Treatment of Arrhythmia

Treatment

Treatment methods for arrhythmia have made great progress due to the development of antiarrhythmic drugs, advances in clinical electrophysiological testing, the introduction of artificial pacemakers, and developments in catheter ablation and surgical techniques.

Treatment for arrhythmia is carried out for arrhythmias that cause symptoms and have the possibility of sudden death. A doctor will comprehensively consider the following factors and choose the treatment method that is most helpful for the patient.​

Considerations before treatment

Is the diagnosis accurate?

Is there an underlying disease?

Are there triggers of arrhythmia such as coffee, smoking, alcohol, or medications?

Is treatment necessary? If so, which treatment method is most effective?

Is preventive treatment necessary? If so, which method is most effective?

When treating arrhythmia, treatment effectiveness can be further improved not only by treating the arrhythmia itself, but also by avoiding triggers and combining treatment for the underlying disease and left ventricular function. There are five treatment methods for arrhythmia: antiarrhythmic drugs, artificial pacemakers, electrical cardioversion, catheter ablation, and surgical treatment.

1. Antiarrhythmic drugs

Antiarrhythmic drugs are medications that help prevent the occurrence of arrhythmia, and depending on their mechanism of action, they are classified as follows.

1. Class I antiarrhythmic drugs

These are drugs that suppress the occurrence of arrhythmia by stabilizing the cell membranes of cardiac muscle or conduction fibers.

2. Class II antiarrhythmic drugs

These are beta-blocker drugs that reduce the occurrence of arrhythmia by blocking the heart’s beta-adrenergic receptors.

3. Class III antiarrhythmic drugs

These are drugs that reduce the occurrence of arrhythmia by prolonging the width of the cardiac action potential curve.

4. Class IV antiarrhythmic drugs

These are calcium-channel blocker drugs that reduce the occurrence of arrhythmia by blocking calcium channels in the cell membrane of cardiac muscle.

5. Digitalis preparations

These are cardiotonic drugs that reduce the occurrence of arrhythmia by prolonging the refractory period of cardiac tissue and reducing conduction velocity.

2. Artificial pacemaker

This is a method of treating arrhythmia by implanting a pacemaker inside the heart to generate a regular electrical rhythm.

3. Electrical cardioversion

This is a method of treating arrhythmia by delivering direct-current electrical shocks through electrode pads placed on the surface of the body over the heart.

Depending on the type or symptoms of arrhythmia, this may also be performed as an emergency procedure, but recently an implantable automatic cardioverter-defibrillator that is placed inside the body and operates only when needed has also been used.

4. Catheter ablation

This method treats arrhythmia by inserting a catheter into a blood vessel, positioning it at the part of the heart causing the arrhythmia, and then delivering electrical shocks or radiofrequency energy to cut or destroy the tissue.

5. Surgery

This method is mainly performed in adolescent patients who cannot be treated with methods such as antiarrhythmic drugs, artificial pacemakers, or catheter ablation, or who cannot tolerate drug treatment well. It is a method of surgically removing the area causing the arrhythmia. Depending on the type of arrhythmia being treated and the treatment method, a permanent pacemaker may need to be applied after surgery.

So far, we have explained the treatment of arrhythmia.

In the next part, we will learn about dry mouth.

Source: Korea Disease Control and Prevention Agency National Health Information Portal