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 Zhou Yan
Geriatrics
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Can arrhythmia be cured?

There are many types of arrhythmia, some of which, like sinus tachycardia, sinus bradycardia, occasional premature atrial contractions, premature ventricular contractions, and premature junctional contractions, can also occur in healthy individuals and usually do not require treatment. Another category requires treatment, such as supraventricular tachycardia, including atrioventricular nodal reentrant tachycardia, which can be cured by radiofrequency ablation. Additionally, conditions like atrial fibrillation can be treated with radiofrequency ablation; many patients may be cured, but some may not respond to this treatment and require medication instead. There are also patients with intrinsic structural heart disease presenting various arrhythmias that can only be managed with medication, not cured.

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Written by Chen Ya
Geriatrics
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What tests are done for arrhythmia?

The examinations required for arrhythmia are as follows: First, an electrocardiogram, which is the most important non-invasive diagnostic technique for diagnosing arrhythmias. Second, a Holter monitor test should be conducted, which records the electrocardiogram continuously over 24 hours to possibly capture the occurrence of symptoms such as palpitations and fainting, and whether they are related to arrhythmias. It clarifies the relationship between arrhythmias or myocardial ischemia attacks and daily activities, as well as their diurnal distribution characteristics, and can assist in evaluating the efficacy of medications and the condition of pacemakers to some extent. Third is the exercise test; if palpitations occur during exercise, an exercise test can assist in making a diagnosis. Fourth is the esophageal electrocardiogram, which is a useful non-invasive method for diagnosing arrhythmias. Fifth is the cardiac electrophysiological study, typically involving the placement of electrode catheters on the upper and lower parts of the right atrial wall, the tip of the right ventricle, the coronary sinus, and the His bundle area, with the electrical activity at these sites being simultaneously recorded using a multi-channel physiological recorder with 8-12 channels or more.

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Written by Chen Ya
Geriatrics
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Why does arrhythmia cause chest pain?

The causes of chest pain due to arrhythmias primarily involve all kinds of arrhythmias reducing the blood flow in the coronary arteries. Although various arrhythmias can decrease coronary blood flow, they rarely cause myocardial ischemia. However, severe arrhythmias that cause significant myocardial ischemia can result in chest pain. For patients with coronary heart disease, various arrhythmias can induce or exacerbate myocardial ischemia, which may also manifest as chest pain and shortness of breath, and in severe cases, lead to acute heart failure, acute myocardial infarction, and persistent, unbearable chest pain and tightness.

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Written by Chen Ya
Geriatrics
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Arrhythmia refers to what?

Arrhythmia refers to the abnormal origination or conduction of impulses in the heart due to abnormal activation of the sinoatrial node, slow conduction, blockages, or passage through abnormal pathways, leading to abnormalities in the frequency and/or rhythm of the heartbeat. Arrhythmias are a significant group of cardiovascular diseases. They can occur alone or in conjunction with other cardiovascular diseases. The prognosis of arrhythmias depends on their causes, triggers, trends in progression, and whether they lead to severe hemodynamic disturbances, potentially causing sudden death or continuous impairment of heart function leading to heart failure.

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Written by Chen Ya
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Do arrhythmias need treatment?

The treatment of arrhythmias should be based on the symptoms of the patient, the type of arrhythmia, and its impact on hemodynamics to determine if treatment is necessary. For instance, mild sinus bradycardia, irregular sinus rhythm, occasional atrial premature contractions, and first-degree atrioventricular block have minimal impact on hemodynamics. Therefore, if there are no obvious clinical symptoms and no cardiac structural disease, temporary drug treatment may not be required. However, severe arrhythmias such as sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and persistent ventricular tachycardia can cause palpitations, chest tightness, dizziness, low blood pressure, severe sweating, and in severe cases, syncope, Adams-Stokes syndrome, or even sudden death, which require immediate medical attention.