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The goals of tachycardia treatment include restoring the heart to normal rhythm, slowing the heart rate and preventing blood clots. Treatment options for tachycardia may include:
Medications
Nonsurgical procedures - atrial fibrillation ablation
Medical devices - implanted pacemaker, defibrillators
Surgery
Follow-up care
Medications may be combined with other treatments for tachycardia. Options may include:
Drugs to slow the heart rate
Choosing an effective medication or combination of medications requires an accurate diagnosis of the rhythm disorder. The medications are usually taken daily for life. Medications may include:
A traditional treatment, digoxin controls the heart rate at rest, but not as well during activity.
A newer approach is calcium channel blockers or beta-blockers. These drugs control heart rate more consistently both at rest and during activity.
Since ventricular tachycardia is life threatening, patients have electrophysiologic testing to determine a medication's effectiveness. The physician stimulates the heart to beat abnormally to determine which medication most effectively restores normal heart rhythm.
Patients with tachycardias and heart disease are at especially high risk of stroke. Blood-thinning medications (anticoagulants) such as warfarin or aspirin may be prescribed.
Atrial Fibrillation Ablation
For tachycardias caused by abnormal heart tissue, atrial fibrillation ablation (pulmonary vein isolation ablation, catheter radiofrequency ablation) uses heat to destroy abnormal tissue. The procedure is performed without open surgery on the chest.
Atrial fibrillation ablation has a high (approximately 90 percent) success and cure rate and a low risk of complications. It offers an attractive alternative to medication, which may have side effects. The procedure causes little or no discomfort and usually is done with local anesthesia and mild sedation. Most people resume normal activities after a few days.
See more information about atrial fibrillation ablation.
Minimal Access Catheter Maze Procedure
With new technology, surgeons can create electrical barriers in the walls of the heart by using cyro-ablation (freezing.) This procedure is a faster, safer and less invasive than the open-heart maze surgery.
Physicians attempt to replicate, through ablation, the lines of scar tissue that are created with the open-heart maze procedure surgery. Success rates for minimal access catheter maze procedure depend on what part of the heart is involved.
AV node ablation with pacemakers
This procedure involves applying radiofrequency energy to the atrioventricular (AV) node through a catheter to destroy a small area of tissue. This prevents the atria from sending too many electrical impulses to the ventricles. The atria continue to fibrillate and anticoagulation medication is still required. In 98 percent of patients, this procedure causes a complete block of the heart's electrical impulses. A pacemaker is then implanted to establish normal rhythm.
In a study, 85 percent of people who had this procedure reported an improved quality of life and increased ability to exercise.
Pacemaker
A pacemaker is a medical device that helps regulate the heartbeat. The device, smaller than a matchbox, is placed under the skin near the collarbone. A wire extends from the device to the heart. If a pacemaker detects a heart rate that is too slow or the heart is not beating, it emits electrical impulses that stimulate the heart to speed up or resume beating.
A pacemaker is used most often for patients with tachycardia in one of two situations:
For people with occasional fibrillation, new types of pacemakers may help prevent recurrences.
Implantable Cardioverter Defibrillator (ICD)
Ventricular tachyarrhythmias can be treated with a medical device called an implantable cardioverter defibrillator (ICD.) Similar to pacemakers, ICDs are small devices that are implanted under the skin below the collarbone. The ICD continuously monitors the heart's rhythm. If the heart rate becomes too slow, the ICD paces the heart to prevent pauses. If the heart beats too fast, the ICD delivers bursts of electrical energy to restore normal rhythm. Clinical studies have shown ICDs to be 99 percent effective in stopping life-threatening ventricular tachyarrhythmias.
Open-heart maze procedure
For surgical maze procedures, surgeons create multiple cuts into the muscle of the atria and then stitch them together. These incision lines interfere with stray electrical pathways and circuits. The lines reduce the size of atrial tissue sections needed to maintain tachycardia.
Due to its complexity, only a few medical centers in the United States perform the surgical maze procedure.
Heart surgeons at Mayo Clinic in Rochester have years of experience with the maze procedure, having performed more than 500 operations. This includes patients with rare forms of heart arrhythmias, acquired heart disease and congenital heart disease.
Of the Mayo Clinic patients who have had the maze procedure for atrial fibrillation (the most common type of tachycardia), 95 percent have had no atrial fibrillation at discharge. Even those who do not respond as well may have more success with drug therapy after the procedure.
See more information about maze procedure surgery.
(for patients who have heart surgery or implanted medical heart devices)
Many patients have benefited from Mayo Clinic's cardiac rehabilitation program while recovering from heart surgery. The program starts with a walking schedule for the first six to eight weeks after surgery and progresses to more vigorous, supervised physical training.
Mayo Clinic also provides long-term monitoring of patients after they have had heart surgery, including monitoring and adjusting medical devices as necessary.
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