TABLE OF CONTENTS:
- What Is a Heart Attack?
- Heart Attack Causes
- What Do I Do if I Have a Heart Attack?
- Heart Attack Diagnosis
- Heart Attack Treatment
- Are there other treatments for a heart attack?
- What happens in the coronary care unit (CCU)?
- Tips for Heart Attack Prevention
- What lifestyle changes are needed after a heart attack?
- Why should I take part in cardiac rehabilitation?
- What Is an Arrhythmia?
- What Causes Arrhythmia?
- What Are the Types of Arrhythmias?
- How Are Arrhythmias Diagnosed?
- How Are Arrhythmias Treated?
- There are different types of ICDs, including
- Keep cholesterol and blood pressure under control
What Is a Heart Attack?
A heart attack happens when something blocks the blood flow to your heart so it can’t get the oxygen it needs.
More than a million Americans have heart attacks each year. Heart attacks are also called myocardial infarctions (MI). "Myo" means muscle, "cardial" refers to the heart, and "infarction" means death of tissue because of a lack of blood supply. This tissue death can cause lasting damage to your heart muscle..
Heart Attack Symptoms
Symptoms of a heart attack include:
Discomfort, pressure, heaviness, tightness, squeezing, or pain in your chest or arm or below your breastbone
Discomfort that goes into your back, jaw, throat, or arm
Fullness, indigestion, or a choking feeling (it may feel like heartburn).
Sweating, upset stomach, vomiting, or dizziness
Severe weakness, anxiety, fatigue, or shortness of breath
Fast or uneven heartbeat
Symptoms can be different from person to person or from one heart attack to another. Women are more likely to have these heart attack symptoms:
Unusual fatigue
Shortness of breath
Nausea or vomiting
Dizziness or lightheadedness
Discomfort in your gut. It may feel like indigestion.
Discomfort in the neck, shoulder, or upper back
With some heart attacks, you won’t notice any symptoms (a "silent" myocardial infarction). This is more common in people who have diabetes.
Angina:
Angina isn’t a condition or disease. It’s a symptom, and sometimes it can signal a heart attack. The sensations may occur with normal activities or exertion but then go away with rest or when you take nitroglycerin.
You may feel:
Pressure, pain, squeezing, or a sense of fullness in the center of the chest
Pain or discomfort in the shoulder, arm, back, neck, or jaw if it gets worse, lasts more than 5 minutes, or doesn't improve after you've taken nitroglycerin. Doctors call that “unstable” angina,” and it’s an emergency that could be related to a heart attack that is about to happen.
If you instead have “stable” angina, which is the most common kind, your symptoms usually happen with predictable triggers (such as a strong emotion, physical activity, extreme hot and cold temperatures, or even a heavy meal). The symptoms go away if you rest or take nitroglycerin that your doctor has prescribed.
Heart Attack Causes
Your heart muscle needs a constant supply of oxygen-rich blood. Your coronary arteries give your heart this critical blood supply. If you have coronary artery disease, those arteries become narrow, and blood can’t flow as well as it should. When your blood supply is blocked, you have a heart attack.
Fat, calcium, proteins, and inflammatory cells build up in your arteries to form plaques. These plaque deposits are hard on the outside and soft and mushy on the inside.
When the plaque is hard, the outer shell cracks. This is called a rupture. Platelets (disc-shaped things in your blood that help it clot) come to the area, and blood clots form around the plaque. If a blood clot blocks your artery, your heart muscle becomes starved for oxygen. The muscle cells soon die, causing permanent damage.
Rarely, a spasm in your coronary artery can also cause a heart attack. During this coronary spasm, your arteries restrict or spasm on and off, cutting off the blood supply to your heart muscle (ischemia). It can happen while you’re at rest and even if you don’t have serious coronary artery disease.
Each coronary artery sends blood to a different part of your heart muscle. How much the muscle is damaged depends on the size of the area that the blocked artery supplies and the amount of time between the attack and treatment.
Your heart muscle starts to heal soon after a heart attack. This takes about 8 weeks. Just like a skin wound, a scar forms in the damaged area. But the new scar tissue doesn’t move the way it should. So your heart can’t pump as much after a heart attack. How much that ability to pump is affected depends on the size and location of the scar.
