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Irregular Heart Rhythm Treatment

  • What is irregular heart rhythm treatment?

    Mount Elizabeth, Irregular Heart Rhythm Treatment d

    Irregular heart rhythm treatment is used to control or eliminate irregular heartbeats. An irregular heart beat (heart arrhythmia) is when the heart beats too slowly (below 50 beats per minute), too quickly (greater than 100 beats per minute), or irregularly.

    Arrhythmias can affect all age groups, but atrial fibrillation, the most common type of arrhythmia, is more common in people who are aged 60 years and older. Patients with atrial fibrillation, also called AF or AFib, may be at a higher risk of developing a stroke due to the increased possibility of a blood clot forming inside their heart chambers. They are also at risk of developing a weakened heart muscle and suffering from heart failure, because AF can affect the heart muscle's efficiency at pumping blood around the body.

    Many factors, including age and overall heart health, play a part in determining appropriate treatment for arrhythmias. Any underlying causes of your arrhythmia, such as heart failure, will need to be treated as well.

    The types of irregular heart rhythm treatment include:

    • Lifestyle changes

      If you have arrhythmias, you will need to make lifestyle changes to improve the overall health of your heart, especially to manage other underlying conditions you might have such as high blood pressure and heart disease. These lifestyle changes include:

      • Eating more heart-healthy foods
      • Be active. Exercise regularly and increase your physical activity.
      • Avoid triggers like nicotine, alcohol, caffeine, dietary and herbal supplements.
      • Manage your blood pressure and blood sugar levels.
      • Maintain a healthy weight. Keeping a healthy weight can help to manage symptoms of atrial fibrillation and improve the results of catheter ablation.
      • Manage stress and sleep disorders.

    • Medication

      Medication can be taken to restore normal rhythm and prevent a relapse in atrial fibrillation. These are known as anti-arrhythmic medication. They help to slow the transmission of impulses or suppress abnormal firing of pacemaker tissue.

      Other medications may also be prescribed to help lower blood pressure and reduce the risk of blood clots and stroke. These may include blood thinners, calcium channel blockers, beta blockers or anticoagulants.

    • Cardioversion

      Cardioversion is a procedure in which an abnormally fast heart rate is converted to a normal rhythm using electricity or drugs. Cardioversion is commonly done by sending electrical shocks to the heart through paddles or patches called electrodes attached to the chest while you are sedated.

      Electric cardioversion takes less time than pharmacologic cardioversion or chemical cardioversion which uses medication instead of an electrical shock to restore your heart’s rhythm. For most people, cardioversion can quickly restore a regular heartbeat. However, you will likely need additional procedures to maintain a normal heart rhythm.

    • Catheter ablation

      If a cardioversion isn't successful, or if the medication is poorly tolerated, your doctor may suggest restoring the normal heart rhythm through a heart procedure known as catheter ablation. Catheter ablation is a non-surgical procedure using either heat (radiofrequency ablation) or by freezing (cryoablation) to target and ablate (remove) the affected area. It is performed using a thin catheter with electrodes, which is carefully inserted into the blood vessels and uses a 3D mapping system to identify the exact site in the heart that is causing the irregular heartbeats.

      Catheter ablation is used to treat certain types of arrhythmias that cannot be controlled by medicine or if you have a high risk for ventricular fibrillation (v-fib), sudden cardiac arrest, or atrial fibrillation.

    • Pacemaker implantation

      If your arrhythmia is serious, you may need a permanent cardiac pacemaker or an implantable cardioverter defibrillator (ICD).

      A pacemaker works by detecting abnormal heartrate and emitting an electrical pulse to stimulate regular rhythm. A cardioverter-defibrillator may be recommended for those who have had or are at risk for cardiac arrest. It continuously monitors heart rhythm and if any abnormality is detected, it provides an electrical charge to reset the heart to a normal rhythm.

    • Cardioverter-defibrillator (ICD) implantation

      An implantable cardioverter-defibrillator (ICD) or automated implantable cardioverter defibrillator is a small battery-powered device placed in your chest to regulate the heart’s electrical problems. Although it’s smaller than a deck of cards, the ICD contains a battery and a small computer that monitors your heart rate. The computer delivers small electrical shocks to your heart at certain moments. This helps control your heart rate. The ICD is able to perform cardioversion, defibrillation, and pacing of the heart.

      While using an ICD does not reverse heart disease, it does reduce your risk of cardiac arrest. The ICD is the preferred treatment for patients at risk for sudden cardiac death due to ventricular fibrillation and ventricular tachycardia.

