Treatment of the underlying condition and control of any reversible factors is usually attempted in all patients. Examples include control of hyperthyroidism, correction of electrolyte imbalance and control of heart failure. Depending on the cause, tachycardia may be treated with medications (e.g., antiarrhythmics, anticoagulants) or by catheter ablation. In an emergency situation, or in the case of a sustained tachyarrhythmia, the patient may undergo cardioversion, or the use of electricity to establish a more normal heart rate.  

Treatment options are largely influenced by the severity of structural heart abnormalities, symptoms, type of arrhythmias and in some case the results of EP testing. Patients with atrial fibrillation or atrial flutter require administration of anticoagulants to prevent embolism.

Ventricular tachycardia may be treated by the surgical insertion of an implantable cardioverter defibrillator (ICD) in the patient’s chest. The ICD monitors and, if necessary, corrects an abnormally fast heartbeat. There has been interest in whether drug therapy alone benefits individuals with ventricular tachycardia. To date, studies have been mixed regarding the benefits of drug therapy alone, without implantation of an ICD. It appears that some antiarrhythmics are associated with increased mortality, while other medications such as beta blockers and amiodarone may be helpful in some patients. Research is still ongoing into alternatives to immediate ICD implantation.

Even with ICD implantation, about 50 percent of patients will need to continue using antiarrhythmic medications for the rest of their lives. However, the ICD allows most patients to reduce the number and/or dosage of medications.