Treatment
Many arrhythmias do not require treatment. However, advances in medical technology have added new treatment methods to the procedures that doctors may use to try to control or eliminate arrhythmias.
Automatic implantable defibrillator: If you have been found to be at recurring risk of heart rhythm problems such as ventricular tachycardia (when the heart beats at a dangerously fast pace) or ventricular fibrillation (when the heartbeat is both fast and irregular), an automatic implantable cardioverter defibrillator (AICD) may be your best insurance against cardiac arrest.
This device effectively controls the abnormal, life-threatening heart rhythms and protects you from sudden cardiac death.
It continuously monitors your heartbeat and delivers precisely calibrated electrical shocks to correct ventricular tachycardia or ventricular fibrillation, restoring a normal heartbeat.
One or two flexible, insulated wires run from the AICD through your veins to the lower chambers of your heart. As the AICD is constantly on guard for abnormal heartbeats and instantly able to correct them, it helps protect you from cardiac arrest even if you are hours away from the nearest hospital.
As the name suggests, the AICD has two primary functions:
• Cardioversion
When the AICD detects ventricular tachycardia, it delivers a mild electrical shock that converts the fast heartbeat into a normal heartbeat.
• Defibrillation
Sometimes cardioversion fails and ventricular tachycardia either worsens or progresses into ventricular fibrillation. At other times, ventricular fibrillation develops spontaneously.
When the AICD detects either of these life-threatening rhythm abnormalities, it delivers a strong electrical shock that defibrillates or resets your heart to start beating normally.
A heart specialist can determine whether you are in need of an implantable defibrillator. He may perform any of the following diagnostic tests:
• Electrocardiography, a noninvasive test that measures your heart’s electrical activity;
• Echocardiography, a noninvasive ultrasound test that shows how well your heart pumps blood;
• Electrophysiology study, a procedure where electrodes are guided through blood vessels to your heart and used to test the condition of your heart’s electrical system, locate short circuits and identify heart rhythm problems by reproducing them;
• Holter monitoring, a noninvasive test that requires you to wear a device that records your heart’s electrical activity for 24 to 48 hours
Pacemaker: If you have been found to have a heartbeat that is too slow, either due to a sinus syndrome or heart block, a pacemaker can be implanted in the body to take over the function.
This small electronic device automatically monitors and regulates the heartbeat, by transmitting electrical impulses to stimulate the heart when it is beating too slowly.
Most pacemakers also have a sensing device that turns off the device when the heartbeat is above the pre-set rate.
Catheter Ablation: For most types of fast heart rhythms, a cure can be achieved by performing a
catheter ablation procedure – an extension of the electrophysiological study.
This procedure is a non-surgical technique in which several thin tubes (catheters) with electrodes are introduced into the blood vessels and directed into the heart.
Small areas of the heart muscle that cause the abnormal heart rhythms are then located, and destroyed using bursts of radiofrequency energy that is delivered via the catheter to ablate (or destroy) it.
When successful, the condition is usually cured and medications may no longer be necessary.