Arrhythmia Chapter 9


Resetting the Heart's Rhythm

Arrhythmia isn't necessarily treated. If the arrhythmia isn't causing significant symptoms or putting the patient at risk for a more serious condition, the arrhythmia may simply need to be monitored.

If the arrhythmia does produce serious symptoms or is life threatening, a number of treatment options are available.

Tachycardia Treatment

  • Medications- Many tachycardias respond well to anti-arrhythmic medications, which may reduce the number of episodes of tachycardia or slow the heart down when there is a tachycardia. Some medications may slow the heartbeat so much a pacemaker is needed.
  • Vagal maneuvers- Some SVTs can be stopped by performing physical activities, such as coughing, holding one's breath and straining, or immersing one's face in ice water. These acts affect the vagal nerves and can cause the heart to slow.
  • Cardioversion- Electrical shock can sometimes be used for atrial tachycardias to reset the heart's rhythm. The patient is sedated for this procedure and so doesn't feel any pain. Risks of cardioversion include stroke and arrhythmia caused by the cardioversion itself.
  • Cardiac ablation- Catheters are threaded into the heart to areas that have been identified as causing the arrhythmia. Using the tip of the catheter, which is either heated with radiofrequency energy or made intensely cold, the area of heart tissue causing the problem will be destroyed (ablated). This usually stops the arrhythmia. Complications of cardiac ablation include infection, damage to the heart or blood vessels, stroke, heart attack, and damage to the heart's electrical system.
  • Implantable Devices- Implantable cardioverter defibrillator (ICD). If the patient is at high risk of developing AF, VT, or VF, the doctor may recommend this device. ICDs are battery-powered devices that are usually implanted near the left collarbone. They continually monitor your heart rhythm. When the heart beats too slowly, they can act as pacemakers and stimulate the heart to beat faster. If they detect VT or VF, they send out high- or low-energy shocks to reset the heart's electrical impulses back to normal. Complications of ICD implantation include inflammation of the pericardium (the sac that surrounds the heart), infection, heart attack, congestive heart failure, and stroke.

Treating Bradycardias

Pacemakers

Sometimes a bradycardia can be corrected through medication or by eliminating a drug that's had the side effect of slowing the heart down. If not, the doctor may prescribe a pacemaker. A pacemaker is a small, battery-powered device generally implanted near the collarbone. Electrode-tipped wires run from the pacemaker to the inner heart. If the heartbeat slows down too much, the pacemaker will send out electrical impulses to stimulate the heart to beat at the proper rate. Common complications include bleeding, infection, lead dislodgment, and lead or pacemaker problems following surgery.

Surgical Treatments

  • Ventricular aneurysm surgery- An aneurysm is sometimes the cause of an arrhythmia. Surgical removal of the aneurysm may end the arrhythmia, but this surgery is usually performed only if cardiac ablation and an implanted ICD are unsuccessful. Complications of this surgery include low cardiac output, ventricular arrhythmias, respiratory failure, bleeding, kidney failure, and stroke.

More on this topic

What are Arrhythmias? (VIDEO)

What Makes Your Heart Beat?

Blood's Pathway

The Electric Heart

Symptoms of Arrhythmia

Heart Disease & Arrhythmia

Risk Factors

Testing & Diagnosis

Resetting the Heart's Rhythm

A Heart Healthy Lifestyle

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Aneurysm and Stent, Angioplasty, Arrhythmia, Cardiovascular Continuum, Cholesterol and Atherosclerosis, Coronary Bypass Surgery, Heart Attack and Angina, Hypertension, Stroke, Thrombosis and Embolism, Women and Cardiovascular Health


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