Arrhythmias

Welcome to the Affordable Drugs arrhythmias information page. Here you can learn about what arrhythmias are, what types of arrhythmias are there, causes of arrhythmias and more. You can also find the best available arrhythmia drug prices. The information contained on this page is not intended to replace the professional advice of your physician.

What are Arrhythmias?

Put simply, arrhythmia is an abnormal rhythm of the heart. This can be either harmless or dangerous, and if the arrhythmia significantly affects the overall heart rate to the point where it becomes less effective, it is often necessary to take action to correct it. Some arrhythmias can lead to cardiac arrest or sudden death, so it is important to be aware of recurring abnormalities in heart rhythm.

A proper heart rhythm can be a crucial life-sustaining mechanism. Blood carries the oxygen which cells, especially brain cells, need to function, so it must be in continuous supply. The heart is what keeps this happening. Heart beats are caused by electrical impulses created by a piece of tissue in the heart called the sinus node. This impulse causes two small chambers, the atria, of the heart, to contract, and stimulates another node, the AV node, to send an electrical impulse. This impulse stimulates two larger chambers, the ventricles, of the heart, to contract. These simultaneous movements of the heart's four chambers are what force blood through them and then onto the rest of the body. If this timing is disrupted, blood may not be as effectively pumped, or it may not be pumped at all, in which case cardiac arrest can occur.

There are several different types of arrhythmia, depending on the speed or regularity of the heart beat. If the heart beats too slowly, it is called bradycardia. It is caused either by a slow sinus node, pauses in activity from the sinus node, or a block of this node's impulse before it reaches the AV node. Bradycardia can cause an insufficient blood supply to the brain, resulting in fatigue or lightheadedness, and in some cases, cardiac arrest. Treatment for bradycardia is generally not needed, but medications are available, and an artificial pacemaker can speed up the heart rate.

If the heart beats too quickly, it is called tachycardia. This can happen if the heart tissue begins sending out impulses on its own rather than leaving that task to the sinus and AV nodes, or it can occur if impulses continue to move through the nodes rather than going from one to another and then stopping. Tachycardia can be life-threatening if the chambers do not have time to fully fill with blood before contracting, since this decreases the amount of blood pumped to the rest of the body. If detected early, it can be treated with medication or a device called an implantable cardioverter defibrillator (ICD).

Fibrillation is a type of arrhythmia which occurs if the heart just quivers with no distinct rhythm. This occurs when the electrical impulses are not synchronized. If the larger chambers of the heart are affected, blood will not be pumped to the body. This is a serious condition, resulting in cardiac arrest. Medications can lessen the chance of this happening, as can an ICD.

As described, arrhythmias are a variety of conditions related to abnormal heart rhythms. Some require immediate care, whereas others are less life-threatening. If caught early, even the most dangerous arrhythmias can be treated, and patients can go on to live normal lives.

Types of Arrhythmias

There are two main types of arrhythmias, tachycardia and bradycardia. Tachycardia is when the heart beats too fast (over 100 beats per minute) and bradycardia is when the heart beats too slow (less than 60 beats per minute). Heart or cardiac arrhythmias can be life threatening if the pumping function of the heart is severely decreased for longer than a few seconds. 

Arrhythmias in the Atria

Atrial fibrillation: During atrial fibrillation, the chambers of the heart receive sporadic electrical currents that cause the upper chambers of the heart to quiver and contract. This type of heart arrhythmia is most common in the elderly and patients with heart valve disease. 

Atrial flutter: During atrial flutter, electrical stimulation runs quickly through the upper chambers of the heart, resulting in a rapid pulse. This type of cardiac arrhythmia is caused by a loop of electricity in the heart.

Supraventricular tachycardia (PSVT): During supraventicular tachycardia, repeated moments of rapid heartbeats begin and then end unpredictably. This type of heart arrhythmia is commonly due to extra connections that occur during birth between the upper and lower chambers of the heart.

Wolff-Parkinson-White syndrome: During Wolff-Parkinson-White syndrome, sudden episodes of rapid heartbeats occur. This type of cardiac arrhythmia is usually caused by an abnormal electrical connection in the chambers of the heart. In patients with this unusual syndrome, there is an extra connection between the top and bottom chambers of the heart. Wolff-Parkinson-White syndrome is most common in infants and children, appearing in 5 out of 100,000 people.

