Arrhythmia Treatment in India: Read the Facts!

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What are the Arrhythmia Treatments?

Arrhythmia treatment depends on the type and the severity of the arrhythmia. In certain cases, no treatment is required. The treatment options for the arrhythmia include lifestyle changes, medications, invasive therapies, electrical devices or surgery.

1. 1. Lifestyle Changes:

Since arrhythmias may be related to certain lifestyle factors, here are the lifestyle changes to reduce the arrhythmia risk factors:

1. 1. 1. If you smoke, stop smoking.
      2. Limit the intake of caffeine to stop taking it. Some people are more sensitive to caffeine and may notice more symptoms while using the caffeinated products like coffee, tea, colas and certain over the counter medications.
      3. Limit the intake of alcohol.
      4. Avoid ingestion of the stimulants. Beware of the stimulants that are used in cold and cough medications and herbal or the nutritional supplements as they contain ingredients that promote irregular heart rhythms. Read the label carefully and ask your doctor or pharmacist what medication is best for you.
      5. Control your blood sugar levels.
      6. Treat sleep apnea to decrease your risk for arrhythmia.
      7. If you are overweight or obese, achieve a desirable weight to reduce your risk for arrhythmias like the atrial fibrillation.
      8. Avoid certain activities, if you happen to notice that your irregular heart rhythm occurs more often due to these activities.
      9. Your family will also be involved in your care by learning to recognize your symptoms and how to start cardiopulmonary resuscitation (CPR) when needed.
   2. Medications

A variety of drugs are available to treat arrhythmias. Everyone is different and so it may take trials of several medications and doses to find the one that works best for you. Several types of drugs used for treating arrhythmia include:

1. 1. • Anti-arrhythmia drugs: These are used to convert the arrhythmia to sinus rhythm, i.e. normal rhythm or to prevent an arrhythmia.
      • Anticoagulant or antiplatelet therapy: Drugs like warfarin or a blood thinner or aspirin are given to reduce the risk of clot formation or strokes.
      • Heart-rate control drugs: These are used to control your heart-rate.
      • Medications used for treating the related conditions that may cause an abnormal heart rhythm.

It is important to know the name of your medications, what they are for and how often and at what times they need to be taken.

1. 1. Invasive Therapies:

The electrical cardioversion and the catheter ablation are invasive therapies used to treat or eliminate irregular heart rhythms. Discuss with your doctor about the benefits and risks of these therapies to determine the best treatment for you.

1. 1. • Electrical cardioversion: Patients with persistent past or irregular arrhythmias, who are not able to achieve a normal rhythm with drug therapy alone requires to undergo an electrical cardioversion. A cardioversion is performed by the doctor in a special procedure room. After administration of a short-acting anesthesia, an electrical impulse is delivered through your chest wall that synchronizes the heart and allows the normal rhythm to restart.
      • Catheter ablation: During an ablation, a high frequency electrical energy is delivered through a catheter to a small area of tissue inside the heart to cause an abnormal heart rhythm. This energy disconnects the pathway of the abnormal rhythm. It may be used to disconnect the electrical pathway between the atria and the ventricles, which will be useful in people with atrial fibrillation. An ablation can be used to treat most SVTs, atrial flutter and some atrial and ventricular tachycardias. Ablation may be combined with other procedures for achieving an optimal treatment.
      • Pulmonary vein isolation: For patients with frequent paroxysmal or persistent atrial fibrillation, the isolation of the pulmonary veins is a type of ablation that targets the areas thought to cause an atrial fibrillation. The goal of this therapy is to create rings of scar to isolate the foci which is responsible for triggering an atrial fibrillation.
   2. Devices:

These devices are inserted by a cardiologist during a procedure performed in the electrophysiology lab.

1. 1. 1. Permanent pacemaker:

A pacemaker is a device that sends small electrical impulses to the heart muscle to maintain a normal heart rate. It has a pulse generator and leads that send the impulses from the pulse generator to the heart muscle along with sensing the electrical activity of the heart. Mostly, the pacemakers are used to prevent the heart from beating too slowly.

