Cardiac arrhythmias: New treatments and growing challenges

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Cardiac arrhythmias are among the most common heart conditions in Germany and result in over 500,000 hospital admissions each year. New research findings and treatment approaches offer hope, but the rising number of cases is posing increasing challenges for the healthcare system.

Key facts at a glance

• Cardiac arrhythmias are the most common cause of death after a heart attack.
• In Germany, over 1.6 million people are affected by atrial fibrillation.
• Scientists in Bonn have succeeded in reducing cardiac arrhythmias in animal experiments using specialised muscle cells.
• Psychological support before surgery can alleviate anxiety and depression in older people.

What are cardiac arrhythmias and why are they so dangerous?

Cardiac arrhythmias are deviations from the normal heartbeat, which is usually regular and ranges between 60 and 100 beats per minute. They can manifest as a heartbeat that is too fast (tachycardia), too slow (bradycardia) or irregular. They are particularly dangerous following a heart attack, as they are the most common cause of death, as reported by *WELT* on 4 July 2007. They can lead to ventricular fibrillation, in which the heart beats at over 300 beats per minute and barely pumps any blood around the body. This interrupts the supply of oxygen to the brain and other organs.

A common and particularly relevant example is atrial fibrillation, a widespread condition affecting more than 1.6 million people in Germany. According to the German Heart Report – Update 2026, presented on 16 September 2026, atrial fibrillation is posing increasing challenges for the healthcare system due to rising incidence rates and the associated risks. It can significantly impair quality of life, increase the risk of stroke and lead to heart failure.

What new treatment approaches are available for cardiac arrhythmias?

Research is making progress in the treatment of cardiac arrhythmias. Scientists in Bonn have succeeded in drastically reducing cardiac arrhythmias in animal trials. They implanted embryonic heart cells into mice following a heart attack. Following this treatment, ventricular fibrillation occurred in only one in three animals despite electrical stimulation of the heart – a rate similar to that seen in healthy rodents. Without treatment, every mouse was affected.

Later, the research team led by Bernd Fleischmann at the University of Bonn achieved similar success with genetically modified skeletal muscle cells. These cells were modified to produce the protein connexin 43, which normally occurs only in heart muscle cells and is essential for electrical communication. Fleischmann explained: “It seems that just a few thousand cells are enough to prevent arrhythmias.” He emphasised, however, that these results so far only apply to the mouse heart and that further research is needed to assess their applicability to humans.

How is atrial fibrillation treated today, and what challenges are there?

The treatment of atrial fibrillation has advanced significantly in recent years. Heart surgery often offers the opportunity to treat atrial fibrillation directly. In a procedure known as ablation, small scars are deliberately created in the heart tissue to interrupt the electrical signals that trigger or sustain atrial fibrillation. Prof. Dr Nicolas Doll, Head of Cardiac Surgery at the SchüchtermannClinic in Bad Rothenfelde and an expert in the cardiac surgical treatment of cardiac arrhythmias, points out that around 12 to 13 per cent of cardiac surgery patients are also affected by atrial fibrillation – that is roughly one in eight people.

Although European guidelines explicitly recommend concomitant ablation during mitral valve surgery and it should also be considered for bypass and aortic valve operations, according to Doll, this has so far been carried out too rarely. One reason for this is funding: the additional ablation entails extra costs for hospitals, which are not reimbursed for certain heart operations. This creates a contradiction between the recommended treatment and the lack of cost reimbursement.

Another area of tension concerns so-called hybrid procedures, in which cardiac surgery and cardiology work closely together. In these procedures, areas of the atria are first treated surgically from the outside and then supplemented cardiologically with a catheter procedure from the inside. Although guidelines recommend these procedures for certain patients, they are rarely used in Germany. Prof. Dr Nicolas Doll emphasises: “Particularly in cases of complex, long-standing atrial fibrillation, it is becoming increasingly apparent that combining both procedures can be more promising than catheter treatment alone.” He is pleased that collaboration between cardiologists and cardiac surgeons is becoming increasingly established.

The Hy⁵ concept, initiated by Nicolas Doll and Prof. Dr Philipp Sommer, is an example of this interdisciplinary collaboration. It is a network of specialised centres where patients with difficult-to-treat atrial fibrillation are treated jointly by cardiac surgeons and cardiologists. According to Doll, it is crucial that the best treatment is identified and implemented through an interdisciplinary approach.

What role does mental health play in heart surgery?

Patients’ mental state before and after an operation can have a significant impact on their recovery. A clinical study by Washington University School of Medicine in St Louis, reported by aponet.de on 11 September 2026, shows that psychological support can alleviate anxiety and depressive symptoms in older people before and after surgery. The study involved 306 people aged 60 and over who were scheduled for heart, cancer or orthopaedic surgery and who exhibited mild to moderate symptoms of anxiety or depression.

The intervention group received information materials and had between eight and twelve telephone consultations with trained professionals. In addition, pharmacists or doctors reviewed the participants’ medication to minimise risks such as drowsiness or confusion. Three months after the operation, anxiety and depressive symptoms had decreased more significantly in this group. Study author Prof. Joanna Abraham noted: “The period surrounding an operation is both a time of risk and an opportunity.” Prof. Eric J. Lenze, Head of the Department of Psychiatry at Washington University School of Medicine, added that it is not just a matter of preparing the body for the procedure, but that “preparing the mind and the brain is just as important.”

This underlines the importance of a holistic approach to medical care. Mental health can also be affected, for example, by worries about financial security, which is a concern for many people in Germany. In such cases, it may be helpful to consult the 2026 Basic Income Calculator to check potential entitlements.

Frequently asked questions

What is atrial fibrillation?

Atrial fibrillation is a common form of cardiac arrhythmia in which the heart’s atria beat irregularly and too quickly, leading to an irregular heartbeat. It affects over 1.6 million people in Germany and can increase the risk of strokes and heart failure.

Can cardiac arrhythmias be prevented?

Whilst some heart rhythm disorders are genetic, others can be influenced by a healthy lifestyle. This includes regular exercise, a balanced diet and avoiding excessive alcohol consumption, which can be better assessed using a blood alcohol calculator. Reducing stress, as described in this article on stress management tips, can also be helpful.

What role do sex hormones play in cardiac arrhythmias?

One sex hormone is being discussed as a possible risk factor for cardiac arrhythmias, as reported by Heilpraxisnet on 18 March 2023. However, further research is needed to fully understand this link and to develop possible preventive or therapeutic approaches.

Sources: DIE WELT · idw-online.de · aponet.de · Heilpraxis – Medicinal Plants, Health and Medicine. Last updated: 21 October 2026.