Premature supraventricular contraction: During premature supraventricular contraction, or premature atrial contraction (PAC), premature heartbeats occur causing an irregular heart rhythm. They usually begin in the upper chambers of the heart and are actually quite common. Since this type of heart arrhythmia is benign, there is usually no treatment needed.

Sick sinus syndrome: During sick sinus syndrome, the hearts' sinus node does not properly give off signals, causing the heart to slow down. In patients' with sick sinus syndrome, the heart typically goes back and forth between fast (tachycardia) and slow (bradycardia) rates. This type of cardiac arrhythmia is most common in the elderly due to degenerative changes in the heart pathways.

Sinus arrhythmia: During a sinus arrhythmia, cyclic changes occur in the heart when a person is breathing. This type of heart arrhythmia is common in both children and healthy adults. Sometimes a pace maker is needed to treat this condition.

Sinus tachycardia: During sinus tachycardia, the sinus node in the heart sends out electrical signals much faster than normal. This results in the heart speeding up causing a rapid pulse. This can occur in normal environments such as a stressful situation or as a result of exercise.

Multifocal atrial tachycardia: During multifocal atrial tachycardia (MAT), various locations within the atria begin to initiate an impulse electrically. These impulses run through ventricles, resulting in a rapid heart beat. For patients with multifocal atrial tachycardia, expect their heart rate to be anywhere from 100 to 250 beats a minute. MAT is most common in patients with lung disease and the elderly.

Arrhythmias in the Ventricles

Premature ventricular contraction: During premature ventricular contraction (PVC), electrical signals from the ventricles cause a premature heartbeat. The heart pauses and then begins to beat again like normal. This type of heart arrhythmia usually goes unnoticed and is found commonly in healthy adults. 

Ventricular fibrillation: During ventricular fibrillation, electrical signals located in the ventricles begin to fire in an uncontrollable and rapid manner. This causes the lower chambers of the heart to quiver and stop pumping blood. If the regular heart rhythm does not go back to normal quickly, the patient may suffer from heart or brain damage. Treatments for those who survive may result in an implanted defibrillator.

Arrhythmia Causes

When the electrical pulses that make your heart beat misfire, the irregular heartbeat that occurs is called an arrhythmia. An arrhythmia can often have few symptoms and many causes. Of these causes, several of them are due to overindulgent, negative social activities, although there are causes that are disease related. How severe an arrhythmia can be to your health depends largely on the overall condition of your heart when you experience it.

On an otherwise healthy heart, it is possible that an arrhythmia may not do any long term damage. However, on a heart that has irregularities or has otherwise been compromised by disease, the effects of an arrhythmia can be devastating or even deadly. Given that many of the external arrhythmia causes are preventable, it makes it important to understand the causes of arrhythmias. Especially if there is already scarring or damage to the heart.

Some of the social activities that contribute to causes of arrhythmias are things such as smoking, overuse of caffeine or alcohol, excessive stress and drug use. There are a few over the counter medications like some cold medicines and diet pills that are proven to contribute to causing arrhythmias. Even some herbal remedies and dietary supplements found on the market have been said to cause arrhythmias. These are all causes of arrhythmia that can be avoided simply by avoiding the activity. For someone with a heart that has previously been damaged should avoid all of these activities to prevent a possible arrhythmia.

In addition to the causes that you can avoid, there are some health conditions that can also cause arrhythmias. An overactive thyroid, high blood pressure, diabetes, all of these can contribute to causing arrhythmias. Even having an electrolyte imbalance in your blood has been known to cause arrhythmias. However, it is most often heart disease that can cause the most damaging arrhythmias. Any condition that affects the structure of the heart, such as inadequate blood flow or damage to heart tissue can interfere with normal electrical pulses in the heart. 

Some of the conditions that are known to cause structural heart damage include Coronary Artery Disease, which causes narrowing of the arteries. Coronary Artery Disease, or CAD, restricts blood flow to the heart causing tissue death. There is also cardio-myopathy, which is a disease that causes the heart to pump blood inefficiently which leads to damage or death of the heart tissues. Diseases of the heart valve can lead to damage to the heart chambers, and this can stop the blood from flowing through the heart properly, causing tissue damage and possibly an arrhythmia. 