1. 1. 1. Implantable cardioverter-defibrillator (ICD):

It is a sophisticated device which is primarily used to treat ventricular tachycardia and ventricular fibrillation, both are life-threatening heart rhythms. The ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm it delivers an energy to the heart muscle, thereby causes the heart to beat again in a normal rhythm.

There are several ways in which the ICD can be used to restore the normal heartbeat:

1. 1. 1. • Anti-tachycardia pacing (ATP): A series of small electrical impulses may be delivered to the heart muscle to restore a normal heart rhythm in case when your heart beats too fast.
         • Anti-bradycardia pacing: Most ICD’s provide a back-up packing to prevent too slow heart rhythm.
         • Cardioversion/defibrillation: When the heart is beating irregularly or dangerously fast, then a shock is delivered to the heart muscle for restoring a normal rhythm.
      2. Biventricular (B-V) pacemakers and defibrillators or cardiac resynchronization therapy (CRT):

A biventricular pacemakers and defibrillators are used in patients with heart failure who also have an evidence of an asynchronous or uncoordinated contraction of the left ventricles. These devices help to synchronize the contraction of the left ventricle. Additionally, one or two leads used by the traditional pacemakers and defibrillators are placed in the right ventricle and the right atrium while the bi-ventricular devices utilizes an additional lead which is placed on the back or the left side of the left ventricle. To reach this area, an additional lead is typically guided through the coronary sinus, a small vein on the back of the heart.

Heart Surgery:

When treating an arrhythmia, the patients may require a heart surgery for three reasons:

1. • A patient may need the heart surgery to treat the heart diseases that may be causing the arrhythmia.
   • In certain cases, biventricular pacemaker leads may be placed on the heart using a minimally invasive or endoscopic techniques.
   • The Maze and modified Maze procedures are two surgeries used to correct the atrial fibrillation, which is not controlled with medications or the non-surgical treatment methods. Often, it is used when other types of heart surgery like a vale surgery are planned, but in some cases, it can be performed on its own.

What follow-up care needs to be taken for arrhythmia?

After you receive treatment for an arrhythmia, you’ll be taken care by the hospital staff. You’ll visit your cardiologist regularly who will closely monitor your condition. You’ll be prescribed medication that helps to prevent the blood clots. The following are additional services provided as a part of your arrhythmia follow-up care:

• • Cardiac rehabilitation

After a heart or vascular procedure, you’ll need help getting back on your feet. Rehabilitation is an important part in your recovery. You’ll benefit from an individualized program of the supervised exercise and health education that focuses on lifestyle changes. Beyond the obvious benefit of improved heart health, our cardiac rehabilitation program also helps to increase strength, lower the blood pressure, control your weight, increase your endurance and improve your self-confidence.

Usually, the rehabilitation starts at the hospital and after consultation with your doctor, the rehab staff will assess your physical condition to discuss the next steps for rehab process. Your doctor will determine the next stage of rehabilitation 2 to 8 weeks post later. You’ll start with a 12-week exercise program designed for people who had heart surgery, chest pain or a heart attack. After completion of the program, you can participate in a partially monitored exercise program, where a member of the rehab staff will check your progress by tracking your heart rate and evaluating your own exertion level.

• • Home care

There is no place like home when you are recovering from an illness, surgery or injury as well as you need the reassurance and care of a highly skilled healthcare professional.

Benefits of Arrhythmia Treatments:

There are various health benefits of arrhythmia treatment. Arrhythmia treatments will help the patient get rid of the following conditions:

• Skipping beats-changes in the pattern of heart rhythm
• Fast or slow heartbeat
• Light-headedness, dizziness
• Sweating
• Paleness
• Chest pain
• Shortness of breath
• Fainting

Alternatives for treating arrhythmia:

The vagal maneuvers are alternative treatment for arrhythmia. These are simple exercises that can slow or stop certain types of supraventricular arrhythmias by affecting the vagus nerve that control your heart rate.