What Do I Do if I Have a Heart Attack?
After a heart attack, you need quick treatment to open the blocked artery and lessen the damage. At the first signs of a heart attack,
The best time to treat a heart attack is within 1 or 2 hours after symptoms begin. Waiting longer means more damage to your heart and a lower chance of survival.
If you’ve called emergency services and are waiting for them to arrive, chew an aspirin (325 mg). Aspirin is a potent inhibitor of blood clots and can lower the risk of death from a heart attack by 25%.
What Do I Do if Someone Else Has a Heart Attack?
start CPR (cardiopulmonary resuscitation) if someone goes into cardiac arrest, which is when the heartbeat has stopped and the person isn’t responsive. CPR doesn't restart the heart; but it keeps the person alive until medical help arrives.
An easy-to-use device called an AED (automated external defibrillator) is available in many public places and can be used by almost anyone to treat cardiac arrest. This device works by shocking the heart back into a normal rhythm.
Here’s how to use an AED:
1. Check responsiveness
For an adult or older child, shout and shake the person to confirm whether they’re unconscious. Do not use AED on a conscious person.
For an infant or young child, pinch their skin. Never shake a young child.
Check breathing and pulse. If absent or uneven, prepare to use the AED as soon as possible.
2. Prepare to use AED
Make sure the person is in a dry area and away from puddles or water.
Check for body piercings or outline of an implanted medical device, such as a pacemaker or implantable defibrillator.
AED pads must be placed at least 1 inch away from piercings or implanted devices.
3. Use AED
For newborns, infants, and children up to age 8, use a pediatric AED, if possible. If not, use an adult AED.
Turn on the AED.
Wipe the chest dry.
Attach pads.
Plug in connector, if necessary.
Make sure no one is touching the person.
Push the “Analyze” button.
If a shock is advised, check again to make sure no one is touching the person.
Push the “Shock” button.
Start or resume continue compressions.
Follow AED prompts.
4. Continue CPR
After 2 minutes of CPR, check the person’s heart rhythm. If it’s still absent or uneven, give them another shock.
If a shock isn’t needed, continue CPR until emergency help arrives or the person begins to move.
Stay with the person until help arrives.
Heart Attack Diagnosis
Emergency medical workers will ask you about your symptoms and do some tests.
Tests to diagnose a heart attack:
Blood tests: Several blood tests, often done every 4 to 8 hours, can help diagnose a heart attack and spot any ongoing heart damage. Different levels of cardiac enzymes in your blood can indicate heart muscle damage. These enzymes are usually inside the cells of your heart. When those cells are injured, their contents -- including the enzymes -- spill into your bloodstream. By measuring the levels of these enzymes, your doctor can find out the size of the heart attack and when it started. Tests can also measure troponin levels. Troponins are proteins inside heart cells that are released when the cells are damaged by the lack of blood supply to your heart.
Echocardiography: In this ultrasound test, sound waves are bounced off your heart to create images. It can be used during and after a heart attack to learn how your heart is pumping and what areas aren’t pumping the way they should. The "echo" can also tell whether any parts of your heart (valves, septum, etc.) have been injured in the heart attack.
Cardiac catheterization: You might need cardiac catheterization, also called cardiac cath, during the first hours of a heart attack if medications aren’t helping the ischemia or symptoms. The cardiac cath can give an image of the blocked artery and help your doctor decide on a treatment.
In this procedure, a catheter (a thin, hollow tube) is inserted into a blood vessel in your groin or wrist and threaded up to your heart. Dye is used to highlight your heart’s arteries. Your doctor can then identify blockages, which are often treated with angioplasty or stents to open the artery and restore blood flow. Your doctor may do several tests to assess your heart. Intravenous blood thinner is an option to open the artery if cardiac catheterization is not available.
Stress testing:Your doctor can do a treadmill test or a radionuclide scan to check whether other areas of the heart are still at risk for another heart attack.
Heart Attack Treatment
A heart attack is a medical emergency that needs immediate care to prevent permanent heart damage or death. Treatment often begins in the ambulance if you called 911, or in the emergency room if someone else took you to the hospital.
What drugs are used to treat a heart attack?
