Treatment of arrhythmias – a guide for the patient

Proven content

Patients with arrhythmias are suggested to many different treatments and may feel confused. This is because there are dozens of types of this condition. They differ in symptoms, severity, prognosis and treatment options.

It is often said that medicine is an art, which means that the diagnosis and treatment of many diseases is ambiguous. Therefore, specialists may have different views on the same disease states, although there are recommendations of scientific societies defining best practices. The decision should be made by the patient after consulting a specialist, and not on the basis of myths circulating among patients.

Arrhythmic myths

Many myths have arisen around the treatment of arrhythmias. Disseminated by patients is certainly not effective in treatment. The first is: My neighbor had this surgery. Why can’t I have? Experts emphasize that while all people appear to be built the same, this is not true. The same applies to arrhythmias. Just because a neighbor has had an ablation procedure, for example, and is now fine, doesn’t mean that every arrhythmia can be treated this way. There are many different arrhythmias, not all of which may be surgically treated.

Another myth is: A friend of mine had a friend who died after having a pacemaker implanted. Unfortunately, it has a significant influence on the decision of many patients to continue treatment. Patients often trust finger-tipped opinions on medical issues from colleagues or neighbors. Each procedure and each medical procedure carries a certain risk, but the risk-benefit analysis weighs the balance on the benefit side. Therefore, it is not worth giving up a good method of treatment just because it carries some, sometimes only trace, risks. It should also be remembered that many patients undergoing cardiac treatment are sick, in poor general condition. Among such people, the risk increases. Always ask your doctor for an objective risk-benefit analysis, which will definitely help you make the right decision.

Many patients also reject certain treatments because they don’t want any machine in their body! Meanwhile, many electrophysiological therapies are based on implanting highly technologically advanced machines into the patient’s body. Some feel uncomfortable knowing that they have such a device inside them. Such fear is unnecessary, because such devices are implanted in medicine more and more often (e.g. artificial dentures, dental implants, etc.). Pacemakers are highly specialized devices that greatly improve the quality of the patient’s life.

The repeated myth that it’s unnatural! Also does a lot of damage. Many patients who believe in a natural approach to treatment are opposed to electrophysiological therapies. The only natural course of action is to leave the patient with the problem to himself, which would inevitably be associated with death in some cases.

Stimulator

There are many treatments for arrhythmia. In the case of serious disturbances of the heart rhythm, periodic lack of pulses or disturbances in their conduction from the atria to the ventricles, implantation of a simulator is considered.

It is a device used to electrically stimulate the heart rhythm. They are implanted under the skin of the chest. It is connected to the heart by one or two wires called electrodes, which are inserted into the heart through a vein.

Kardiowerter – defibrillator

A cardioverter defibrillator is a small, subcutaneously implanted electronic device designed to identify life-threatening cardiac arrhythmias and perform appropriate electrical intervention to terminate it. The device connects to the heart with a wire called an electrode, which is inserted into the heart through a vein. The cardioverter defibrillator is powered by an internal battery, the duration of which depends on the number and type of interventions. It is implanted in patients who have severe arrhythmias of ventricular origin, such as ventricular tachycardia, and in those who have had VF arrest. It is worth emphasizing that the cardioverter-defibrillator interrupts the patient’s malignant arrhythmia, which is the most common cause of sudden cardiac death.

Resynchronization systems (CRT resynchronization pacemaker)

Another device is a cardiac resynchronization pacemaker, whose task is to reduce the degree of desynchronization in the work of the heart ventricles in people with impaired conduction of electrical impulses in the heart. It is implanted subcutaneously and connected to the heart by electrodes. The device has three electrodes and it is the additional third electrode that stimulates the left ventricle. It is inserted into one of the heart’s veins on the side wall of the left ventricle. Appropriate programming of the device allows for the synchronization of the contractions of the right and left ventricles, which improves the work of the heart by about 20%.

RF ablation

The ablation procedure consists in removing the focus of the arrhythmia. First, electrodes are inserted through the femoral vein or artery into the heart. In order to determine where the focus of the arrhythmia is, attempts are made to trigger it by stimulation or pharmacology. When an arrhythmia focus is successfully registered, the tip of the electrode is heated to approximately 60 ° C to permanently burn the arrhythmic site. Ablation may feel like a burning sensation in your chest. During the procedure, the patient is given painkillers. Then the effectiveness of the procedure is verified by trying to trigger the arrhythmia again. Then the electrodes are removed, a pressure dressing is put on, with which the patient has to lie down for several hours.

Medical consultation: dr Radosław Sierpiński, Heart for Arrhythmia Foundation