How are cardiac arrhythmias treated?

Cardiac arrhythmias, or cardiac rhythm disturbances, may be treated with medications that help restore heartbeat to normal rhythm as a first step. In some circumstances, that medication regimen may also include blood thinners to prevent blood clots from forming in the heart.

Additionally, it's possible that the doctor may try to “shock” the heart out of the abnormal rhythm. This is called a cardioversion, and it is a procedure where medication would be given so that no pain or awareness would be experienced during the short procedure.

If medications or cardioversion cannot maintain a normal heart rhythm, the doctor may recommend a treatment such as a pacemaker, an ablation or a combination of therapies. An ablation is when an electrophysiologist attempts to disrupt, or ablate, the abnormal electrical signals and allow the heart to use the normal pathways instead. This procedure can take several hours but is performed through a blood vessel in the groin with special instruments and devices and does not require heart surgery.

When these less invasive methods are not working, or if doctors feel like the heart might not respond to them, surgery may be recommended.

Surgery for atrial rhythm problems is called the Maze procedure. This is similar to the ablation, but uses different ways to disrupt the abnormal electrical channels. One way is to cut them, freeze them or even make small burns to create scars over the abnormal areas so that the heart will use the normal electrical pathways instead. Doing this requires direct vision of the heart, and therefore a surgical incision is made on the chest cavity. Sometimes cameras are used to allow smaller incisions.

In people who have atrial fibrillation in addition to other forms of heart disease, the Maze procedure is frequently performed along with other open heart surgical procedures, such as mitral valve repair or replacement.

This content originally appeared online in "The Patient Guide to Heart, Lung, and Esophageal Surgery" from the Society of Thoracic Surgery.

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