Cardiac arrhythmias - treatment and therapy

Complications may be expected in persistent cardiac arrhythmia, especially when the heart muscle due to an organic heart disease such as coronary heart disease, cardiomyopathy, heart valve disease or myocarditis is so far damaged that it can not maintain its normal pumping function by the cardiac arrhythmia and thus the circulation is impaired.

Types of arrhythmias

In the most vicious form of ventricular arrhythmia, the so-called ventricular fibrillation, it comes in any case, regardless of the muscle power of the heart, the cardiovascular arrest - and without emergency treatment by an electric shock to cardiac death. Even severe circulatory disorders of the heart muscle may be triggered by cardiac arrhythmia.

In less serious cases, persistent or recurrent cardiac arrhythmias may increase pre-existing cardiac insufficiency. A particular form of cardiac arrhythmia, atrial fibrillation, which may be accompanied by a rapid, irregular pulse, also promotes the formation of blood clots in the atrial cavities of the heart. If these blood clots enter the brain with the natural bloodstream, strokes can occur.

First diagnosis, then treatment

As a rule, it is the general practitioner who first makes an electrocardiogram, or ECG, at rest. Electrodes are placed on the upper body and wired with the measuring device - this is fast and painless. The curve of the recorded cardiac currents gives first indications as to whether the heart is healthy or a possible disorder exists.

For even more accurate results, the ECG can be repeated under load on the stationary or treadmill, or an ECG can be made around the clock (24-hour ECG). Sometimes an ultrasound echocardiogram or a catheter examination with a contrast image of the coronary arteries or the cardiac conduction tracts becomes necessary for the exact clarification. The doctor will refer you to a cardiologist.

Treatment of cardiac arrhythmias

Basically, depending on the type of cardiac arrhythmia, the following treatment options exist, which can be used individually or in combination:

  • drugs
  • shock
  • Herzkatheterablation
  • Automatic defibrillator
  • heart surgery

Emergency treatment for acute cardiac arrhythmias

Acute, persistent arrhythmias originating in the ventricle usually respond well to either electrical shock or intravenous medication. Especially with chronically damaged hearts, but also, for example, in the context of acute myocardial infarction, cardiac arrhythmias of this kind always represent a no-accident situation requiring immediate medical intervention.

Therapy for arrhythmia from the atrium

The far less threatening arrhythmias from the atria can usually also be successfully treated by medication or in some cases by electroshock.

In addition, there is a possibility of catheter ablation in a certain type of cardiac arrhythmia from the atrium, whose attachments are usually already formed at birth. With this method, cardiac catheterization can be used to detect important conduction structures in the heart with electrocatheters for the maintenance of arrhythmia, and to switch them off using radio-frequency energy. In most cases this is associated with a definitive cure.

Treatment of chronic cardiac arrhythmias

In contrast to the acute treatment of cardiac arrhythmias, the drug therapy of chronic recurrent arrhythmia from the heart chambers for the attending physician represents a much greater challenge dar. The dilemma is that on the one hand, the occurrence of potentially life-threatening arrhythmia is not predictable, on the other hand, one hundred percent safe drugs Prevention of these arrhythmias are currently unavailable.

Since the mid-1980s, implantable defibrillators have therefore been developed specifically for patients with recurrent, life-threatening ventricular arrhythmias. These multifunctional devices the size of a cigarette case are usually used under the breast muscle above the left of the heart and can not prevent cardiac arrhythmia, but deliver an effective electric shock when they occur.

Inserting a pacemaker

If a dysrhythmia leads to symptoms such as dizziness, collapse, or fainting due to a slow heartbeat, implanting a cardiac pacemaker is the treatment of choice.

In contrast to the more complex automatic defibrillators, pure pacemakers can also stimulate the heart via electrodes to maintain a minimum heart rate, but are unable to fight cardiac arrhythmias by delivering an electric shock. Due to their lower technical possibilities, pure pacemakers are also significantly smaller than automatic defibrillators.

In individual cases, the problem of cardiac arrhythmia can be remedied or at least favorably influenced by heart surgery, for example heart valve surgery, bypass surgery or, of course, heart transplantation.

Preventive measures

If cardiac arrhythmias in a patient are an expression of organic heart disease, an effective therapy of the underlying disease can usually also treat the arrhythmia. Consequently, any measures required by the patient to prevent progression of his heart disease can simultaneously protect him from arrhythmias.

These include:

  • Dietary measures, nicotine abstinence
  • adequate physical activity and weight regulation in coronary heart disease
  • regular medication
  • Observance of the respective medical orders for all forms of heart disease.

Since heart rhythms often have psychological causes, reducing stress can have a positive effect on the course. In turn, in cardiac arrhythmias, which represent an independent problem of "cardiac electrics", there is usually no possibility of influencing the patient.

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