From the social activities that can be controlled to serious cardiac diseases of the heart, there are a number of causes of arrhythmias. The extent of the damage that can be caused by an arrhythmia will depend upon the condition of the heart. The healthier the heart is when the arrhythmia is experienced, the less likely it is that long term damage will be done to the heart.

Arrhythmia Symptoms

Arrhythmia is a condition in which a person has an irregular heartbeat. People who have arrhythmia can also have irregular heart rates. The normal heart rate ranges from 50 to 100 beats per minute. A person may experience arrhythmia but still have a normal heart rate. Arrhythmias that occur with slow heart rates of less than 60 beats per minute are called bradyarrhythmias, and those that occur with fast heart rates of more than 100 beats per minute are called tachyarrhythmias. Over 850,000 people require hospitalization for treatment of arrhythmia each year in the United States. 

Arrhythmias can be caused by coronary artery disease, electrolyte imbalances in the blood, heart muscle changes, injury sustained during a heart attack, or from the healing process subsequent to heart surgery. Arrhythmias may not manifest any symptoms and can go undetected in some cases. A physician can identify an irregular heartbeat during a physical examination by taking a pulse or by using an electrocardiogram. When symptoms do occur, they will often include palpitations, a pounding feeling in the chest, dizziness, the feeling of being light-headed, shortness of breath, pain or discomfort in the chest, perspiration, a pale appearance, weakness or fatigue, low blood pressure, and fainting. Palpitations will seem like skipped heartbeats, thumps, fluttering of the heart, or a racing feeling. People experiencing heart palpitations are often more aware of the palpitations right before going to sleep during the night time, especially if they lie down on the left side of their bodies. 

Treatment of arrhythmia depends on the type of arrhythmia and the seriousness of the accompanying symptoms. Some people who have arrhythmias do not require any treatment, while other need to begin a medical regimen, make lifestyle changes, and may even have to undergo surgical procedures to treat arrhythmia symptoms. Medications commonly used to treat arrhythmias include antiarrhythmic drugs that control heart-rate, such as beta-blockers. Anticoagulant or antiplatelet drugs, such as warfarin or aspirin, can also be used to combat arrhythmia symptoms and are effective in reducing the risk of blood clots. Different medications will interact with one's individual body chemistry differently, so it may require trials of a few medications and dosages to determine which pharmaceutical regimen works best. 

Those who have been diagnosed with arrhythmia should undertake certain lifestyle changes to ensure that the symptoms do not worsen. People with arrhythmia should refrain from smoking, limit their intake of alcohol and caffeine, and avoid stimulants commonly used in cough and cold medications. Physical exercise has also been shown to increase the parasympathetic nervous supply and minimize the adverse effects of arrhythmia. If a combination of drugs and lifestyle changes are not sufficient to control a persistent problem with irregular heartbeat, an electrical cardioversion may be required. This process involves delivering an electrical shock to the chest wall that synchronizes the heart muscle and induces the normal heart rhythm to resume. Other possible solutions for the most serious manifestations of arrhythmia include pacemakers, implantable cardioverter defibrillators (or ICDs), catheter ablations, and heart surgery. 

Arrhythmia Drugs

Arrhythmia is a serious condition that can lead to life-threatening complications if not treated properly. Your doctor may recommend taking arrhythmia drugs that can prevent a heart attack or stroke in most people. A list of arrhythmia drugs is stated below with both generic and common brand names (in parenthesis). You should consult your doctor to find out what medication works best for you and your condition. This list simply explains the various types of arrhythmia drugs available for your own knowledge. Arrhythmia drugs are listed according to the Vaughan Williams classification for antiarrhythmic agents, which are based on how the drug works to control arrhythmias. 

