The treatment of a cardiac arrhythmia depends on its cause:
Sinus node dysfunction - In people with frequent, severe symptoms, the usual treatment is a permanent pacemaker.
Supraventricular tachyarrhythmias - The specific treatment depends on the cause of the arrhythmia. In some people, massaging the carotid sinus in the neck will stop the problem. Other people need medications such as beta-blockers, calcium channel blockers, digoxin (Lanoxin)and amiodarone (Cordarone). Some patients respond only to a procedure called radiofrequency catheter ablation, which destroys an area of tissue in the A-V node to prevent excess electrical impulses from being passed from the atria to the ventricles.
Atrial fibrillation - Atrial fibrillation resulting from an overactive thyroid can be treated with medications or surgery. Fibrillation resulting from rheumatic heart disease may be treated by replacing damaged heart valves. Medications, such as beta-blockers (for example atenolol and metoprolol), digoxin, amiodarone, diltiazem (Cardizem, Tiazac) or verapamil (Calan, Isoptin, Verelan), can be used to slow the heart rate. Drugs such as amiodarone can be used to reduce the chances that the atrial fibrillation will return. Other treatment options include radiofrequency catheter ablation, or electrical cardioversion, a procedure that delivers a timed electrical shock to the heart to restore normal heart rhythm.
A-V block - First-degree A-V block typically does not require any treatment. People with second-degree A-V block may be monitored with frequent EKGs, especially if they do not have any symptoms and have a heart rate that is adequate for their daily activities. Some patients with second-degree heart block may require permanent pacemakers. Third-degree A-V block is almost always treated with a permanent pacemaker.
VT - Non-sustained VT may not need to be treated if there is no structural damage to the heart. Sustained VT always needs treatment, either with intravenous medication or emergency electrical shock (defibrillation), which can restore the heart's normal rhythm.
Ventricular fibrillation - This is treated with defibrillation, giving the heart a measured electrical shock to restore normal rhythm. The electrical shock can be delivered on the skin over the heart in an emergency situation. People who have survived ventricular fibrillation and those at high risk are potential candidates for an automatic implantable cardioverter defibrillator. The device is similar to a pacemaker, with wires attached to the heart that connect an energy source placed under the skin. The procedure is done in the operating room.