At the emergency facility or hospital, you’ll quickly get drugs to prevent further blood clotting in the heart and ease the strain on the heart. Drug therapy aims to break up or prevent blood clots, stop platelets from collecting and sticking to the plaque, stabilize the plaque, and prevent more ischemia.
You should get these medications as soon as possible (within 1 or 2 hours from the start of your heart attack, if possible) to limit heart damage.
Drugs used during a heart attack may include:
Aspirin to stop blood clotting that may make the heart attack worse
Other antiplatelet drugs, such as clopidogrel (Plavix), prasugrel (Effient), or ticagrelor (Brilinta) to stop clotting
Thrombolytic therapy ("clot busters") to dissolve blood clots in your heart's arteries
Any combination of these Other drugs given during or after a heart attack help your heart work better, widen your blood vessels, lower your pain, and help you avoid life-threatening heart rhythms.
Are there other treatments for a heart attack?
Treatment may also include a procedure to open the blocked arteries.
Cardiac catheterization: In addition to making a picture of your arteries, cardiac cath can be used for procedures (such as angiography or stent) to open narrowed or blocked arteries.
Balloon angioplasty: This treatment can be done, if needed, during cardiac catheterization. A balloon-tipped catheter (thin, hollow tube) is inserted into the blocked artery in the heart. The balloon is inflated gently to press plaque outward against the walls of the artery, to open the artery and improve blood flow. Most of the time, this is not done without putting in a stent.
Stent placement: In this procedure, a small tube is inserted through a catheter into a blocked artery to "prop" it open. The stent is usually made of metal and is permanent. It can also be made of a material that your body absorbs over time. Some stents have medicine that helps keep the artery from getting blocked again.
Bypass surgery: You might have bypass surgery in the days after a heart attack to restore the blood supply to your heart. Your surgeon will reroute blood flow around your blocked artery, usually using a blood vessel from your leg or chest. They can bypass multiple arteries.
What happens in the coronary care unit (CCU)?
If you’ve had a heart attack, you’ll usually stay in a CCU for at least 24 to 36 hours. Once past the critical phase, you’ll continue to get a variety of drugs, including:
Beta-blockers to slow the heart
Nitrates to increase heart blood flow
Blood thinners such as aspirin, Brilinta, clopidogrel, Effient, heparin, or Plavix to prevent further clotting
ACE inhibitors to help the heart muscle heal
Statins -- cholesterol-lowering drugs such as atorvastatin and simvastatin -- to help the heart muscle heal and lower the risk of another heart attack
While you’re in the hospital, medical staff will constantly monitor your heart by EKG in case you develop unusual heart rhythms.
Some people may need to be fitted with a pacemaker, a battery-powered device to help keep a steady heart rhythm. If you have a dangerous arrhythmia known as ventricular fibrillation, medical providers will give an electric shock to your chest.
Treatments don’t cure coronary artery disease. You can still have another heart attack. But you can take steps to make it less likely.
Tips for Heart Attack Prevention:
The goal after your heart attack is to keep your heart healthy and lower your risk of having another heart attack. Take your medications as directed, make healthy lifestyle changes, see your doctor for regular heart checkups, and consider a cardiac rehabilitation program.
Why do I need to take drugs after a heart attack?
You might take certain drugs after a heart attack to:
Prevent blood clots
Help your heart work better
Prevent plaques by lowering cholesterol
You might take medications that treat an uneven heartbeat, lower your blood pressure, control chest pain, and treat heart failure.
Know the names of your medications, what they’re used for, and when you need to take them. Go over your medications with your doctor or nurse. Keep a list of all your medications, and take it to each of your doctor visits. If you have questions about them, ask your doctor or pharmacist.
It sounds like a no-brainer, but don't skip your medications. Many people don't take their medications the way their doctor told them to. Figure out what keeps you from taking your medicine -- it could be side effects, cost, or forgetfulness -- and ask your doctor for help.
What lifestyle changes are needed after a heart attack?
To keep heart disease from getting worse and to head off another heart attack, follow your doctor's advice. You might need to change your lifestyle.
Here are some changes you can make that can cut your risk and put you on the path to a healthier life:
Stop smoking:Smoking dramatically raises your risk of both heart attacks and strokes. Talk to your doctor about how to quit. You'll also be doing your friends and family a favor, since secondhand smoke can also lead to heart disease.
