What medicine to buy for arrhythmia?

Written by Zhou Yan
Geriatrics
Updated on September 26, 2024
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Arrhythmia encompasses a large category of diseases, including sinus tachycardia, bradycardia, sick sinus syndrome, as well as atrial fibrillation, flutter, premature atrial contractions, supraventricular tachycardia, premature ventricular contractions, and atrioventricular block, among others. Due to the various types of arrhythmias, the medications used also differ. It is necessary to go to a hospital for a clear diagnosis to determine the specific type of arrhythmia before using appropriate anti-arrhythmic drugs. Some arrhythmias cannot be resolved just by medication; for instance, in cases like pacemaker syndrome, a pacemaker needs to be installed. Additionally, patients with atrial fibrillation who have tachy-brady syndrome also require a pacemaker. Therefore, the decision on what medication to purchase for arrhythmia should be made by a doctor.

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Causes of sinus arrhythmia

Sinus arrhythmia, the most common cause of which is instability of the nerves that regulate the heart, referred to as the autonomic nervous system. This instability leads to sinus arrhythmia, which is commonly seen in children during their growth phase, women during menopause, or individuals who often stay up late and are under significant work stress, leading to dysfunction of the autonomic nervous system. It can also be caused by patterns of breathing that lead to arrhythmias; the heart rate increases during inhalation and slows during exhalation, producing this type of physiological arrhythmia. Generally, this kind of arrhythmia does not require drug treatment. By improving physical exercise, ensuring adequate sleep, and avoiding stimulating beverages or coffee, this type of heart rate can return to normal.

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Written by Chen Ya
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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.

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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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Is atrial fibrillation a serious arrhythmia?

Atrial fibrillation is a type of cardiac arrhythmia, primarily feared for its potential to form blood clots within the heart. These clots can travel to other organs via the bloodstream, most commonly to the brain. Additionally, pieces of these clots can also travel to coronary arteries causing myocardial infarction, leading to organ embolism wherever they lodge. Generally, if no blood clots are formed, many individuals with atrial fibrillation may not experience symptoms. However, if combined with other cardiac conditions such as heart failure or coronary artery disease, atrial fibrillation can exacerbate the risk of developing these heart diseases. Thus, atrial fibrillation on its own is not severe but becomes concerning when associated with other cardiac conditions, increasing the risk of other heart diseases. If atrial fibrillation occurs with left or right accessory pathways, it may also lead to ventricular fibrillation, resulting in sudden death of the patient. Moreover, if the atrial fibrillation has no apparent cause, and the heart structure is normal with no symptoms, then such isolated atrial fibrillation does not typically form blood clots and is considered relatively mild.

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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.