Treatments
Treatments for Heart Rhythm Disorders
Treatment depends on the type of arrhythmia, the symptoms, any underlying heart condition and an individual clinical assessment. This page explains the main options and how they differ.
On this page
Individual decisions
Why Treatment Differs
Two people with similar symptoms may need different treatment. The doctor considers which rhythm is present, how it arises, how much it affects daily life, whether the heart has any underlying condition, and what the patient prefers. Some people need monitoring or medicines only. Others are offered a procedure or a device.
The options below are not interchangeable. Each one has its own purpose, and the choice is made after assessment.
The main options
Treatment Groups
Core ablation technologies
The catheter approach and the energy sources used to treat rhythm disorders.
The overall catheter-based approach to treating rhythm disorders.
Heat energy applied through a catheter tip.
Cold energy used to treat selected targets.
Electrical field energy delivered in short pulses.
Arrhythmia-specific ablation
How ablation is planned for particular rhythm disorders.
Isolating the pulmonary veins and treating atrial triggers.
Interrupting the flutter circuit in the right atrium.
AVNRT, accessory pathways and WPW.
Treating the origin of frequent premature beats.
Treating the ventricular circuit or substrate.
Advanced ablation approaches
Specialised techniques used in selected patients.
Reaching the outer surface of the heart.
Modifying cardiac autonomic nerve input.
Devices and other interventions
Treatments that are not ablation, including stroke-prevention and device therapy.
A controlled shock to restore normal rhythm.
A device that supports a slow heart rhythm.
A device that treats dangerous ventricular rhythms.
A stroke-prevention device procedure. Not an ablation.
The usual route
From Diagnosis to Treatment
Treatment follows assessment. Not every patient needs every step.
Diagnosis
The rhythm is recorded and identified.
Mechanism
The cause or mechanism is clarified.
Individual plan
Options are discussed with the patient.
Procedure or device
Used where appropriate.
Follow-up
Regular review of rhythm and treatment.
Overview
Catheter Ablation
Catheter ablation uses thin flexible catheters to reach the heart through blood vessels. Energy is delivered to a small area to treat the source or pathway of an abnormal rhythm. It is considered in selected patients after assessment, and the technique depends on the rhythm.
Mechanism only
Ablation Energy Technologies
Different energy sources can be used during ablation. The comparison below describes how each one works, not which one is better.
Heat
Radiofrequency
Heat energy delivered at the catheter tip creates a small treated area.
Cold
Cryoablation
Cold energy freezes the tissue to create a small treated area.
Electrical field
Pulsed field
Short electrical pulses act on the heart tissue.
Device therapy
Pacemaker and ICD
Both are implanted devices, but they have different purposes.
Slow rhythms
Pacemaker
Senses the heart’s rhythm and sends small impulses when the heart beats too slowly or its conduction is impaired.
Supports the rhythm.
Fast dangerous rhythms
ICD
Monitors for dangerous fast rhythms from the lower chambers and can treat them with pacing or a shock.
Used in selected patients after assessment.
Other Strategies
Medication, AV Node Ablation and Surgical Options
Medication as a treatment alternative
Some rhythm disorders are managed with medication rather than a procedure, and medication may also be used before, alongside or after one. Drugs are chosen according to the rhythm and the person. See Antiarrhythmic Medication.
AV node ablation
AV node ablation is a distinct strategy rather than a cure for the underlying rhythm. It deliberately interrupts conduction between the upper and lower chambers so that a fast atrial rhythm can no longer drive the ventricles; a pacemaker is then required. It is considered only in selected situations.
Hybrid and surgical ablation
Hybrid and surgical ablation are separate concepts in which a surgeon works on the outside of the heart, sometimes together with catheter treatment. They may be discussed for selected patients with persistent atrial fibrillation or when other approaches are not suitable.
Which strategy fits depends on the rhythm, symptoms and general health, and is decided in individual assessment.
Questions
Frequently Asked Questions
Does every rhythm disorder need treatment?
No. Some need only monitoring or reassurance. Treatment depends on the rhythm, symptoms and individual factors.
Are the treatments interchangeable?
No. Each has a different purpose, and the choice depends on the individual situation.
What is the difference between ablation and a device?
Ablation aims to treat the source or pathway of a rhythm problem. A device is implanted to support a slow rhythm (pacemaker) or to treat dangerous fast rhythms (ICD).
How is the energy source chosen?
The choice depends on the type of rhythm problem, the patient and the doctor’s judgement.
Is cardioversion a cure?
It can restore a normal rhythm, but it does not remove the underlying tendency to the rhythm problem.
Will I need follow-up?
Yes. Follow-up is a normal part of treatment and is planned individually.
Where can I read about preparing for a procedure?
The patient information page gives general guidance, and each treatment page has more detail.
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