Heart Block
Heart block occurs when the electrical signal is sent properly, but the signal is not sent through the lower electrical pathways as quickly as it should be. This is often caused by aging or swelling or scarring of the heart from coronary artery disease.

• First-degree heart block means that impulses are moving too slow.
• Second-degree means that impulses travel thru the atria but are delayed lower down and the delay fails to make the ventricles beat at the right moment.
• Third-degree heart block happens when no impulses reach the ventricles. This is known as a Stokes-Adams attack. Third-degree heart block is very serious and can lead to heart failure or death.

Long QT Syndrome
Long QT may be a congenital (birth) disorder (in approximately 85% of the time) or may be acquired through certeain drugs--toxins or electrolyte (calcium/magnesium/potassium) disturbances. This syndrome can cause synscope (fainting) cardiac arrest and can be brought on by emotional or physical distress.

Symptoms of Arrhythmias
You may or may not have symptoms and they depend upon the health of your heart and the type of arrhythmia. Symptoms of bradycardia (slow beating heart) are: feeling tired, short of breath, dizzy or faint. Symptoms of tachycardia (fast beating heart) are: your heartbeat feels like a strong pulse in your neck, or a fluttering, racing beat in your chest. You may feel chest discomfort, weak, short of breat, faint, sweaty and dizzy.

Diagnosis of Arrhythmias
Arrhythmias can be diagnosed by the following:

• ECG or EKG
• Holter Monitoring (a 24 or more hour reading of your heart rate)
• Transtelephonic monitoring (when you feel symptoms, you can telephone a monitoring station where a record can be made or you can turn on the device's memory function and later send in the recorded info using a telephone. These devices also work during episodes of fainting.
• Electrophysiology studies (EPS) are done by a specially trained cardiologist (Electrophysiologist). A catheter is inserted in a vein in your leg and guided to your heart. The doctor can give you controlled electrical impulses to show how your heart reacts. Medicines may also be tested at this time to see if it will stop the arrhythmia.
• Tilt-table exam. This is non-invasive and your heart rate and blood pressure are monitored as you lie flat on a table -- the table is then tiled to 65 degrees. Doctors can then see how your heart responds.

Treatment and/or Medicines for Arrhythmias
Anti-arrhythmic medicines (see below), digitalis, beta blockers, and calcium channel blockers are sometimes the first approach.

Following from the Gale Encyclopedia re antiarrhythmia drugs:

Antiarrhythmic drugs are available only with a physician's prescription and are sold in capsule (regular and extended release), tablet (regular and extended-release), and injectable forms. Commonly used antiarrhythmic drugs are disopyramide (Norpace, Norpace CR), procainamide (Procan SR, Pronestyl, Pronestyl-SR), and quinidine (Cardioquin, Duraquin, Quinidex, and other brands). Do not confuse quinidine with quinine, which is a related medicine with different uses, such as relieving leg cramps. Never take larger or more frequent doses. Do not stop taking this medicine without checking with the physician who prescribed it. Stopping it suddenly could lead to a serious change in heart function.

Antiarrhythmic drugs work best when they are at constant levels in the blood. To help keep levels constant, take the medicine in doses spaced evenly through the day and night. Do not miss any doses. If taking medicine at night interferes with sleep, or if it is difficult to remember to take the medicine during the day, check with a health care professional for suggestions.

Precautions Persons who take these drugs should see their physician regularly. The physician will check to make sure the medicine is working as it should and will note any unwanted side effects. Some people feel dizzy, lightheaded, or faint when using these drugs. This medicine may cause blurred vision or other vision problems. Because of these possible problems, anyone who takes these drugs should not drive, use machines or do anything else that might be dangerous until they have found out how the drugs affect them. If the medicine does cause vision problems, wait until vision is clear before driving or engaging in other activities that require normal vision. Antiarrhythmic drugs make some people feel lightheaded, dizzy, or faint when they get up after sitting or lying down. To lessen the problem, get up gradually and hold onto something for support if possible. (from the Gale Encyclopedia).

Amiodarone and dofetilide (TIKOSYN) are also used for arrhythmias.

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IMPORTANT LINK: See THE MERCK MANUAL for more arrhythmia information and anti-arrhythmia drugs.

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Other treatments for arrhythmias include the following:

• VT and VF (ventricular tachycardia and fibrillation) can be treated by implanting an automatic cardioverter defibrillator (AICD, or ICD) This device can give electrical impulses or a shock if needed to restore a normal heartbeat. (For more information see Heart Help's ICD Section.)
• A pacemaker is used in cases of slow heart rates. The pacemaker's batteries supply the electrical energy that acts like your heart's natural pacemaker.
• Radiofrequency ablation is done using a cathether and a device for mapping the electrical pathways of the heart.
• Surgical ablation using computerized mapping techniques which indicate which cells are misfiring and then eliminate the tissue and destroy the "misfiring" cells.
• Maze surgery may be recommended if you have atrial fibrillation.
• Ventricular resection lets a surgeon remove the area in the heart's muscle where the arrhythmia starts.

Sometimes, no treatment is needed and people with an arrhythmia lead normal active lifestyles. Certain lifestyle habits such as avoiding caffeine and over-the-counter pain medicines, or avoiding alcohol are enough to stop the arrhythmia.

(This page was written with the help of The Merck Manual.)

Our URL is www.heart-help.net

Ginger@heart-help.net
Lee@LeeJRoush@msn.com

Last Modified on February 08, 2006

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