The key to successful treatment of cardiac arrhythmias is in effective treatment and elimination of the cause that caused it. So, if an arrhythmia has arisen as a result of a dysfunction of the thyroid gland, at a reduced function, it is necessary to assign replacement therapy to a patient – the intake of thyroid hormones. In the case of thyrotoxicosis, the prescription of drugs that suppress the secretion of hormones and, in some cases, the removal of the active nodular, will be determining in treatment. If the root cause of the arrhythmia was alcohol abuse, you need to get rid of this bad habit. In the case of diagnosing a heart defect or irreversible sclerotic changes in the cardiac conduction system, surgical intervention may be the decisive method.
Symptoms of arrhythmia
Most often, the symptoms of cardiac arrhythmias are the result of already existing chronic or acute diseases, as well as their complications.
Heart palpitations – a feeling of fluttering or trembling in the heart area – the most common symptom characteristic of tachyarrhythmias. However, it does not always indicate the presence of the disease, since a sharp increase in heartbeat can occur in response to many stressful factors (such as anxiety) and is a fairly common reaction. A more significant sign of a pathological heartbeat is a sudden acceleration of the heart rate at rest and the same rapid resolution of the attack, especially in combination with other symptoms, such as shortness of breath.
Shortness of breath – a feeling of lack of air in combination with tachy- or bradyarrhythmia indicates a violation of the ability of the heart to pump blood. Initially, shortness of breath occurs only during exercise. In the future, serious cardiac dysfunctions associated with arrhythmia can lead to a decrease in cardiac output even at rest. In such cases, there may be other symptoms of heart failure – for example, paroxysmal night dyspnea (awakening in the middle of the night from feeling short of breath).
Presinkopalnye state – dizziness is quite common, not always associated with impaired cardiac activity, but it can be a symptom of a decrease in blood pressure due to arrhythmia. In severe cases, there is a brief deactivation of consciousness (syncope).
Chest pain – may occur with arrhythmic paroxysms (most often with tachyarrhythmias). A distinctive feature of such pain is that it occurs only during an attack. Pain in the heart, which is observed in other conditions, for example during exercise or after eating, most likely has other causes.
Since in most cases the cause of arrhythmias are chronic heart diseases – ischemic heart disease, arterial hypertension, chronic heart failure, the patient is assigned to groups of drugs, the use of which has repeatedly proved their effectiveness in stopping the progression of the underlying disease. These drugs include angiotensin-converting enzyme inhibitors (i-ACE), sartans, beta-adrenoreceptor blockers (? -Blockers), calcium channel antagonists, diuretics, statins, and some other cardiovascular agents. The above groups of drugs have a very multifaceted impact on the pathological processes occurring in the cardiovascular system, but their beneficial effects can manifest themselves only with prolonged use. The treatment of any cardiac arrhythmia of one of the above groups of drugs can only be prescribed by a doctor.
Special antiarrhythmic drugs such as amiodarone (Cordarone), propafenone (Propanorm), sotalol (Sotalex) also have a positive effect on the heart muscle – they not only treat and prevent arrhythmias, but also give rest to the heart, exhausted by arrhythmia.
Surgical treatment method
Surgical procedures for the treatment of cardiac arrhythmias are used quite rarely, and only when the drug method is ineffective.
Pacemaker implantation. A pacemaker is a housing that contains the necessary electronics, and a battery that lasts about 10 years or more. Two or three small wiring with electrodes are connected to the pacemaker. During surgery, they are carried out through the blood vessels to the heart itself, or rather to the atrium and ventricle. Sending, if necessary, electrical impulses that irritate the myocardium, the pacemaker replaces the sinus node and the cardiac conduction system. Thus, the implantation (establishment) of a programmable device allows the patient suffering from arrhythmia to return the normal rhythm of heart muscle contractions. Pacemaker placement occurs more frequently under local anesthesia. It is implanted under the skin or under the pectoral muscle, for which the surgeon makes an incision about 4 centimeters in size.
Implantation of a defibrillator. A defibrillator is an apparatus that is similar in principle to a pacemaker and provides for the restoration of a synchronous contraction of heart fibers using electrical discharges of varying power from less than 1 to 40 J. The defibrillator is implanted into the upper chest, making a cut for this. After that, electrodes are introduced and tested to find the most optimal location. Then the electrodes are attached to the defibrillator, and, after testing its automatic function, the incision in the patient’s chest is sutured. The last step follows: programming of the defibrillator. Studies have shown that for some patients with arrhythmias the implantation of a defibrillator is more effective than drug treatment when it comes to prolonging life.
Radiofrequency ablation (RFA). This is a minimally invasive surgical procedure developed in the nineties of the last century, which allows you to completely cure certain types of arrhythmias. The procedure is carried out in the case of too high a heart rate, with a pulse deficit. The essence of RFA is that using a special catheter, small punctures are made, through which cauterization of a specific, problematic portion of the conductive structures of the heart is done using radio waves. To understand exactly which part of the heart to carry out ablation, an electrophysiological study is performed immediately before this procedure. Ablation is used to restore normal heart rhythm. The greatest effect of RFA is achieved with WPW syndrome.