Treatment

The goal of tachycardia treatment is to:

• Slow the fast heart rate when it occurs
• Prevent future episodes
• Reduce complications
• Treat underlying disease that may contribute to tachycardia

Slowing a fast heart rate

A fast heart rate may correct itself. You also may be able to slow your heart rate using simple physical movements. However, medication or other medical treatments may be needed to slow down your heartbeat.

Ways to slow your heartbeat include:

• Vagal maneuvers. Your doctor may ask you to perform an action, called a vagal maneuver, during an episode of a fast heartbeat. The maneuvers include coughing, bearing down as if you're having a bowel movement and putting an ice pack on your face. Vagal maneuvers affect the vagus nerve, which helps control your heartbeat.
• Medications. If vagal maneuvers don't stop the fast heartbeat, you may need an injection of an anti-arrhythmic drug to restore a normal heart rate. An injection of this drug is given at a hospital. Anti-arrhythmic medicine is also available in pill form.
• Cardioversion. In this procedure, a shock is delivered to your heart through paddles, an automated external defibrillator (AED) or patches on your chest. The current affects the electrical impulses in your heart and restores a normal heartbeat. It's generally used when emergency care is needed or when maneuvers and medications don't work.

Preventing episodes of a fast heart rate

With the following treatments, it may be possible to prevent or manage episodes of tachycardia.

• Catheter ablation. This procedure is often used when an extra electrical pathway is responsible for an increased heart rate.

In this procedure, a doctor inserts catheters into your groin, arm or neck and guides them through the blood vessels to your heart. Electrodes at the catheter tips can use extreme cold or radiofrequency energy to damage (ablate) the extra electrical pathway and prevent it from sending electrical signals.

Catheter ablation does not require surgery to access the heart, but it may also be performed in conjunction with other heart valve or artery repair surgeries.

• Medications. Anti-arrhythmic medications taken by mouth may prevent a fast heart rate when taken regularly.

  Other heart medications, such as calcium channel blockers and beta blockers, may be prescribed instead or in combination with anti-arrhythmic drugs.

• Pacemaker. Some types of tachycardias may be treated with a pacemaker. A pacemaker is a small device that's surgically implanted under your skin. When the device senses an abnormal heartbeat, it sends an electrical pulse that helps the heart resume a normal beat.
• Implantable cardioverter. If you're at risk of having a life-threatening tachycardia episode, your doctor may recommend an implantable cardioverter-defibrillator (ICD). The pager-sized device is surgically implanted in your chest. The ICD continuously monitors your heartbeat, detects an increase in heart rate and delivers precisely calibrated electrical shocks, if needed, to restore a normal heart rhythm.

• Surgery. Open-heart surgery may be needed in some cases to destroy an extra electrical pathway causing tachycardia.

  Tachycardia may also be treated with a maze procedure. During this procedure, a surgeon makes small incisions in heart tissue to create a pattern or maze of scar tissue. Because scar tissue doesn't conduct electricity, it interferes with stray electrical impulses that cause some types of tachycardia.

  Surgery is usually used only when other treatment options don't work or when surgery is needed to treat another heart disorder.

Preventing blood clots

Some people with tachycardia have an increased risk of developing a blood clot that could cause a stroke or heart attack. Your doctor may prescribe a blood-thinning medication to help lower your risk.

Treating an underlying disease

If another medical condition is contributing to tachycardia, such as some form of heart disease or hyperthyroidism, treating the underlying problem may prevent or minimize tachycardia episodes.