What medicine is used for arrhythmia?

Written by Chen Ya
Geriatrics
Updated on September 04, 2024
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There is still no consensus on the drugs commonly used for arrhythmia. The main classes used clinically are as follows: The first class is sodium channel blockers, which include three subclasses: moderate, mild, and significant sodium channel blockers, respectively comprising quinidine, lidocaine, and propafenone. The second class mainly consists of adrenergic receptor blockers, with propranolol being a representative drug. The third class of drugs selectively prolongs the repolarization process, among which amiodarone is commonly used clinically. The fourth class is calcium channel blockers, which mainly block calcium channels and inhibit the inflow of calcium, with verapamil being the main representative drug. Long-term use of anti-arrhythmia drugs can cause varying degrees of side effects, with severe cases possibly leading to ventricular arrhythmia or fatal cardiac conduction block. Therefore, when using these drugs clinically, it is essential to strictly control the indications, monitor adverse reactions, and strictly follow the doctor's prescription for rational medication.

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Written by Chen Ya
Geriatrics
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Does arrhythmia require hospitalization?

Arrhythmia treatment should be determined based on the patient's symptoms, type of arrhythmia, and its impact on hemodynamics. For instance, minor conditions like slight sinus bradycardia, irregular sinus rhythm, occasional atrial premature contractions, and first-degree atrioventricular block, which have minimal impact on hemodynamics and no significant clinical manifestation or structural heart disease, do not necessitate hospitalization. However, more severe arrhythmias such as sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and sustained ventricular tachycardia, which can cause symptoms like palpitations, chest tightness, dizziness, low blood pressure, sweating, and in severe cases, fainting, Adam-Stokes syndrome, and even sudden cardiac death, require prompt medical attention and hospitalization for treatment.

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Written by Wei Shi Liang
Intensive Care Unit
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Can arrhythmia be cured?

Arrhythmias come in many types, most of which are curable. Once arrhythmia occurs clinically, an electrocardiogram should be performed as soon as possible to determine the type of arrhythmia. Common arrhythmias can be classified into tachyarrhythmias and bradyarrhythmias, and based on the location of occurrence, into supraventricular arrhythmias and ventricular arrhythmias. Clinically common are supraventricular arrhythmias, such as sinus tachycardia, junctional tachycardia, along with atrial tachycardia, atrial fibrillation, and atrial flutter. These generally do not affect the stability of hemodynamics and are relatively easy to treat. On the other hand, ventricular arrhythmias such as ventricular fibrillation, ventricular tachycardia, and sinus arrest are clinically challenging to cure and require aggressive resuscitation.

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Written by Chen Ya
Geriatrics
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Arrhythmia is caused by what?

Arrhythmia is caused by abnormal excitation of the sinoatrial node or excitation originating outside the sinoatrial node, with slow conduction, blockage, or conduction through abnormal pathways. This results in the frequency and (or) rhythm abnormalities of heartbeats, which are collectively referred to as arrhythmias. Most of the causes include the following: one is genetic arrhythmias, often due to gene channel mutations, such as the commonly seen long QT syndrome, short QT syndrome, Brugada syndrome, etc. There are also acquired arrhythmias, seen in various organic heart diseases, including coronary atherosclerotic heart disease, commonly referred to as coronary heart disease, cardiomyopathy, myocarditis, and rheumatic heart disease, particularly prevalent during heart failure or acute myocardial infarction. Arrhythmias are also not uncommon in basically healthy individuals or patients with autonomic dysfunction. Other causes include electrolyte imbalance or endocrine disorders, and sometimes anesthesia, hypothermia, or surgery, such as thoracic or cardiac surgery, or medications, central nervous system diseases may also cause arrhythmias, but the specific reasons are not very clear.

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Written by Chen Ya
Geriatrics
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Can arrhythmia cause sudden death?

The clinical manifestations of hemodynamic changes caused by arrhythmias mainly depend on the nature, type, cardiac function, and the extent of impact on hemodynamics. Mild conditions such as slight sinus bradycardia, sinus arrhythmia, occasional atrial premature contractions, and first-degree atrioventricular block have minimal impact on hemodynamics and therefore do not exhibit significant clinical manifestations, and sudden death is generally not expected. However, more severe arrhythmias, such as sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and sustained ventricular tachycardia, can lead to palpitations, chest tightness, dizziness, hypotension, and sweating. In severe cases, syncope, Adams-Stokes syndrome, or even sudden death may occur.

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Written by Chen Ya
Geriatrics
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How to treat arrhythmia?

The treatment of arrhythmias should be based on the symptoms of the patients with arrhythmias, the type of arrhythmias, and their impact on hemodynamics. Control of arrhythmias during episodes involves removing the cause and focus of the disease and preventing recurrence, which can be divided into non-pharmacological and pharmacological treatments. Non-pharmacological treatments include methods such as eyeball compression, carotid sinus massage, pinching the nose to exhale forcefully and hold breath to reflexively excite the vagus nerve, along with electrical treatments like electrical cardioversion, defibrillation, pacemaker implantation, and ablation surgery. There are mainly four types of drugs used: sodium channel blockers; beta-adrenergic blockers; drugs selectively prolonging the repolarization process, such as amiodarone; and calcium channel blockers. However, long-term use of these antiarrhythmic drugs can have varying degrees of side effects, and severe cases can cause ventricular arrhythmias or cardiac conduction block which can be fatal. Therefore, in clinical application, it is essential to strictly control the indications, monitor for adverse reactions, and rigorously follow the doctor's orders.