How Are Arrhythmias Treated?
Common arrhythmia treatments include medicines,
medical procedures, and surgery. Treatment is needed when an arrhythmia causes
serious symptoms, such as dizziness, chest pain, or fainting, or when it
increases your chances of developing complications, such as
heart
failure,
stroke, or
sudden
cardiac death.
Medicines
Medicines can be used to speed up a heart that's
beating too slow, or slow down a heart that's beating too fast. They also can
be used to convert an abnormal heart rhythm to a normal steady rhythm.
Medicines can be used to control an underlying medical condition, such as heart
disease or a thyroid condition, that might be causing an arrhythmia. Medicines
used to convert an abnormal rhythm are called antiarrhythmics.
Some of the medicines used to slow a fast heart rate
are beta blockers (such as metoprolol and atenolol), calcium channel blockers
(such as diltiazem and verapamil), and digoxin (digitalis). These medicines are
often used to slow the heart rate in people with atrial fibrillation.
Some of the medicines used to restore an abnormal
heartbeat to a normal rhythm are amiodarone, sotalol, flecainide, propafenone,
dofetilide, ibutilide, quinidine, procainamide, and disopyramide. These
medicines often have side effects. Some of the side effects can make an
arrhythmia worse or even cause a different kind of arrhythmia.
People with atrial fibrillation and some other
arrhythmias are often treated with blood-thinning medicines (anticoagulants) to
reduce the chances of developing blood clots. Aspirin, warfarin
(Coumadin®), and heparin are commonly used blood thinners.
Medical Procedures
Some arrhythmias are treated with a device called a
pacemaker. The pacemaker is a small device that's surgically placed under the
skin at the collarbone; wires lead from it to the atrium and ventricle(s). The
pacemaker sends small electric signals through the wires to control the speed
of the heartbeat. Most pacemakers contain a sensor that activates the device
only when the heartbeat is abnormal.
Some arrhythmias are treated with a jolt of
electricity delivered to the heart. This type of treatment is called
cardioversion or defibrillation, depending on which type of arrhythmia is being
treated.
Some people who are at risk for ventricular
fibrillation are treated with a device called an implantable cardioverter
defibrillator (ICD). This device is surgically implanted in the chest and
connected to the heart with wires. It continuously monitors the heartbeat. If
it senses a dangerous ventricular arrhythmia, it sends an electric shock to the
heart to restore a normal heartbeat.
A procedure called radiofrequency ablation is
sometimes used to treat certain types of arrhythmias when medicines don't work.
In this treatment, a special wire is inserted through a vein in the arm or leg
and threaded up to the heart. Radiowave energy is sent through the wire to
destroy abnormal tissue in the heart that's interrupting the normal flow of
electric signals. Radiofrequency ablation is usually done in the hospital as
part of an
electrophysiologic study.
Surgery
Sometimes, surgery is used to treat arrhythmia.
Often this is done when surgery is already being performed for another reason,
such as repair of a heart valve. One type of surgery for atrial fibrillation is
called "maze" surgery. In this operation, the surgeon makes small cuts or burns
in the atria, which prevent the spread of disorganized electrical signals.
Coronary artery bypass surgery may be needed for
arrhythmias caused by
coronary
artery disease. The operation improves blood supply to the heart
muscle.
Other Treatments
Vagal maneuvers are another arrhythmia treatment.
These are simple exercises that sometimes can stop or slow down certain types
of supraventricular arrhythmias. They stop the arrhythmia by affecting the
vagus nerve, which is one factor that controls the heart rate. Some vagal
maneuvers include:
- Gagging
- Holding your breath and bearing down (Valsalva
maneuver)
- Immersing your face in ice-cold water
- Coughing
- Putting your fingers on your eyelids and pressing
down gently
Vagal maneuvers aren't an appropriate treatment for
everyone. Discuss with your doctor whether vagal maneuvers are safe and
effective for you to try. |