Keep a healthy body weight: If you're overweight or obese, you don't have to get thin to reduce your risk for a heart attack or stroke. If you lose 5% to 10% of your weight, you'll improve your cholesterol numbers and lower your blood pressure and blood sugar levels.
Follow an exercise plan: Moderate physical activity lowers your chances of a heart attack. It also can reduce your blood pressure and LDL or "bad" cholesterol, raise your HDL or "good" cholesterol, and help you stay at a healthy weight.Aim for 30 minutes of exercise that gets your heart pumping at least 5 days a week. Brisk walking or swimming are some good choices. On the other 2 days, do strength training, like lifting weights. If you've got a tight schedule, break your exercise routine into small chunks.
Eat a heart-healthy diet: Fill your plate with different kinds of fruits, veggies, beans, and lean meats, such as poultry without the skin. Also up your intake of whole grains like oatmeal, quinoa, and brown rice and of f ish, especially those with omega-3 fatty acids, such as salmon, trout, and herring.Avocados, olive oil, and flaxseeds also have omega-3s, as do some nuts and seeds. Fat-free or low-fat dairy products such as milk, yogurt, and cheese also are better choices for your heart health than higher-fat versions.
Cut back on unhealthy foods: Stay away from processed or prepared foods that often are high in salt and added sugar. They're also filled with preservatives. Avoid fatty beef, butter, fried foods, and palm oil. All are high in saturated fats.Skip sugary drinks like sodas and fruit punch, which can lead to weight gain. So can packaged baked goods such as cookies, cakes, and pies. They are high in trans fats and can raise your cholesterol levels.
Limit alcohol: If you don't drink already, don't start. If you do drink, limit how much you drink. The recommendation is no more than one drink a day if you are a woman and no more than two a day if you are a man. Drinking raises your heart rate and blood pressure. It also increases the level of fat in your blood and can cause weight gain.Get regular checks of your cholesterol, blood pressure, and blood sugar (glucose) levels: If you have diabetes, make sure it’s controlled. Keeping a check on these numbers can help you be more aware of the changes you need to make to keep these levels within normal limits.
Control stress: You may feel anxious or frustrated at times. Make sure you open up to your family and friends about what’s going on. Support groups can help you learn how others adjusted to life after a heart attack or stroke.You may want to talk to a mental health professional or ask your doctor about a stress management program. You can also reduce stress with plenty of physical activity and mind-body practices like meditation.
Pay attention to your symptoms: Don't just hope they'll go away. See your doctor if you feel anything unusual, like shortness of breath, changes in your heart rhythm, or extreme tiredness. Also, watch for pain in your jaw or back, nausea or vomiting, sweating, or flu-like symptoms.
Why should I take part in cardiac rehabilitation?
If you've had a heart attack or have been diagnosed with heart disease, your doctor may recommend cardiac rehabilitation. You'll work with a team of experts to boost your health and avoid future problems.
Your team may include doctors and nurses, as well as specialists in exercise, nutrition, physical therapy, occupational therapy, and mental health. They'll set up a program to fit your needs. They can also help you make changes in your daily life. If you stick with it, it can make a big difference in your recovery and overall well-being.
When will I see my doctor again after I leave the hospital?
Make a doctor's appointment for 4 to 6 weeks after you leave the hospital following a heart attack. Your doctor will want to check your recovery. You might need an exercise stress test on a regular basis. These tests can help your doctor find or slow blockages in your coronary arteries and plan your treatment.Call your doctor if you have symptoms such as chest pain that happens more often, gets stronger, lasts longer, or spreads to other areas; shortness of breath, especially while you’re resting; dizziness; or uneven heartbeats.
What Is an Arrhythmia?
An arrhythmia is an irregular heartbeat. It means your heart is out of its usual rhythm.
It may feel like your heart skipped a beat, added a beat, or is "fluttering." It might feel like it’s beating too fast (which doctors call tachycardia) or too slow (called bradycardia). Or you might not notice anything.
Arrhythmias can be an emergency, or they could be harmless. If you feel something unusual happening with your heartbeat, get medical help right away so doctors can find out why it's happening and what you need to do about it.
What Are the Symptoms of Arrhythmia?
An arrhythmia can be silent, meaning you don't notice any symptoms. Your doctor may spot an uneven heartbeat during a physical exam.
