5 Arrhythmia drug options and medical procedures to treat it

Arrhythmias include heart disease that causes disturbances in the normal heart rate. In some mild cases, arrhythmias do not need special treatment. However, in more severe cases, arrhythmia treatment is needed because it can cause stroke or heart failure. So, what are the options for arrhythmia drugs and medical procedures to treat heart disease? Check out the following reviews of anti-arrhythmic drugs.

Drug options for treating cardiac arrhythmias

Arrhythmias can recur causing disturbing symptoms, such as the change in heart rate (faster, slower, or irregular) that some people feel, such as the sensation of a pounding heart. Sometimes, the symptoms are also followed by shortness of breath, chest pain, dizziness, and weakness.

Fortunately, the symptoms of this heart rate disturbance can be relieved and the recurrence is prevented by the treatment of arrhythmias, namely by taking medication. According to the Vaughan-Williams classification system, these cardiac arrhythmia drugs are divided into 4 main categories with several additional drugs, including:

1. Drug class I

Class I anti-arrhythmic drugs are a group of sodium-channel blockers, which slow down electrical conduction in the heart. The reason is, electrical disturbances in the heart are one of the causes of arrhythmias because they can slow down, speed up, and even increase the number of heartbeats.

Studies have found that the fatal side effect of using this drug is death. This is most likely due to an overdose, that is, overdoing the recommended drug dose or using another drug that changes the substance elimination kinetics.

Therefore, the use of arrhythmia drugs must be very careful and in accordance with the recommendations given by the doctor.

Examples of class I drugs include ethmozine (moricizine), rythmol SR (propafenone), Norpace CR (disopyramide), dilantin (phenytoin), procanbid (procainamide), xylocaine HCl (lidocaine), quinidex extentabs (quinidine), and mexitil (mexiletine).).

2. Class II drugs

This class II anti-arrhythmic drug is a type of beta-blocker drug. These drugs work by blocking stimulation of the sympathetic nervous system to the heart, thereby reducing the delivery of impulses to the heart.

In addition, this drug can also reduce blood pressure which blocks the effects of the hormone epinephrine (adrenaline), so that the heart rate does not exceed normal levels too fast.

Common side effects when you use this arrhythmia drug are insomnia, weight gain, fatigue, and cold hands and feet.

Beta blocker drugs are commonly used as first-line treatment for heart rate disorders, such as symptomatic supraventricular tachycardia (SVT).

Examples of types of beta-blocker drugs include sectral pro (acebutolol), innopran XL pro (propranolol), brevibloc pro (esmolol), inderal pro (propranolol), inderal pro LA (propranolol), and pro hemangeol (propranolol).

3. Drugs group III

Arrhythmia drugs group III is a class of potassium-channel blockers, whose job is to bind and block potassium channels, which in turn can prolong cell membrane repolarization. Repolarization is the condition of the cell membrane to rest or not receive stimulation.

By blocking the potassium channels, sinoatrial and atrioventricular performance is not compromised. Sinoatrial, also known as sinus node, is a cluster of cells in the right upper part of the heart. These cells function to send electrical signals so that the heart muscle can contract regularly.

While atrioventricular is the node that lies between the atria and ventricles. Its job is to regulate electrical activity in the heart.

The use of this drug must be supervised by a doctor because side effects can affect heart rhythm, namely causing the heart rate to slow down below 60 beats per minute and heart node dysfunction.

Examples of potassium-channel blockers include pacerone pro (amiodarone), tikosyn pro (dofetilide), multaq pro (dronedarone), cordarone pro (amiodarone), and betapace pro (sotalol).

4. Drugs group IV

Group IV arrhythmia drugs are a class of calcium-channel blockers that act to block calcium channels and thus reduce the movement of calcium ions in cells during their potential action.

That is, it regulates the entry of calcium into muscle cells so that it does not cause excessive contraction in the smooth muscle of the heart, relaxes the smooth muscle of blood vessels, and decreases the conduction rate in the heart.

The side effects of these anti-arrhythmic drugs are causing bradycardia, headaches, edema (swelling in the body), and a drop in blood pressure below normal (hypotension).

Examples of calcium-channel blockers are dilt-XR pro (diltiazem), isoptin SR pro (verapamil), tiazac pro (diltiazem), cartia XT pro (diltiazem), cardizem LA pro (diltiazem), and calan pro (verapamil).

5. Other arrhythmia drugs

In addition, there are also several other types of drugs used for the treatment of arrhythmias, including:

Adenosine

Adenosine is a drug used to treat various types of arrhythmias and is taken during a cardiac stress test. This drug is available in liquid form and how to use it is injected into a vein. This medicine should not be used in combination with other medicines that contain caffeine, because of the risk of causing side effects.

If you have seizure problems, asthma, or emphysema (chronic obstructive pulmonary disease), tell your doctor before using this anti-arrhythmic medication. Possible side effects include seizures, chest pain, shortness of breath, headache, and sudden numbness.

