How is ventricular arrhythmia treated?

Doctors may prescribe medications, an implantable cardioverter defibrillator, or both for the treatment of ventricular arrhythmias.

Both ventricular tachycardia (VT) and ventricular fibrillation (VF) are life-threatening heart rhythms. In emergencies, paramedics or medical personnel can treat these arrhythmias with external defibrillators, such as an AED. Long-term treatment options vary according to the type of arrhythmia and individual patient circumstances.

Tachyarrhythmias can sometimes be stopped or treated with medicines or surgery. These treatments are used in an effort to control or destroy the portion of heart tissue that causes the abnormal rhythms.

In other cases, an implanted electronic device may be used to treat the arrhythmia. An implantable cardioverter defibrillator (ICD) delivers electrical energy to the heart to slow it down to a more normal rhythm. This allows the S-A node to take control again.

An ICD can use one or more types of energy to help your heart beat normally again. They include:

Anti-tachycardia pacing (ATP) – If your rhythm is regular but fast, the ICD system can deliver a series of small, rapid electrical pacing pulses. These are used to interrupt the arrhythmia and return your heart to its normal rhythm.

Cardioversion – If your arrhythmia is regular but very fast, the ICD can deliver a low-energy shock. This can stop the arrhythmia and return your heart to its normal rhythm.

Defibrillation – For arrhythmias that are very fast and irregular, like VF, high-energy shocks can be used to stop the arrhythmia. Then your heart can return to its normal rhythm. 

Many people have arrhythmias that are dangerous and that can occur at any time. You might already have had an episode of VT or VF. This can happen even if you are taking medication to treat your abnormal heart rhythm. After studying test results, your doctor may decide that you might experience abnormal heart rhythms again, and perhaps, cardiac arrest. Your doctor may recommend an ICD for one or more of the following reasons:

  • At least one experience of VT or VF
  • Previous cardiac arrest or abnormal heart rhythm that caused you to pass out
  • A fast heart rhythm that keeps returning and could cause death
  • A fast heart rhythm that cannot be controlled with drugs
  • Severe side effects from drug therapy
  • A fast heart rhythm that cannot be cured by surgery
  • Previous heart attack and a low ejection fraction 

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