If you have symptoms, they may include:
Palpitations (a feeling of skipped heartbeats, fluttering, or "flip-flops")
Pounding in your chest
Dizziness or feeling lightheaded
Fainting
Shortness of breath
Chest pain or tightness
Weakness or fatigue (feeling very tired)
Anxiety
Blurry vision
Sweating
What Causes Arrhythmia?
You could have an arrhythmia even if your heart is healthy. Or it could happen because of:
Heart disease
The wrong balance of electrolytes (such as sodium or potassium) in your blood
Heart injury or changes such as reduced blood flow or stiff heart tissue
Healing process after heart surgery
Infection or fever
Certain medications
Problems with the electrical signals in your heart
Strong emotions, stress, or surprise
Things in your daily life like alcohol, tobacco, caffeine, or exercise
What Are Some Arrhythmia Risk Factors?
Things that may make you more likely to have an arrhythmia include your:
Age. The chances go up as you get older.
Genes. Your odds might be higher if a close relative has had an arrhythmia. Some types of heart disease can also run in families.
Lifestyle. Alcohol, tobacco, and recreational drugs can raise your risk.
Medical conditions.High blood pressure, diabetes, low blood sugar, obesity, sleep apnea, and autoimmune disorders are among the conditions that may cause heart rhythm problems.
Environment. Things in the world around you, like air pollution, can make an arrhythmia .
What Are the Types of Arrhythmias?
Arrhythmias are divided up by where they happen. If they start in the ventricles, or lower chambers of your heart, they’re called ventricular. When they begin in the atria, or upper chambers, they’re called supraventricular.
Doctors also group them by how they affect your resting heart rate. Bradycardia is a heart rate of fewer than 60 beats per minute. Tachycardia is more than 100 beats per minute.
Supraventricular arrhythmias include:
Premature atrial contractions. These are early extra beats. They’re harmless and generally don't need treatment.
Atrial fibrillation (AFib). The upper chambers of your heart contract in an unusual way. Your heart might beat more than 400 times a minute.
Atrial flutter. This is usually more organized and regular than atrial fibrillation. It happens most often in people who have heart disease and in the first week after heart surgery. It often changes to atrial fibrillation.
Paroxysmal supraventricular tachycardia (PSVT). This is a rapid heart rate, usually with a regular rhythm. It begins and ends suddenly.
Accessory pathway tachycardias. You can have a rapid heart rate because of an extra pathway between your heart's upper and lower chambers. Think of it as an extra road on your way home as well as your usual route. When that happens in your heart, it can cause a fast rhythm.
AV nodal reentrant tachycardia (AVNRT). This is caused by an extra pathway through a part of your heart called the AV node. It can cause heart palpitations, fainting, or heart failure.
Ventricular arrhythmias include:
Premature ventricular contractions (PVCs). These are among the most common arrhythmias. They're the "skipped heartbeat" that many of us feel sometimes.
Ventricular tachycardia (V-tach). This is a rapid heart rhythm starting from your heart's lower chambers. Because your heart is beating too fast, it can't fill with enough blood. This can be a serious arrhythmia, especially in people who have heart disease, and it may be linked to other symptoms.
Ventricular fibrillation (V-fib). This happens when your heart's lower chambers quiver and can't contract or pump blood to the rest of your body. It’s a medical emergency that must be treated with CPR and defibrillation as soon as possible.
Long QT syndrome. Your heart’s lower chambers take too long to contract and release. This may cause dangerous rhythm problems and death.
Another type of arrhythmia, bradyarrhythmia, is a slow rhythm because of disease in your heart's electrical system or because of medication. It may make you pass out or feel like you will.
Types of bradyarrhythmia include:
Sinus node dysfunction. This is caused by a problem with your heart's sinus node, its natural pacemaker.
Heart block. There’s a delay or a block of the electrical impulse as it travels from your heart's sinus node to its lower chambers.
How Are Arrhythmias Diagnosed?
To diagnose an arrhythmia or find its cause, doctors use tests including:
EKG. An electrocardiogram records the electrical activity of your heart. You wear small electrode patches on your chest, arms, and legs for the quick, painless test, which you take in your doctor's office.