The vagal maneuvers include:

• Coughing
• Gagging
• Immerse your face in ice-cold water
• Hold your breath and bear down
• Put your fingers on your eyelids and press down gently

Since the vagal maneuvers are not appropriate treatment for everyone, so it is suggested to discuss with your doctor to find out if it is an option for you.

Why Travel to India for Arrhythmia Treatment?

India has become a healthcare hub for the international patients as it offers the latest in medical treatment facilities at quite an affordable price. The medical services in India are world class making it easy and comfortable for the patients travelling to India from abroad countries. The Indian medical institutes offer a gamut of services that ranges from a general medicine and surgery for many heart diseases and conditions. The complete pre-departure services, references and contact with the best surgeon in the country attracts the foreign patients to get their arrhythmia treatment in India. Indian hospitals are internationally accredited ISO hospitals that use imported equipments and latest technology for providing high quality medical treatments. The medical treatment charges and hospitalization costs are quite competitive compared to those in the developed countries.

Cost of Arrhythmia Treatment in India:

Cost of arrhythmia treatment in India is quite economical as compared to other developed country. Many international patients visit India for the arrhythmia treatment as they get it done at a lower price.

FAQ’s

• • What happens in the heart to cause an arrhythmia?
    • Any interruptions in the heart’s electrical system can cause arrhythmias. For example, an irregular heartbeat may begin with an abnormal impulse in the part of the heart other than the normal pacemaker (the sinus node), or the sinus node may develop an abnormal rate or rhythm.

• • What can trigger an arrhythmia?
    • Common causes of an arrhythmia can include stress, tobacco, caffeine, alcohol, diet pills and cough and cold medicines. If your heart tissue is damaged as a result of acquired heart disease, such as myocardial infarction (heart attack) or congenital heart disease, you may be at risk of developing an arrhythmia.

• • How do I know what kind of arrhythmia I have?
    • You will need to visit your doctor and have an ECG. If the ECG does not detect any abnormality, it may be necessary to arrange for further monitoring of your heart. This may involve having a continuous ECG for a period of time, usually 24-72 hours.There are also other ways of monitoring your heart over a period of time; your nurse, physiologist or doctor will discuss this with you if required.

• • How do I make an appointment with the best cardiologist in India?
    • All you have to do is send us your medical report and be rest assured. We will choose the best suitable surgeon for you, after consulting the experts.

• • What are the Arrhythmia Treatment goals?
    • The arrhythmia treatment goals are:
      • Prevent blood clots from forming to reduce stroke risk
      • Control your heart rate within a relatively normal range
      • Restore a normal heart rhythm, if possible
      • Treat heart disease/condition that may be causing arrhythmia
      • Reduce other risk factors for heart disease and stroke

• • What are treatment options for this heart rhythm irregularity?
    • Medications are often given as the first treatment for this type of arrhythmia. However, if the medications are not effective, cause side effects, or the patient does not want to take them long-term, catheter ablation is another treatment option for SVT.

• • What is the success rate of the cardiac catheter ablation procedure when used for supraventricular tachycardias?
    • The success rate of the catheter ablation procedure when used for SVTs is approximately 90-95%. This success rate may be lower if the SVT pathway is in a difficult to reach area or near part of the normal electrical conduction system.

• • How often do I have to have the pacemaker replaced?
    • Pacemakers are generally replaced every six-to-eight years. You will be scheduled for routine follow-up at the Pacemaker Clinic to check for normal functioning and remaining generator life to anticipate when it will need to be replaced.

• • How do pacemakers and ICDs differ?
    • Pacemakers can only make sure that your heart rate will not go too slow. ICDs can monitor for life-threatening arrhythmias and deliver a shock if necessary. Both types of devices can provide pacing if needed.