Treatment
Medication
All drugs used in the treatment of arrhythmias have potentially serious side effects – sometimes an anti-arrhythmic drug may worsen or even cause arrhythmias.
Treatment therefore must be given with this borne in mind and can often be by trial and error.
Artificial Pacemakers
These are small electrical devices that are placed under the skin and have wires that go down through a vein into the heart. They now have a life of 10 -15 years.
Pacemakers stimulate the heart muscle and are usually fitted to treat slow arrhythmias but they can be used to override and reduce fast arrhythmias.
Electrical cardioversion
This is when an electrical shock is used to shock the heart out of the arrhythmia and to restore normal rhythm.
A defibrillator is the machine that delivers the shock. These are used in hospitals, ambulances etc.
Sometimes, an implantable cardioverter defibrillator (ICD) is placed under the skin and used in patients who are likely to die of an arrhythmia.
These electronic devices sense the arrhythmia and initially “overdrive” the arrhythmia and if this is not successful then deliver a shock to the heart to restore sinus (or "normal") rhythm.
The patient would be likely to need medication as well.
It is the preferred treatment for ventricular tachycardia or ventricular fibrillation and these patients usually will have experienced at least one cardiac arrest in the past.
Radiofrequency Catheter Ablation
This is now used in the management of arrhythmias and is the treatment of choice for arrhythmias such as ectopic atrial tachycardias, AV nodal re-entry tachycardia and the Wolff-Parkinson-White syndrome.
Atrial flutter and rare forms of, and difficult-to-treat atrial fibrillation, can be treated this way. If heart block is caused by the ablation a permanent pacemaker must be used to pace the heart.
Treatment (depends on type of arrhythmia)
- Reassurance may be all that is needed in harmless arrhythmias.
- Remove factors such as caffeine, alcohol, thyrotoxicosis, anaemia, pregnancy and electrolyte imbalance of the blood.
- Treat underlying condition such as ischaemic heart disease.
- Drug treatment may be only used for an attack or may be on a regular basis.
- Pacemaker may be needed.
- Defibrillator including "anti- tachycardia pacing".
- Ablation.
