What Drug Do Doctors Use to Stop the Heart and Start It Again

Drug cabinet: Anti-arrhythmics

Some abnormal heart rhythms tin can be treated with medication. Consultant cardiologist and electrophysiologist Dr Martin Lowe explains all to Doireann Maddock.

An arrhythmia is an abnormal middle rhythm and information technology happens as a result of a problem with the electrical impulses that regulate your center. It can make your center beat likewise speedily, as well slowly or in an irregular way.

The symptoms of an arrhythmia will depend on what type you take and how it affects the operation of your heart. Arrhythmias are a common problem and can range from existence a minor inconvenience to a life-threatening status.

What are anti-arrhythmic drugs?

Anti-arrhythmic drugs are designed to treat an aberration of the heart rhythm. They may be used to terminate the aberrant rhythm, prevent it happening or slow the heart charge per unit during the abnormal rhythm to make information technology more than tolerable.

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Why would I be prescribed an anti-arrhythmic?

Anti-arrhythmics are generally the outset handling offered, because almost abnormal heart rhythms respond to them

Anti-arrhythmic drugs are generally the starting time handling that a person is offered, because they can be started straight abroad and most abnormal center rhythms respond to them.

At that place are two approaches to drug dosing. One is a 'pill in the pocket' method when people deport a supply of the medication and take a tablet when an episode of arrhythmia happens. This is frequently recommended when the episodes are less frequent and a benefit of this is that you lot can minimise the potential side effects from taking long-term medication. If you lot've been advised to take this approach, information technology can exist a good idea to keep the pill in your wallet or purse and then that you always have information technology on you.

The second method is to take medication on a regular basis to endeavour to forestall the change in rhythm occurring in the first place.

Your specialist or GP will advise which option is virtually suitable for yous.

What are the different types of anti-arrhythmic drugs available?

In that location are many different types and some of them, such equally beta blockers and calcium channel blockers, are also commonly prescribed for other uses, for example in the treatment of high blood pressure. When treating a heart rhythm problem, sometimes it's more appropriate to control the rate and frequency of the rhythm trouble rather than seek to cure it.

When treating a centre rhythm problem, sometimes it's more appropriate to control the rate and frequency of the problem rather than seek to cure it

This tin can be a complex decision and involves considering factors such as the type and severity of the arrhythmia you have, how long you lot've had information technology, your age and how information technology is affecting (or likely to affect) your life.

The most common arrhythmia is atrial fibrillation (AF), which is ordinarily treated with beta blockers such as atenolol, bisoprolol and metoprolol. Beta blockers may stop the arrhythmia occurring but, more frequently, are useful for slowing downwardly the middle rate during the arrhythmia without actually terminating it. Calcium channel blockers such as verapamil and diltiazem piece of work in a similar manner. Digoxin is also commonly prescribed for AF to assistance control the rate.

Flecainide, sotalol (as well a beta blocker) and amiodarone are as well unremarkably prescribed for arrhythmias. They accept the power to terminate an arrhythmia and are usually given to prevent the abnormal rhythm from occurring or reduce its frequency or duration.

What are the possible side effects and how are they managed?

Many side effects are not too troublesome and y'all can commonly behave on taking your medication.

Beta blockers have a general slowing effect on metabolism and can cause lethargy, which tin exist more than noticeable with the first few doses and then frequently settles with time.

Many side furnishings are not too troublesome and you lot can usually acquit on taking your medication

Amiodarone, although very effective as an anti-arrhythmic drug, has a number of potential side effects including making your thyroid over- or underactive, affecting liver function and making your skin more than sensitive to sunlight. Skin sensitivity to sunlight with amiodarone requires utilize of a loftier-factor sun foam to prevent sunburn. For many people, amiodarone-related thyroid furnishings can be treated with medication to command thyroid function, but some may need to stop taking the drug. If this happens, dronedarone, which is structurally like to amiodarone, may be substituted as it has no agin effects on thyroid office.

Anti-arrhythmic drugs such as flecainide are usually well tolerated but can cause breadbasket upset and, very occasionally, induce Brugada syndrome – a more dangerous arrhythmia, which can increment the chance of sudden cardiac death. Flecainide-induced Brugada syndrome is uncommon but y'all'd need to stop taking the medication and further investigation in a specialist arrhythmia clinic would exist required.

Every bit with all medication, it's of import that y'all discuss any side effects with your GP or specialist. Do non suddenly stop taking your medication unless your doctor has instructed yous to do and then.

Are there instances where I wouldn't be prescribed an anti-arrhythmic?

If you accept heart muscle impairment from a previous middle attack or have a type of heart muscle disease and you have been diagnosed with a life-threatening arrhythmia, it may be more than appropriate to accept an ICD implanted because drugs have not been shown to be constructive at preventing sudden cardiac decease (caused by the dangerous arrhythmia) in these cases.

Is there an alternative option to taking anti-arrhythmic drugs?

Many abnormal rhythms, such as AF, can be treated with a technique chosen ablation, which involves burning or freezing the abnormal tissue in the heart that is responsible for the arrhythmia. Yet, this may not exist suitable for everyone. Although this is a commonly performed procedure and has the potential to cure the rhythm abnormality, it's not e'er successful with a single procedure (and may need to be repeated at a afterwards appointment), especially when used for AF.

Open heart surgery is rarely required to treat an arrhythmia, but if the patient is having coronary artery featherbed surgery or valve surgery, the surgeon may take the opportunity to treat the arrhythmia at the same time.

For those with a heart trouble that puts them at risk of a life-threatening arrhythmia, an ICD can be implanted to manage this.

Your specialist volition be able to discuss what treatment options are best for you.

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Source: https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/drug-cabinet/anti-arrhythmics

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