Holter monitor. This is a portable EKG (also called an "ambulatory electrocardiogram" or an ECG) about the size of a postcard or digital camera that you'll use for 1 to 2 days, or up to 2 weeks. The test measures the movement of electrical signals or waves through your heart. These signals tell your heart to contract (squeeze) and pump blood.
You'll have electrodes taped to your skin. It's painless, although some people have mild skin irritation from the tape used to attach the electrodes to the chest. You can do everything but shower or bathe while wearing the electrodes. After the test period, you'll go back to see your doctor. They'll download the information.
Event monitor. If your symptoms don't happen often, your doctor may suggest that you wear one of these, usually for about a month. When you push a button, it records and stores your heart's electrical activity for a few minutes. Try to get a reading when you notice symptoms. Your doctor will interpret the results.
Implantable loop recorder. Your doctor puts this under your skin, where it constantly records your heart’s electrical activity. It can send information to your doctor’s office.
Stress test. There are different kinds of stress tests. The goal is to check how much stress your heart can manage before having a rhythm problem or not getting enough blood. For the most common type of stress test, you'll walk on a treadmill or pedal a stationary bike while you get an EKG and have your heart rate and blood pressure monitored. Technicians slowly raise the intensity level of your exercise.
Echocardiogram. This test uses ultrasound to check your heart muscle and valves.
Cardiac catheterization. Your doctor will insert a long, thin tube, called a catheter, into a blood vessel in your arm or leg. They’ll guide it to your heart with help from a special X-ray machine. Then, they’ll inject dye through the catheter to help make X-ray videos of your heart valves, coronary arteries, and chambers.
Electrophysiology study. This test records your heart's electrical activities and pathways. It can help find out what's causing heart rhythm problems and find the best treatment for you. During the test, your doctor will safely trigger your unusual heart rhythm. Then, they may give you medications to see which one controls it best or to see what procedure or device you need to treat it.
Head-up tilt table test. Doctors use this test to find out what's causing fainting spells. It measures the difference in heart rate and blood pressure when you're standing up and lying down. You'll get this test in a lab. You'll lie on a stretcher, tilted at different angles while you get an EKG and specialists check your blood pressure and oxygen level. This shows if symptoms of passing out are due to your electrical system, nervous system, or vascular system.
How Are Arrhythmias Treated?
Treatment will depend on what type of arrhythmia you have. Your doctor may recommend one or more of these.
Medications
Medicines that treat uneven heart rhythms include:
Adenosine (Adenocard)
Atropine (Atropen)
Beta-blockers
Calcium channel blockers
Digoxin (Digitek, Digox, Lanoxin)
Potassium channel blockers
Sodium channel blockers
Vagal maneuvers
Cough or gag
Hold your breath and bear down (Valsalva maneuver)
Lie down
Put a cold, wet towel over your face
Electrical cardioversion:
If drugs can't control an uneven heart rhythm (such as atrial fibrillation), you might need cardioversion. For this, doctors put you under and then send an electrical shock to your chest wall to trigger your heart’s regular rhythm.
Pacemaker:
This device sends small electrical impulses to your heart muscle to keep a safe heart rate. It includes a pulse generator, which houses the battery and a tiny computer, and wires that send impulses to the heart muscle.
These techniques trigger your body to relax by affecting your vagus nerve, which helps control your heart rate. Your doctor might tell you to:
Implantable cardioverter defibrillator (ICD)
Doctors mainly use ICDs to treat ventricular tachycardia and ventricular fibrillation, two life-threatening heart rhythms.
The ICD constantly tracks your heart rhythm. When it detects a very fast, unusual rhythm, it delivers an electric shock to the heart muscle to make it beat in a regular rhythm again. The ICD has two parts: the leads and a pulse generator.
The leads are made up of wires and sensors that monitor the heart rhythm and deliver energy used for pacing or defibrillation. The generator houses the battery and a tiny computer. Energy is stored in the battery until it is needed. The computer receives information from the leads to determine how the heart is beating.
Your doctor programs the ICD to include one or all of the following functions:
Anti-tachycardia pacing (ATP). A series of small electrical impulses to the heart muscle restores a regular rate and rhythm.
Cardioversion. You may get a low-energy shock at the same time your heart beats to restore regular rhythm.
