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Treatment options for arrhythmias

Arrhythmias are abnormalities in the heartbeat due to irregular electrical activity of the heart. This condition is diagnosed and treated by Best Cardiologist in Lahore depending on the causative factor and severity. Read on to know more about arrhythmias and how to deal with them:

What are arrhythmias?

Arrythmias are irregularities in the heart rate stemming from irregular and abnormal electrical activity in the heart. This leads to heart beating too fast, too slow or inconsistently. With very fast heart rate, there is inadequate filling time, and thus less blood reaches the body. Similarly, with very slow heart rate, the heart is unable to maintain the stroke volume. 

Arrhythmias are caused by changes in the heart muscle (cardiomyopathies), hypertension, coronary artery disease, valvular disorder and even electrolyte disturbances in the body.  

What are the symptoms of arrhythmias?

Arrhythmias may be silent or may cause a myriad of symptoms. These include: 

  • Shortness of breath 
  • Palpitations 
  • Chest discomfort 
  • Weakness 
  • Anxiety 
  • Dizziness 

What are the treatment options?

As mentioned before, the treatment options of arrhythmias depend on their severity. Apart from medication, invasive therapies, electrical devices and surgery are used for management. In addition, lifestyle changes help to decrease the risk, as well. 

Non-invasive vagal maneuver

In case of supraventricular tachycardias vagal maneuvers are helpful in stopping the irregular rhythms. These maneuvers activate the Vagus nerve and thus the parasympathetic nervous system that slow the heart rate. 

Examples of vagal maneuvers include: holding the breath and straining, massaging the single side of the neck where the pulse is felt, dunking the face in cold water and coughing. However, vagal maneuvers do not work for every type of arrhythmia. 

Medication for treatment

The medication used for treatment includes:

  • Anti-arrhythmic drugs that restore the normal sinus rhythm. 
  • Beta blockers that control the heart rate. 
  • Antiplatelet and anticoagulant drugs to reduce the risk of clots. 
  • Treatment of the underlying condition that predispose one to arrhythmias

Electrical cardioversion

In people with persistent arrhythmias, medication alone may not be sufficient. In such cases, cardioversion is performed by driving an electrical impulse through the chest to synchronize the heartbeat and stopping the abnormal electrical activity. This procedure is performed after giving short-acting anesthesia. 

Pulmonary vein isolation 

If there are recurrent atrial arrhythmias, isolation and ablation of the foci of electrical activity near the pulmonary veins helps to terminate the arrhythmia and prevent recurrent attacks. The idea with this type of ablation is to create scar tissue which do not allow propagation of irregular electrical current responsible for atrial fibrillation.  

Catheter ablation 

A high-frequency electrical energy is given to the heart through a catheter to ablate the abnormal rhythm-producing area. This helps to prevent propagation of abnormal current, which is responsible for arrhythmias. Catheter ablation is useful in treating atrial flutter, supraventricular tachycardia, and ventricular tachycardias. For optimal treatment, this ablation is combined with other forms of therapy. 

Implantable cardioverter-defibrillator (ICD)

This sophisticated device treats ventricular arrhythmias by monitoring the electrical activity of the heart. When it detects abnormal and fast rhythm, it delivers a small ‘shock’ to restore the normal rhythm of the heart. 

Pacemaker 

In case of arrhythmias causing the heart to slow down (bradyarrhythmias), the condition is often treated with pacemakers. Pacemakers are devices implanted near the collarbone with electrodes reaching the inner aspect of the heart through blood vessels. When the heart rate slows, pacemakers send impulses to the heart to stimulate it. This maintains steady rate of the heart.  

Heart surgery

If the medication and devices are not resolving the arrhythmias, heart surgery is used for treatment. Two surgeries for correcting the rhythm abnormalities include: Maze and the modified Maze. These procedures are performed on their own, or combined with valve surgery. 

Maze procedure involves incisions in the upper part of the heart (atria) to create a maze-like scar tissue, thereby interfering with abnormal electrical activity of the heart. Know more about this procedure at oladoc.com.

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