Digoxin

The drug digoxin is commonly used to treat heart failure and arrhythmias. The function of this drug is to help the heart work better while controlling the normal heart rate.

Digoxin is available in tablet, capsule, and liquid form and is usually taken only once a day. Tell your doctor if you are taking antacids, antibiotics, or other heart medications.

Side effects that may occur after you take this anti-arrhythmic medicine include dizziness, irregular heartbeat, impaired vision, nausea and vomiting, and diarrhea.

Things to watch out for when taking arrhythmia drugs

Taking medication as a treatment for arrhythmia is indeed a powerful way to control symptoms. However, whether or not you can use the arrhythmia treatment requires permission from a doctor. The reason is, not all drugs are safe for use in people with certain health problems.

In addition, some people also react to different drugs. That is why, there are some people who are not suitable for taking certain arrhythmia medications because their bodies have unusual reactions. Dosage rules and timing of taking medication must also be in accordance with the doctor's advice.

Ask a heart specialist who treats various things you may need to avoid or limit, such as drinking coffee, alcohol, or other drugs.

How to treat arrhythmias other than taking medication

If the treatment for arrhythmias in the form of drug consumption does not relieve heart rhythm disorders, the doctor will take further action, namely recommending a medical procedure.

Reporting from the National Heart, Lung, and Blood Institute page, medical procedures performed as a way to treat arrhythmias include:

1. Cardioversion

Cardioversion, also known as defibrillation, is a medical procedure that needs to be performed when an arrhythmic patient has a sudden heart attack. It is also necessary that atrial fibrillation patients have a high risk of having a stroke or heart failure.

Cardioversion is usually performed by a cardiac surgeon, which takes several minutes. The preparation begins with the administration of anesthesia in the blood vessels to make you lose consciousness. Then, electrodes will be placed on your chest or back.

There is a cardioversion machine that records the electrical activity of the heart and sends a shock to the heart. When ready, one or more surprises will be sent to restore a normal heart rhythm.

After the procedure, you will need to rest for several hours in the hospital. Doctors and medical personnel will monitor heart rhythm and blood pressure to avoid complications. After being allowed to go home, you will be prescribed an arrhythmia medication.

Although rare, cardioversion can cause side effects, for example, a red rash on the skin, a blood clot rupture, which can lead to a stroke. In addition to anti-arrhythmic drugs, you will also be given anticoagulant or anti-platelet drugs.

2. Radio frequency ablation

Radio frequency ablation is a procedure for treating arrhythmias using radio frequency signals that are sent by making an incision. The process of forming an incision usually uses laser light energy or cold energy (cryoablation).

This procedure is done specifically to treat certain types of arrhythmias, for example ventricular fibrillation and atrial fibrillation.

All types of ablation require cardiac catheterization to place a flexible tube into the heart. But before it is done, you will first be given an anesthetic to be more relaxed and not feel pain. The opening for the catheter is made around the arm, groin, upper thigh, or neck area.

Fluoroscopic imaging methods are also needed to help the surgeon see the position of the catheter towards the heart. Some catheters are sometimes equipped with wire electrodes to record and locate the source of an abnormal heartbeat.

Once the catheter has successfully entered the site, a surge of energy will be sent to create a scar (ablation line). This scar is what will become a barrier to electrical impulses from the damaged tissue so that arrhythmias do not occur again.

After that, the doctor will pull out the catheter and close your wound. Usually will be asked to spend the night in the hospital for deeper monitoring of treatment. You are also prohibited from moving a lot, to prevent bleeding from the scar. Therefore, the doctor will provide arrhythmia drugs and other drugs to support the body's recovery.

Just like cardioversion, cardiac ablation procedures can also have side effects, such as infection, bleeding, damage to blood vessels, and blood clots.

3. Pacemakers

Apart from surgical procedures, treatment for arrhythmias can also be done by using a pacemaker. This device is placed on the chest or stomach to help control abnormal heart rhythms by sending electrical impulses to the heart.

The use of a pacemaker can prevent fatigue and fainting, thereby helping arrhythmia patients to be more active. The use of heart aids can be temporary or permanent, depending on the patient's health condition.

4.Implantable cardioverter-defibrillator (ICD)

Apart from pacemakers, there is also an implantable cardioverter-defibrillator (ICD) device. This tool is recommended for patients experiencing very fast heart rates, such as ventricular tachycardia. Likewise with people who are at risk of sudden heart attack, the use of tools is highly recommended.

An ICD is a battery-powered device that is implanted under the skin near the collarbone, similar to a pacemaker. One or more wires that end with electrodes are threaded through a vein to the heart. The goal, to monitor your heart rhythm.

Even if you use this tool, arrhythmia drugs and other drugs still need to be taken to keep heart function stable.

5. Maze procedure

A surgeon will make an incision in the upper heart tissue to create a maze-shaped scar. That is why, this procedure is called the Maze procedure.

The goal of this treatment is to create a barrier to the tissue so that electrical impulses no longer cause arrhythmias. Usually this is done when previous medical procedures have not treated the arrhythmia effectively.

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