Abnormal Heart Rhythms - Treatments

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What is the treatment for heart rhythm disorders?

There is no one treatment for a heart rhythm abnormality. When the patient is unstable, with no pulse or blood pressure, or when they are unconscious, American Heart Association guidelines are available to direct care to hopefully restore the heart rhythm to normal and return a pulse.

For V-fib and V-tach, electricity may be the most important drug, and the heart is shocked back into a heart rhythm, hopefully compatible with life. Other common medications used in crisis situations depend upon the life-threatening rhythm and may include epinephrine (adrenalin), atropine, and amiodarone.

For patients with supraventricular tachycardia (SVT), the goal is not only to slow down the heart rate but also to identify which rhythm is present. Vasovagal maneuvers, like holding one's breath and bearing down as if to have a bowel movement may resolve the situation, or it may slow the rate temporarily to make the diagnosis. Adenosine can be injected and may convert SVT to normal sinus rhythm by slowing the electrical impulse at the AV node. It can also be used as a diagnostic challenge to help identify atrial fibrillation or atrial flutter with rapid ventricular response.

For atrial fibrillation with rapid ventricular response, the initial goal is to slow the rate and maintain normal blood pressure. Calcium channel clockers like diltiazem and beta blockers like metoprolol may be used intravenously to control rate. Digoxin is a second-line mediation that may be helpful when first-line medications fail. In unstable patients, with chest pain, shortness of breath, or decreased consciousness, cardioversion with an electric shock may be required. The decision to electively convert A-fib to normal sinus rhythm depends upon the patient and situation and is often a decision left to the primary care professional. The question regarding anticoagulation also will need to be addressed.

Return to Abnormal Heart Rhythms (Heart Rhythm Disorders)

See what others are saying

Comment from: Newt, 55-64 Male (Patient) Published: May 09

I am a 62 year old male. I have been diagnosed with afib in 2006. In 2008 an ablation was done and the irregular beats subsided. I was told it could return. It did in 2012. I noticed when I get tired the heart starts to beat irregular. It may last anywhere from a few minutes to hours. But the irregular beats are different from the afib.

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Comment from: quizzical, 55-64 Female (Patient) Published: April 02

I have been having disturbing irregular heartbeats for many years. Doctors tell me that this is normal. I don't have other symptoms associated with the episodes, which sometimes go on continuously for days, sometimes only happen a few times in the evening, and some days don't happen at all. My intuition tells me that these irregularities are related to my digestive tract. I cannot determine any definitive relationship to alcohol, caffeine, or decongestants, because I don't have symptoms immediately after ingesting these things, but I suspect there might be a relationship. I had an EKG when the symptoms were not occurring last year. It was considered normal, but the symptoms have continued erratically. I feel that something is wrong. I am thinking about seeking more tests and / or treatment, or wondering if I should just trust that this is "normal.

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