart Rhythm Society. "Treatments." Copyright, 2004. PDF attached.
3. American Heart Association. "Antiarrhythmic Drugs." Available at: http://www.americanheart.org/presenter.jhtml?identifier=153. Copyright, 2009. Accessed 12/3/09
4. American Heart Association. "Arrthythmia Medications." Available at: http://www.americanheart.org/presenter.jhtml?identifier=18 Copyright, 2009. Accessed 12/3/09
5. Homound, Munther K. Introduction to Antiarrhythmic Agents. Tufts-New England Medical Center. Spring 2008. (PDF attached.)
6. JMCP Supplement/pg S11/col 1/para 1/lines 7-9]
7. StopAfib.org Web site. http://www.stopafib.org. Accessed December 11, 2009.
8. Cardiac Ablation Patient Brochure.