What medicine is used for arrhythmia?

Written by Chen Ya
Geriatrics
Updated on September 04, 2024
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There is still no consensus on the drugs commonly used for arrhythmia. The main classes used clinically are as follows: The first class is sodium channel blockers, which include three subclasses: moderate, mild, and significant sodium channel blockers, respectively comprising quinidine, lidocaine, and propafenone. The second class mainly consists of adrenergic receptor blockers, with propranolol being a representative drug. The third class of drugs selectively prolongs the repolarization process, among which amiodarone is commonly used clinically. The fourth class is calcium channel blockers, which mainly block calcium channels and inhibit the inflow of calcium, with verapamil being the main representative drug. Long-term use of anti-arrhythmia drugs can cause varying degrees of side effects, with severe cases possibly leading to ventricular arrhythmia or fatal cardiac conduction block. Therefore, when using these drugs clinically, it is essential to strictly control the indications, monitor adverse reactions, and strictly follow the doctor's prescription for rational medication.

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Written by Chen Ya
Geriatrics
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How to treat arrhythmia?

The treatment of arrhythmias should be based on the symptoms of the patients with arrhythmias, the type of arrhythmias, and their impact on hemodynamics. Control of arrhythmias during episodes involves removing the cause and focus of the disease and preventing recurrence, which can be divided into non-pharmacological and pharmacological treatments. Non-pharmacological treatments include methods such as eyeball compression, carotid sinus massage, pinching the nose to exhale forcefully and hold breath to reflexively excite the vagus nerve, along with electrical treatments like electrical cardioversion, defibrillation, pacemaker implantation, and ablation surgery. There are mainly four types of drugs used: sodium channel blockers; beta-adrenergic blockers; drugs selectively prolonging the repolarization process, such as amiodarone; and calcium channel blockers. However, long-term use of these antiarrhythmic drugs can have varying degrees of side effects, and severe cases can cause ventricular arrhythmias or cardiac conduction block which can be fatal. Therefore, in clinical application, it is essential to strictly control the indications, monitor for adverse reactions, and rigorously follow the doctor's orders.

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Written by Chen Ya
Geriatrics
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Arrhythmia is caused by what?

Arrhythmia is caused by abnormal excitation of the sinoatrial node or excitation originating outside the sinoatrial node, with slow conduction, blockage, or conduction through abnormal pathways. This results in the frequency and (or) rhythm abnormalities of heartbeats, which are collectively referred to as arrhythmias. Most of the causes include the following: one is genetic arrhythmias, often due to gene channel mutations, such as the commonly seen long QT syndrome, short QT syndrome, Brugada syndrome, etc. There are also acquired arrhythmias, seen in various organic heart diseases, including coronary atherosclerotic heart disease, commonly referred to as coronary heart disease, cardiomyopathy, myocarditis, and rheumatic heart disease, particularly prevalent during heart failure or acute myocardial infarction. Arrhythmias are also not uncommon in basically healthy individuals or patients with autonomic dysfunction. Other causes include electrolyte imbalance or endocrine disorders, and sometimes anesthesia, hypothermia, or surgery, such as thoracic or cardiac surgery, or medications, central nervous system diseases may also cause arrhythmias, but the specific reasons are not very clear.

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Written by Wang Li Bing
Intensive Care Medicine Department
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What is ventricular arrhythmia?

Ventricular arrhythmias mainly refer to disorders of the ventricular rhythm and are relatively common clinically, including premature ventricular contractions, ventricular tachycardia, ventricular flutter, and ventricular fibrillation. Premature ventricular contractions generally do not cause noticeable clinical symptoms, while ventricular flutter and ventricular fibrillation are very dangerous clinically and must be treated promptly with defibrillation. Therefore, ventricular arrhythmias must be treated promptly, actively treating the underlying disease, and managing the arrhythmia to prevent sudden death.

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Written by Chen Ya
Geriatrics
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What should be paid attention to in daily life with arrhythmia?

For managing arrhythmias, it's important to pay attention to several aspects. First, maintain a regular lifestyle and ensure adequate sleep. Second, the living environment should be quiet and serene to avoid noise, and it’s beneficial to grow various plants for a better temperament. Third, balance work and rest according to personal capacities and engage in appropriate physical activities such as walking, Tai Chi, and Qigong; moderate sexual activities and avoid colds. Fourth, strive to maintain a standard weight and not indulge in overeating, as obesity can increase cardiac load. Fifth, be mindful of changes in seasons, weather, and climate, as extreme cold or hot conditions can significantly impact the disease, potentially aggravating or triggering arrhythmias. Sixth, diet should be light with frequent, small meals, and avoid coffee, strong alcohol, fried foods, and minimise strong tea. Seventh, keep a stable emotional state and try to eliminate stress, fear, anxiety, irritation, and anger which are stimulants that could negatively affect your emotions. Eighth, in addition to daily medications, have emergency medications prescribed by a doctor on hand, such as Xintiandan, Shexiang Baoxin Pill, Xintongding, Atropine, etc. Ninth, if there are sudden exacerbations of arrhythmia accompanied by palpitations, chest tightness, dizziness, low blood pressure, and sweating, and in severe cases fainting, seek medical attention promptly.

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Written by Chen Ya
Geriatrics
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What department should one go to for arrhythmia?

Arrhythmia is an important group of diseases among cardiovascular diseases. It can occur on its own or in conjunction with other cardiovascular diseases, thus it mainly requires consulting a department of cardiology. However, due to other causes such as electrolyte or endocrine disorders, anesthesia, hypothermia, thoracic or cardiac surgery, drug effects, and central nervous system diseases, the assistance of endocrinologists and neurologists is needed for diagnosis and treatment. Sometimes, the arrhythmia might be caused by endocrine disorders, such as thyroid diseases or hypoglycemic symptoms in diabetes, necessitating a consultation with the department of endocrinology. If symptoms like transient blindness, fainting, dizziness, or convulsions occur, it is essential to consider brain-related diseases, such as epilepsy or transient insufficient brain blood supply, and consult the department of neurology to make a differential diagnosis.