The heart’s ability to pump blood depends on the coordinated action of four heart chambers. What controls this elegant series of heart muscle contractions and relaxations? There is an electrical system that is present right in the heart muscle itself. About 60 times a minute the heart sends out a signal that is transmitted across the heart muscle causing it to contract and relax at just the right time. The electrical system works beautifully in most cases, but when it does not, the condition is known as a cardiac arrhythmia.
There are a number of different cardiac arrhythmias, or abnormal heart rhythms. Some cardiac arrhythmias are more serious than others. Atrial fibrillation, for example, can be dangerous over the long term if untreated, but is not usually immediately fatal. On the other hand, ventricular tachycardia or ventricular fibrillation can spell death within a few minutes. The type of cardiac arrhythmia treatment depends on the type of cardiac arrhythmia.
For immediately life-threatening conditions, cardiac arrhythmia treatment is delivered through a cardiac defibrillator. Newer systems which are present in airports, sports stadiums, and other public places can automatically detect the abnormal rhythm. If a particular abnormal rhythm is present, the device delivers cardiac arrhythmia treatment in the form of an electric shock to the chest (and heart). This shock or series of shocks is usually enough treatment for arrhythmia since it “resets” the heart’s electrical system and puts it back into a normal rhythm.
For cardiac arrhythmias that are not immediately life-threatening, there are a number of medical and surgical arrhythmia treatments available. Medical arrhythmia treatment is divided into two main types: rate control or rhythm control treatments for arrhythmia. Rate control cardiac arrhythmia treatments, as you would expect, attempt to keep the heart rate reasonably slow. If the heart can beat slowly, even if the rhythm is a little off, it can usually pump enough blood to the body. Also the heart can receive a good blood supply from the coronary arteries if the heart rate is slow enough.
Rhythm control medications make or maintain a normal cardiac rhythm. These drugs change the electrical conductivity of the heart muscle. Again the type of cardiac arrhythmia treatment is dependent on the type of cardiac arrhythmia.
There are pros and cons to both rate and rhythm control medications. The arrhythmia treatments that target heart rate are very safe but not terribly effective. On the other hand, the rhythm drugs can be very effective but are associated with a number of potentially serious side effects. One of the major side effects of rhythm control medications is that they can cause new cardiac arrhythmias. This is obviously not very helpful.
Pacemakers and defibrillators within the heart are two tried-and-true cardiac arrhythmia treatments. A cardiac pacemaker is a device that overrides the hearts natural electrical system and delivers it own pulse to control the pumping action of the heart. An intracardiac defibrillator gives a little shock to the heart from the inside if a dangerous cardiac arrhythmia is detected. Both of these actions may be found in the same device.
One of the newer forms of arrhythmia treatment is radiofrequency ablation. A catheter is placed in a vein or artery in the leg and maneuvered into the right or left atrium. An area of abnormal heart tissue is identified and ablated (destroyed) with the catheter tip. Radiofrequency ablation is usually sufficient arrhythmia treatment for certain heart arrhythmias such as atrial fibrillation and atrial flutter.