Treatment Options for Arrhythmias

Our Approach

Ablation

Cardioversion

Pacemaker Implantation

Implantable Cardioverter Defibrillator (ICD)

Atrial Fibrillation/Pulmonary Vein Ablation Procedure

Treatment Options for Arrhythmias

Many patients with arrhythmias require no treatment whatsoever. In fact, the most important aspect of any initial evaluation is to determine the significance of the arrhythmia and the need for any type of intervention. For other patients, particular drugs may be used to control the abnormal heart rhythm. Examples include antiarrhythmic drugs, calcium channel blockers, and beta-blockers. Patients may also take anticlotting drugs such as warfarin (Coumadin) or aspirin -- especially those with atrial fibrillation, whose risk of stroke is increased.

If you are taking drugs for an arrhythmia, one of the following tests will probably be used to see whether your treatment is working: a 24-hour Holter monitor while you are on drug therapy, an exercise ECG, or an electrophysiology study to see how easily the arrhythmia can be induced. Blood levels of antiarrhythmic drugs may also be checked.

However, the side effects of some of the drugs used to treat arrhythmias can be difficult to manage, and they can even induce new arrhythmias in some patients. Your doctor will take these side effects and your type of arrhythmia into account when deciding whether antiarrhythmic drugs may be an option for you.

Our Approach

For patients in whom these drugs fail to work, and in those for whom such agents are not appropriate, NYU Langone Medical Center's Cardiac Electrophysiology/Heart Rhythm Center offers several types of therapies to treat arrhythmias through more invasive -- and in most cases, more effective -- means. We try to combine diagnostic tests and treatments in one procedure whenever possible -- such as performing an ablation or implanting a pacing device immediately after the diagnostic portion of an electrophysiology test. This approach is significantly more convenient for the patient.

In an effort to advance the care of patients with arrhythmias and those with heart failure, the Cardiac Electrophysiology/Heart Rhythm Center is participating in several national trials to evaluate new, potentially more effective treatment approaches. For information on trials currently accruing patients, visit the Clinical Trials page.

We offer the following forms of treatment for arrhythmias:

Ablation

This form of treatment is often applied at the same time doctors perform an electrophysiology study. Once doctors have identified the source of an arrhythmia during EP testing, they may take advantage of the fact that the patient is already catheterized and perform an ablation -- a way to treat arrhythmias by cauterizing the abnormal electrical pathways causing the arrhythmia by using radiofrequency heat applied through a special ablating catheter. With a success rate of more than 90 percent, this form of therapy can completely cure the arrhythmia in many cases and has been shown to be quite safe after many years of experience. NYU has been actively involved in catheter ablation for more than fifteen years.

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Cardioversion

To quickly restore a heart to its normal rhythm -- particularly one that is beating too quickly -- the doctor may apply an electrical shock to the chest wall. This technique is called cardioversion, and may be applied externally or internally. After cardioversion, drugs may be prescribed to prevent the arrhythmia from recurring.

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Pacemaker Implantation

Pacemakers are used to treat people with a slow heart rate (bradycardia). An artificial pacemaker can take charge of sending electrical signals to make the heart beat if the heart's natural pacemaker is not working properly or its electrical pathway is blocked. During a simple operation, this small electrical device -- about the size of a matchbook -- is placed under the skin. One or two leads extend from the device to the right side of the heart. Electrical impulses travel from the device into the heart to maintain the proper heart rate.

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Implantable Cardioverter Defibrillator (ICD)

ICDs are devices used to correct serious ventricular arrhythmias -- such as tachycardia and fibrillation -- that can lead to sudden death. The defibrillator, which is about the size of a pager, is surgically placed inside the patient's chest. There, it monitors the heart's rhythm and quickly identifies serious arrhythmias. It immediately disrupts a deadly arrhythmia by delivering an electrical shock.

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Atrial Fibrillation/Pulmonary Vein Ablation Procedure

If a person experiences frequent episodes of paroxysmal or persistent atrial fibrillation despite medication therapy, ablative therapy may be an option to prevent further episodes. Ablation therapy is when an energy source, currently radio frequency energy, is applied to an area in the heart that is a focus for an arrhythmia.

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Cardiac Electrophysiology / Heart Rhythm Center

NYU Langone Medical Center
403 East 34th Street, RIV-2nd Floor
New York, NY 10016
Phone: 212-263-7149