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Cardiology Services: Arrhythmia Treatment
 Arrhythmia Treatment

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(213) 372-5245  |  (949) 650-2400

Arrhythmia Treatment

Arrhythmia is irregular heart rhythm that is too fast, too slow or erratic. It is caused by a change in the normal  sequence of electrical impulses that control contraction of heart muscles and thereby control pumping of blood from the heart to the rest of the body. Some arrhythmias are harmless and occur as a normal response to exercise or stress. However, there are other types of heart rhythm abnormalities that are associated with heart disease, stroke and heart failure. These are serious and require medical treatment to keep the heartbeat regular.
 

Causes

Arrhythmia may be caused by many different factors which include:
  • Smoking
  • Alcohol abuse
  • Excessive caffeine
  • Drug abuse
  • Certain medications and supplements, including over-the-counter cold and allergy drugs and nutritional supplements
  • Stress
  • Diabetes
  • High blood pressure
  • Coronary artery disease
  • Overactive thyroid gland (hyperthyroidism)
  • Underactive thyroid gland (hypothyroidism)
  • Heart attack that is currently underway
  • Injury to the heart from a previous heart attack
  • Changes to the heart's structure (such as in cardiomyopathy)
  • Congenital heart disease - being born with a heart abnormality
  • Electrolyte imbalances in the blood (such as sodium, potassium, calcium or magnesium)
  • Sleep apnea - breathing interruption during sleep
  • Genetics

Symptoms

Symptoms of arrhythmia often include:
  • Lightheadedness  or dizziness
  • Breathlessness (shortness of breath)
  • Fainting (syncope) or near fainting
  • Chest pain
  • Palpitations
  • Sweating
  • Fluttering in the chest (or fibrillation)
  • Racing heartbeat (tachycardia) - a resting heart rate greater than 100 beats per minute
  • Slow heartbeat (bradycardia) - a resting heart rate less than 60 beats per minute
  • Premature heartbeats - an extra heartbeat that often feels like a skipped beat

Diagnosis

Tests that are used to diagnose arrhythmia include:
Patient with arrhythmia

Treatment

Treatment depends on the seriousness of your condition. Some arrhythmias require no treatment. Effective therapy of more serious arrhythmia depends on the underlying cause. 
Therapies that we offer include:
Vagal maneuvers - coughing
  • Vagal maneuvers
Vagal maneuvers are used to slow down a fast heart rate. They include holding your breath and bearing down (straining) , gagging, immersing your face in ice-water, or coughing. These maneuvers stimulate the nervous system that controls your heart beat (vegus nerves) and they slow the electrical impulses through the atrioventricular (AV node) of the heart. However, vagal maneuvers don't work for all types of arrhythmia.
Heart medications
  • Medications
If you have fast-heartbeat-arrhythmia (tachycardia), the doctor may prescribe medications to control your heart rate or establish a normal heart rhythm. There are a number of drugs available for treating arrhythmia. These include drugs to control heart rate, drugs to convert arrhythmia to sinus (normal) rhythm, anti-coagulant or anti-platelet drugs to reduce risk of blood clots or strokes and medications to treat related conditions that may be causing an abnormal heart rhythm. It is important to take these medications exactly as directed by your doctor to minimize complications.
Cardioversion
  • Cardioversion 
If a persistent irregular heart rhythm (such as atrial fibrillation)  cannot be controlled by drugs, cardioversion may be required. In this procedure, after administering a short-acting anesthesia, electrical shock is delivered to the heart using special paddles or patches on the chest to restore normal rhythm.
Heart pacemaker
Implantable cardioverter-defibrillator
  • Pacemaker 
Usually implanted just below the collarbone, a pacemaker is a small device that sends electrical impulses to your heart muscle to keep a steady heart rate. It is mainly used to prevent the heart from beating too slowly.
  • ICD (implantable cardioverter-defibrillator)
An ICD is a small device the size of a stopwatch that is inserted under the skin just below the collarbone. It consists of a pulse generator and wires called leads. The pulse generator, which contains a tiny computer is connected via the wire leads to specific locations in the heart. ICD restores normal heart rhythm by delivering low- or high-energy electrical impulses or shocks to the heart muscle. It is generally recommended for those who are at high risk of cardiac arrest due to a ventricular arrhythmia such as ventricular tachycardia and ventricular fibrillation, two life-threatening heart rhythms. ICDs can be used for:
o    Anti-tachycardia pacing - regulating a fast heart beat by sending electrical impulses to the heart.
o    Cardioversion/Defibrillation - correcting a heart rhythm that is dangerously fast or irregular by delivering a shock to the heart muscle.
o    Anti-Bradycardia pacing - Providing backup pacing and stimulating a heart that beats too slow until normal rhythm returns.
Catheter cardiac ablation
  • Catheter Ablation Therapy 
Also known as cardiac ablation, this procedure guides a catheter through which high frequency electrical energy is delivered to a small area of tissue inside the heart that is causing the abnormal rhythm. Cardiac ablation works by scarring or destroying the suspected tissue or by disconnecting the pathway of the abnormal rhythm. This procedure can be used to treat most Supraventricular Tachycardias (SVTs), atrial flutter, some atrial and ventricular tachycardias and atrial fibrillation.
  • Lifestyle changes
In addition to other treatments, the doctor may suggest changes to your lifestyle to keep your heart as healthy as possible. These changes are outlined under 'Prevention' section below.

Prevention

Living a heart-healthy lifestyle may help prevent heart arrhythmia and reduce the risk of heart disease. A heart-healthy lifestyle includes:
  • Avoiding or limiting caffeine and alcohol intake
  • Avoiding smoking
  • Exercising caution when using over-the-counter medications and supplements as some may produce a rapid heartbeat
  • Eating a heart-healthy diet
  • Increasing physical activity
  • Reducing stress
  • Maintaining a healthy weight
Heart-healthy lifestyle
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