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Drugs to Treat Abnormal Heart Rhythms

By

L. Brent Mitchell

, MD, Libin Cardiovascular Institute of Alberta, University of Calgary

Full review/revision Jan 2023
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There are many causes of abnormal heart rhythms Causes Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are... read more Causes (arrhythmias). Some arrhythmias are harmless and do not need treatment. Sometimes arrhythmias stop on their own or with changes in lifestyle, such as avoiding alcohol, caffeine (in beverages and foods), and smoking. Other arrhythmias are dangerous or bothersome enough to need treatment. Antiarrhythmic drugs are one type of treatment. Other treatments for arrhythmias include insertion of a pacemaker Artificial Pacemakers There are many causes of abnormal heart rhythms (arrhythmias). Some arrhythmias are harmless and do not need treatment. Sometimes arrhythmias stop on their own or with changes in lifestyle,... read more Artificial Pacemakers or an implantable cardioverter-defibrillator (ICD) Implantable Cardioverter-Defibrillator (ICD) There are many causes of abnormal heart rhythms (arrhythmias). Some arrhythmias are harmless and do not need treatment. Sometimes arrhythmias stop on their own or with changes in lifestyle,... read more , cardioversion-defibrillation Cardioversion-Defibrillation There are many causes of abnormal heart rhythms (arrhythmias). Some arrhythmias are harmless and do not need treatment. Sometimes arrhythmias stop on their own or with changes in lifestyle,... read more Cardioversion-Defibrillation , or destruction of a small area of heart tissue that is responsible for the arrhythmia (ablation Destroying Abnormal Heart Tissue (Ablation) There are many causes of abnormal heart rhythms (arrhythmias). Some arrhythmias are harmless and do not need treatment. Sometimes arrhythmias stop on their own or with changes in lifestyle,... read more ).

Antiarrhythmic drugs are useful for suppressing fast arrhythmias that cause intolerable symptoms or pose a risk. No single drug suppresses all arrhythmias in all people. Sometimes several drugs must be tried until the response is satisfactory. Sometimes antiarrhythmic drugs can worsen or even cause arrhythmias. This effect is called proarrhythmia. Antiarrhythmic drugs may also cause other side effects.

There are many different antiarrhythmic drugs, which are divided into groups based on how they work. The main groups include beta-blockers, calcium channel blockers, potassium channel blockers, and sodium channel blockers.

Beta-blockers block the effects of the hormone epinephrine (adrenaline). In the heart, this blockade slows the natural pacemaker activity of heart cells and slows conduction of impulses through the heart's normal electrical pathways Normal electrical pathway Abnormal heart rhythms (arrhythmias) are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are... read more Normal electrical pathway .

Calcium, potassium, and sodium are electrolytes Overview of Electrolytes Well over half of the body's weight is made up of water. Doctors think about the body's water as being restricted to various spaces, called fluid compartments. The three main compartments are... read more that flow in and out of heart cells and are responsible for the heart's normal electrical activity. These electrolytes flow through the walls of heart cells through microscopic pores called channels. There are separate channels for each electrolyte. Blocking one of these channels can slow conduction through the heart's electrical system and/or decrease the natural pacemaker activity of heart cells.

Important antiarrhythmic drugs that are not in these classes include adenosine and digoxin. These drugs work by different ways to slow conduction of impulses through the atrioventricular node (AV node). In normal people, the AV node is the only electrical connection between the atria and ventricles.

Table

Drugs Mentioned In This Article

Generic Name Select Brand Names
Adenocard, Adenoscan
Digitek , Lanoxicaps, Lanoxin, Lanoxin Pediatric
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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