How are Arrhythmias Treated

How are arrhythmias treated?

Many arrhythmias require no treatment. Serious arrhythmias are treated in several ways depending on what is causing the arrhythmia. Sometimes the heart disease is treated to control the arrhythmia. Or, the arrhythmia itself may be treated using one or more of the following treatments.

Drugs

There are several kinds of drugs used to treat arrhythmias. One or more drugs may be used. Drugs are carefully chosen because they can cause side effects. In some cases, they can cause arrhythmias or make arrhythmias worse. For this reason, the benefits of the drug are carefully weighed against any risks associated with taking it. It is important not to change the dose or type of your medication unless you check with your doctor first.

If you are taking drugs for an arrhythmia, one of the following tests will probably be used to see whether treatment is working: a 24-hour electrocardiogram (ECG) while you are on drug therapy, an exercise ECG, or a special technique to see how easily the arrhythmia can be caused. Blood levels of ant arrhythmic drugs may also be checked.

Cardio version

To quickly restore a heart to its normal rhythm, the doctor may apply an electrical shock to the chest wall. Called cardioversion, this treatment is most often used in emergency situations involving potentially life threatening problems, such as very low blood pressure or decreased level of consciousness, or in patients who have repeatedly failed to respond to medication. After cardioversion, drugs are usually prescribed to prevent the arrhythmia from recurring.

Automatic implantable defibrillators

These devices are used to correct serious ventricular arrhythmias that can lead to sudden death. The defibrillator is surgically placed inside the patient's chest. There, it monitors the heart's rhythm and quickly identifies serious arrhythmias. With an electrical shock, it immediately disrupts a deadly arrhythmia.

Artificial pacemaker

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. It works by sending small, painless amounts of electricity to the heart to make it beat. During a simple operation, this small electrical device is placed under the skin. A lead extends from the device to the right side of the heart, where it is permanently anchored.

A variety of rhythm disorders can be successfully controlled with an artificial pacemaker. Slow heart rates, such as heart block, are the most common reason to use a pacemaker. However, new technology now lets doctors treat some fast heart rates with a pacemaker.

Radiofrequency Catheter Ablation and Surgery

Some tachycardias are lifethreatening or significantly interfere with normal activities. Permanent treatment is often needed for these problems.

One procedure, called radiofrequency catheter ablation, is done with several catheters in the heart. This is called an electrical physiologic study (EPS testing) and requires a cardiologist with specialized training as well as special equipment.

This therapy involves threading an electrode into the heart through a large central vein and electrically locating the abnormal conduction tract. Once the location of the bypass tract is known another catheter is positioned directly over the area that's causing the tachycardia. Its tip is heated and that small area of the heart is altered so that electrical current won't pass through the tissue.

Surgery that interrupts the abnormal connection in the heart is another treatment.

What is a heart block?

Heart block is a condition in which the electrical signal cannot travel normally down the special pathways to the ventricles. It doesn't mean the blood flow is blocked; it means that the flow of the electrical signal within the heart is blocked. For example, the signal from the atria to the ventricle may be

• delayed, but each one conducted;
• delayed with only some getting through; or
• completely interrupted. If there is no conduction, the beat generally originates from the ventricles and is very slow.