Class 1 anti-arrhythmic drugs

Class 1 anti-arrhythmic drugs work by changing the sodium channel in the body. Three types of sodium blockers exist to block sodium channels to different degrees. Type 1a drugs work at an intermediate pace, and can be used for people who suffer from ventricular arrhythmia. These types of drugs include:

Disopyramide (Norpace)
Procainamide (Procan or Procanbid)
Quinidine 

Type 1b drugs work at a fast pace, and are used for people who may suffer from atrial fibrillation, or ventricular tachycardia. These types of drugs include:

Phenytoin (Phenytek or Dilantin)
Mexiletine (Mexitil)
Lidocaine (Xylocaine) 

Type 1c drugs work at a slow pace, and are used for recurrent tachyarrhythmias and paroxysmal atrial fibrillation. These types of drugs include:

Moricizine
Flecainide (Tambocor)
Propafenone (Rythmol)

Class II anti-arrhythmic drugs

Class II anti-arrhythmic drugs work by reducing the effect of physical exertion on the heart rate and contraction, also known as beta blockers. These types of drugs help control the sympathetic nervous system to help reduce blood pressure. Beta blockers can help decrease heart rate, and is used to prevent tachyarrhythmias and death from myocardial infarction. These types of drugs include:

Atenolol (Tenormin)
Timolol (Blocadren)
Esmolol (Brevibloc)
Metoprolol (Lopressor or Toprol)
Propranolol (Inderal)
Acebutolol (Sectral)
Pindolol (Visken)
Nadolol (Corgard)
Penbutolol (Levatol)
Betaxolol (Kerlone)
Carteolol (Cartrol)
Bisoprolol/hydrochlorothiazide (Zebeta or Ziac)

Class III anti-arrhythmic drugs 

Class III anti-arrhythmic drugs work by blocking potassium channels in a similar way class 1 anti-arrhythmic drugs work to block sodium channels. These types of drugs are used to treat Wolff-Parkinson-White syndrome. Sotalol helps treat ventricular tachycardias while Ibutilide helps treat atrial flutter. Both drugs help treat atrial fibrillation. These types of drugs include:

Sotalol (Betapace)
Ibutilide (Corvert)
Amiodarone (Cordarone or Pacerone)
Dofetilide (Tikosyn)

Class IV anti-arrhythmic drugs 

Class IV anti-arrhythmic drugs work by decreasing calcium channels in the body. These types of drugs reduce the force of contraction of the heart thereby slowing heart rate and reducing blood pressure. These types of drugs are used to treat atrial fibrillation and prevent paroxysmal supraventricular tachycardia. These types of drugs include:

Verapamil (Calan, Covera, Isoptin, Verelan)
Diltiazem (Cardizem, Cartia, Dilacor, Diltia or Tiazac)
Amlodipine (Norvasc, Lotrel)
Felodipine (Plendil)
Nisoldipine (Sular)
Isradipine (Dynacirc)
Nimodipine (Nimotop)
Nicardipine (Cardene)
Nifedipine (Adalat, Procardia)

Other arrhythmia drugs include anticoagulants, which helps thin your blood to prevent blood clots. Anticoagulants can help prevent stroke because they prevents blood clots. Anticoagulants, however, cannot dissolve a blood clot that has already formed. It can prevent this blood clot from getting any bigger though. These types of drugs work by stopping the blood from clotting. Anticoagulants include warfin and aspirin. 

Warfin (Coumadin) is used to prevent strokes in atrial fibrillation patients. Due to the risk of bleeding, patients taking warfin must be frequently monitored by their doctor. Medicines and some foods can interact with warfin, so be sure to tell your doctor what medications you are taking and the foods you eat while taking warfin. 

Aspirin is a very common, over-the-counter anticoagulant that prevents blood platelets from sticking. This anti-platelet effect can help prevent stroke. Even though aspirin is readily available without a prescription, ask your doctor before you begin taking aspirin everyday to prevent stroke. Aspirin may not be the best arrhythmia drug for all conditions. 

All arrhythmia drugs can help patients who suffer from arrhythmia, but these drugs must be taken under a doctor's orders. As with all drugs, arrhythmia drugs may have some side effects. For the most part, the medication's benefits will outweigh the side effects. Not all patients diagnosed with arrhythmia need medication. Various factors such as age, health, and condition will determine whether medication is needed. Consult your doctor to personalize the health care you need for your arrhythmia.