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Heart Rhythm Disorders (cont.)

What medications treat arrhythmias (heart rhythm disorders)?

The choice and use of medications depends on the specific type of arrhythmia present. Although detailed discussion about this is beyond the scope of this article, the reader is encouraged to click onto the links to the predominant arrhythmias to determine the common medications and common surgical methods used to treat these heart beat disorders.

Although some arrhythmias may require some special uses of medications (for example, IV adenosine for PSVT), most utilize various beta-blockers and calcium channel blockers to control fast rates. Although atropine may be used for a short time to speed up heart rates, usually the treatment will be a pacemaker.

What electrical and surgical treatments are available for arrhythmias (heart rhythm disorders)?

The most common electrical and surgical treatments are listed as follows:

  • Electrical: These include pacemakers and defibrillators (several types including ones that can either pace, defibrillate, or even cardiovert manually ) and automatic external defibrillators (AEDs) that are available to the public, and function with external sources of electricity.
  • Ablation: This technique is done by surgically placing small probes that can destroy tissue and then are removed once the tissue is altered. (Technically, ablation -- which kills cells found usually in the atria, thus stopping arrhythmia-generating cells -- may be done with hot or cold probes.) This is sometimes termed a modified MAZE procedure (see below).
  • Surgical implants: These are pacemakers that regulate heartbeat rates by either including extra beats if the heartbeat is too slow or "overdrive pacing" if the rate is too fast (for example, ventricular tachycardia); defibrillators that detect and then interrupt ventricular fibrillation; and devices that can both pace and defibrillate, all of which are surgically implanted and battery-powered.
  • Surgery: This is open-heart surgery (termed MAZE surgery or MAZE procedure) where small cuts are made in the heart tissue to induce scar formation that blocks electrical impulses or removes cells causing impulses (currently infrequently done).

Electrical cardioversion is most often used in emergencies, although patients with certain arrhythmias who are stable may have electrical cardioversion done non-emergently. Most of the surgical procedures (implants) are done in patients whose arrhythmias are under medical control (temporarily or longer-term).

Do I need to follow-up with my doctor after being diagnosed with an arrhythmia?

Follow-up is usually done with the primary care professional and often with a heart specialist (cardiologist). The patient is monitored for effectiveness of treatment, recurrence of symptoms or arrhythmia, side effects of medication, additional routine testing, and overall condition. For those requiring pacemakers, follow-up on a regular basis is mandatory. Patients are advised to make all follow-up appointments and should not attempt to change their medications without first consulting their doctor(s).

What is the outlook or life-expectancy for a person with an arrhythmia (heart rhythm disorder)?

The detection and management of heart rhythm disorders are undergoing constant improvement. The past years have seen an unprecedented explosion of information about these conditions. Detection and management of heart rhythm disorders has improved the quality and quantity of life. However, patients need to keep follow-up appointments and maintain their medications because not doing this can severely reduce a person's outcome. Untreated, ignored, or "undertreated" serious arrhythmias can result in syncope, strokes, heart failure, and sudden death.

Medically reviewed by Robert J. Bryg, MD; Board Certified Internal Medicine with subspecialty in Cardiovascular Disease

REFERENCE:

Bocka, Joseph J., MD. "Automatic External Defibrillation." Medscape. Updated: May 30, 2014.
<http://emedicine.medscape.com/article/780533-overview>


Last Reviewed 11/20/2017

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