The right treatment for arrhythmias depends on each person’s condition and exact diagnosis. Treatment options range from drug therapy to implantable devices, radiofrequency ablation, and open heart surgery.
Drug therapy is often the first approach taken to treat an arrhythmia. A variety of antiarrhythmic medications are now available. Some medications are well proven for therapy, while others are still under investigation.
For patients with a slow heart rhythm (bradycardia), a pacemaker can often correct the problem. The pacemaker contains a generator the size of a silver dollar that is surgically implanted under the skin in the chest. The pacemaker senses the heart’s rhythm, and when the heart rate is too slow, it sends a small electrical impulse to the heart.
There are many types of pacemakers that pace different chambers of the heart; some even self-adjust for the activity of the person. Pacemakers can be individually adjusted after implantation via radio waves and their function can be assessed through telephone transmission.
Implantable Cardioverter Defibrillator
An Implantable Cardioverter Defibrillator (ICD) is a device implanted in the chest that automatically monitors your heart rate and rhythm. When the heart rate is extremely fast or so abnormal that the heart cannot function, the ICD shocks the heart back to its normal rhythm. The devices need regular check-ups to ensure they are functioning correctly, which can be done by a telephone check.
ICDs may also be required for patients with a low ejection fraction, a low amount of blood pumped from your heart with each heartbeat.
Open Heart Surgery
A patient unresponsive to drug and other therapies may be a candidate for surgical intervention. Physicians can locate and remove the heart tissue causing the abnormal rhythm and alter it to prevent future arrhythmia.
Physicians may also perform “maze” surgery, in which a maze of carefully planned sutures (stitches) can create an electrical conduction route so normal impulses can travel appropriately. Open heart surgery may also be needed to repair a structural problem with the heart (such as a diseased valve or area of muscle) that is causing the arrhythmia.
Radiofrequency ablation, also known as catheter ablation, is a non-surgical procedure in which a catheter with high radiofrequency energy or freezing energy eliminates the additional pathway of electrical impulse that is causing the arrhythmia. The catheter, which contains electrodes at the tip of the wires, is inserted into the body, usually the groin or the neck, and threaded up to the heart. The electrodes send out radio waves that cure the arrhythmia and eliminate the need for life-long medications and their associated side effects.
In addition, Baylor St. Luke’s features the Stereotaxis Gentle Touch™ Magnetic Navigation System, which is among the most advanced technology for treatment of cardiac arrhythmias.
Electrophysiology (EP) is a cardiac specialty that tests electrical activities in the heart to find the cause of your heart rhythm abnormalities—irregular heartbeats or abnormalities that cause the heart to beat too quickly, too slowly, or irregularly— and determine the best treatment for you.
To find the cause of your heart rhythm disturbance, physicians will insert one or more small wires through a vein in the leg or upper extremity leading to the heart. Programmed electrical stimulation then reproduces your arrhythmia to determine the nature and location of the rhythm disturbance.
Based on the findings, your physician may have you try different medications, or recommend a procedure or device to treat your heart rhythm.