Defibrillation. When your heartbeat is dangerously fast or uneven, your heart muscle gets a higher-energy shock to restore a regular rhythm.
Anti-bradycardia pacing. Many ICDs give backup pacing to keep the heart rhythm if it slows too much
There are different types of ICDs, including:
Single-chamber ICD. A lead is attached in the right ventricle. If needed, energy is delivered to the ventricle to restore a normal heart rhythm.
Dual-chamber ICD. Leads are attached in the right atrium and the right ventricle. Energy can be delivered to the right atrium and then to the right ventricle, helping your heart to be paced in a normal sequence.
Biventricular ICD. Leads are attached in the right atrium, the right ventricle, and the coronary sinus adjacent to the left ventricle. This technique helps the heart beat in a more efficient way and is specifically used for patients with heart failure.
Your doctor will determine which type of ICD is best for you. Before you have your ICD implanted, ask your doctor what medications you can take. Your doctor may ask you to stop taking certain medications before the procedure. You will receive specific instructions.
After it’s implanted, you might not notice a low-energy shock. Or it may feel like a flutter in your chest. The high-energy shock lasts just a second, but it can hurt. Some people say it feels like being hit with a baseball bat or being kicked by a horse. Most people feel it more in their back than their chest. If you feel a shock, sit or lie down because you may pass out.
Talk to your doctor about what to do if you ever get shocked. If you do get shocked, call your doctor immediately.
Catheter ablation
Think of this procedure as rewiring to fix an electrical problem in your heart.
Your doctor will insert a catheter through your leg. It delivers high-frequency electrical energy to a small area inside your heart that causes the unusual rhythm. This energy "disconnects" the pathway of the unusual rhythm.
Doctors use ablation to treat most PSVTs, atrial flutter, atrial fibrillation, and some atrial and ventricular tachycardias.
Heart surgery for arrhythmias
The maze procedure is a type of surgery to correct atrial fibrillation. Your surgeon makes a series, or "maze," of cuts in your heart's upper chambers. The goal is to keep your heart's electrical impulses only on certain pathways. Some people need a pacemaker afterward.
Your doctor might recommend other procedures, such as a coronary bypass, to treat other forms of heart disease.
Complications of Arrhythmias
Without treatment, an uneven heart rhythm could cause dangerous problems such as:
Alzheimer’s disease and dementia. These cognitive disorders may happen because your brain doesn’t get enough blood over time.
Heart failure. Your heart might not pump as well as it should after repeated arrhythmias.
Stroke. Blood that lingers in your atria can clot. If a clot travels to your brain, it may cause a stroke.
Cardiac arrest. V-fib could cause your heart to stop.
Safe Driving Concerns
If you have an arrhythmia, you could faint behind the wheel. This could put you, other motorists, pedestrians, and property at great risk.
To figure out whether you can drive safely, your doctor will consider:
What type of arrhythmia you have
How serious yours is
The treatment you receive for it (if any)
How often you have symptoms and how serious they are
If you have no symptoms and you haven't had any serious heart rhythm problems, you should be able to drive as you always have. If meds keep your arrhythmia under control, your doctor may give you the green light to drive, too.
In addition to meds to help manage your heart rhythm, you may have two other treatments. Both would keep you out of the driver's seat for a while:
Ablation: This treatment will usually restrict you to the passenger's seat for about a week. It may keep you there longer, depending on your medical history.
Implantable cardioverter defibrillator: Usually after you get an ICD, you'll be asked not to drive for a week. If you got an ICD after fainting or surviving cardiac arrest, you may have to wait several months before you get back behind the wheel.
You can't drive commercially (as in a delivery truck or a taxi) at all if you have an ICD.
Arrhythmia Prevention
You can’t always prevent arrhythmias. Regular checkups with your doctor can help keep you from having more heart rhythm problems. Be sure they know all of the medications you’re taking. Some cold and cough medicines can trigger an arrhythmia, so talk to your doctor before using them.
They may also recommend some lifestyle changes:
Eat a healthy diet. Get plenty of fruits and vegetables, fish, and plant-based proteins. Avoid saturated and trans fats.
Keep cholesterol and blood pressure under control:
Don’t smoke.
Keep a healthy weight.
Exercise regularly.
Manage stress.
Limit alcohol and caffeine.
STAY-HEALTHY