    • Surgery

      Surgery is usually done only when all other treatments have not been successful. Surgical ablation or Maze procedure, is a major surgery and would require general anaesthesia. The surgeon can use small incisions, radio waves, freezing, or ultrasound energy to create scar tissue. The scar tissue, which does not conduct electrical activity, blocks the abnormal electrical signals causing the arrhythmia. The scar tissue then directs electric signals through a controlled path, or maze, to the lower heart chambers (ventricles).

      The maze procedure can be done in different ways. It may be done through small cuts in the chest. Or it may be done during open-heart surgery. Your doctor will recommend a maze procedure if you are having another heart surgery, such as coronary artery bypass and valve repair or replacement.

  • Many factors, including age and overall heart health, play a part in determining appropriate treatment for irregular heart rhythm. The goal of irregular heart rhythm treatment is to restore normal heart rhythm where possible, and reduce the risk for serious complications and heart disease.

    In patients with AF, studies have reported that patients' conditions have improved after undergoing catheter ablation, with success rates of 95 – 98% even after medication is stopped. Clinical studies have also demonstrated that catheter ablation is more effective at restoring and maintaining a normal heart rhythm compared to medication. This reduces the need for life-long treatment and the side effects linked with medication. There is also evidence that catheter ablation can improve heart function.

    Seeking treatment for irregular heart rhythm is usually advised if the arrhythmias are highly irregular, if symptoms are severe or if it places the patient at risk for dangerous and potentially fatal complications such as stroke and heart failure especially for patients whose arrhythmia is caused by a weak or damaged heart.

  • The main goal of any arrhythmia treatment is to restore quality of life. In most people, heart-healthy lifestyle are important parts of managing the condition. However, if your condition is causing significant symptoms and your doctor is recommending other treatment options, be sure to discuss any concerns with your healthcare provider before the procedure.

    Preparing for irregular heart rhythm treatment

    Your doctor will likely order several tests to evaluate your heart condition before discussing with you the risks and benefits of your treatment. Inform your doctor about the allergies or reactions you have had to medications.

    You will be asked to fast the night before your procedure. It is important to inform your doctor about all of the medications you are taking before your surgery, including prescriptions, vitamins, minerals, herbs, drugs, or any other supplements. If you have an implanted heart device, such as a pacemaker or implantable cardioverter-defibrillator, talk to your doctor to see if you need to take any additional precautions.

    During irregular heart rhythm treatment

    The most common type of irregular heart rhythm treatment is catheter ablation for atrial fibrillation.

    During a catheter ablation for atrial fibrillation, your doctor will insert an intravenous line into your forearm or hand, and you'll be given a sedative to help you relax. After your sedative takes effect, your doctor will numb a small area near a vein on your groin, neck or shoulder before inserting a needle into the vein and place a tube (sheath) through the needle.

    Your doctor will thread catheters through the sheath and guide them to several places within your heart. The procedure usually takes 3 – 6 hours to complete. Complicated procedures may take slightly longer.

    It is possible to feel some minor discomfort during the procedure. However, if you experience any type of pain or shortness of breath, let your doctor know.

    After irregular heart rhythm treatment

    After your treatment, your irregular heart rhythm may recur especially for older people and those with other heart conditions, high blood pressure or a history of difficult-to-treat atrial fibrillation.

    You will likely have a follow-up appointment with your doctor about 3 months after your procedure. If your atrial fibrillation does come back, you may now be able to control it with medications. Some people may need another ablation procedure. If you continue to have heart rhythm problems, your doctor may recommend a permanent pacemaker.

    Risk/complications of irregular heart rhythm treatment

    Side effects of arrhythmia treatment vary depending on the particular treatment, but they can include diarrhoea, nausea, vomiting, hypotension, heart failure, tremor, headache, depression and seizures. With this is mind, when choosing the most suitable treatment option for your condition, the decision must be made with due consideration of both the potential benefits and the associated risks.

  • Mount Elizabeth Hospitals are established private hospitals with over 40 years’ experience serving patients with various heart conditions. We offer a comprehensive range of treatments for irregular heart rhythm, supervised by an experienced cardiovascular team.

    Our facilities at both Mount Elizabeth Orchard and Mount Elizabeth Novena Hospitals, together with a multidisciplinary team of specialists, nurses and therapists are well-equipped to provide quality, customised treatment and support during recovery.

    We welcome any inquiries – please make an appointment and take your first step with us for a healthier future.

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