Other Treatments for Arrhythmias (Heart Rhythm Disturbances)
In this procedure a catheter is introduced through a vein and advanced until it reaches your heart. Then, electrodes are heated with a radiofrequency energy that subsequently destroys (ablates) areas of the heart tissue that where causing the arrhythmia. This procedure is most frequently used to treat arrhythmias such as atrial flutter.
Various causes of a rapid heartbeat can be shocked back to a normal rhythm using electrical current. This procedure is called electrical cardioversion. The underlying mechanism of cardioversion is based on the fact that these rhythms represent circular electrical currents that keep the heart muscle—or parts of it—twitching in an uncoordinated fashion. The electric shock stops the current from circling and allows the natural pacemaker (the sinus node) to take charge. Often, medications are given beforehand to assist in the procedure and protect the patient from the unpleasant effects of the shock.
Cardioversion can also be done with medications called anti-arrhythmics. These medications work by restoring normal sinus rhythm. Frequently, a patient must take these for a prolonged period of time. Common side effects include dizziness, fatigue and nausea.
If the sinus node malfunctions or stops working, an artificial pacemaker can be implanted to generate regular impulses. The devices have long-lasting power supplies, but they need to be checked periodically to make sure they are functioning properly. Pacemakers are implanted during a minor surgical procedure. A wire is attached to your heart either through a blood vessel or directly into the chest. The wire is also attached to the device. An incision is made, and the device is placed under your skin, usually near the collarbone.
These are implantable devices for people who have dangerous rhythm disturbances. They are automatic devices that detect dangerous rhythms and administer an electric shock to the heart if those rhythms occur. The power of the electrical shock depends on the heart rhythm abnormality. It may deliver low energy impulses that most of the time you won't be able to feel . It may also deliver an electrical shock to perform cardioversion which usually feels like a thump in the chest. In case the defibrillator is activated, the device delivers a strong electrical shock that is painful.
These devices have power sources that last a long time. Nevertheless, they should be checked occasionally to make sure they are still working. Your cardiologist will give you instructions on the care and maintenance of your pacemaker or defibrillator.
When to Contact Your Doctor
Contact your doctor if:
- The rhythm disturbance returns, and you don't think it was properly controlled
- You experience dizziness or fainting spells
Bryant J, Brodin H, Loveman E, Clegg A. Clinical effectiveness and cost-effectiveness of implantable cardioverter defibrillators for arrhythmias: a systematic review and economic evaluation. Int J Technol Assess Health Care. 2007;23(1):63-70.
Gillinov AM. Advances in surgical treatment of atrial fibrillation. Stroke. 2007;38(2):618-623.
Harrison's Principles of Internal Medicine . 14th edition. McGraw-Hill; 1998.
Mayo Clinic and Foundation for Medical Education and Research website. Available at: http://www.mayo.edu/ .
Last reviewed June 2008 by
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