When your heartbeat feels strange, it’s easy to pass it off as a brief, meaningless occurrence. Most often, it doesn’t mean anything, but for some, an abnormal heartbeat can be a sign of an arrhythmia.
If I require a device to correct my arrhythmia, should I be worried?
No. The sooner you get treatment for your arrhythmia, the better. The procedures and surgeries are very safe, and even if there are complications with an antiarrhythmic device, they are not life-threatening. A medical professional will be able to guide you through the process and find what’s best for you.
What devices are used to correct an arrhythmia?
Defibrillator (cardioversion)
You’ve most likely seen someone resuscitated by a defibrillator in movies and TV shows after their heart stops. Although it certainly has its uses when returning someone “from the dead,” that’s not the only thing a defibrillator can be used for. A defibrillator used to resuscitate someone aims to bring any heartbeat back to the patient, but a defibrillator used on a patient with arrhythmia is used to restore their heartbeat to normal. This is called cardioversion. Cardioversion controls an arrhythmia when there's a severe risk of an event like a stroke or cardiac arrest, and other treatments cannot control the arrhythmia.
To have cardioversion done, a patient has to schedule an appointment in advance. During the appointment, the patient is first given anesthetic to make them fall asleep, after which electrodes are placed on their chest and sometimes their back. It’s possible that “paddles” are used instead (these are the ones most often seen in movies). A device records the patient’s heart’s electrical activity before shocking the heart. Sometimes more than one shock is needed to restore the heart to normal. After the procedure, a medical team monitors the patient for any complications.
There may be some soreness after the procedure. Complications are rare. It can do more damage to the heart than it repairs by starting new abnormal rhythms or making the current abnormal rhythm worse. The procedure can make currently-harmless blood clots in the heart travel to other parts of the body, which can be life-threatening. Sometimes medicine is given to the patient before the procedure to prevent blood clots from happening.
Catheters (catheter/cardiac ablation)
Catheters are used to make changes to the heart to remedy an arrhythmia. They are similar to a defibrillator in that it’s a one-time procedure to give the heart a normal rhythm again. However, the procedure requires inserting the catheters into the patient's body and making much more permanent changes to the patient’s heart.
Catheters carry out a procedure called catheter ablation. Put simply, it’s a surgery that damages a problematic part of the heart. Electrical signals control the heart’s beats, and a problem with those signals can cause an arrhythmia. By damaging the electrical pathways in the heart, it’s possible to stop an arrhythmia by stopping harmful electrical signals from moving throughout the heart.
Anesthesia will be given to the patient during this procedure, although it won’t put them under. While the procedure is happening, the heart’s activity will be monitored. To insert a catheter, an area will have to be cleaned and numbed either near the arm, groin, upper thigh, or neck.
After that, the surgeon creates a hole in a blood vessel, and catheters are carefully guided towards the heart. Sometimes the catheters are designed to locate the source of the arrhythmia. Once found, the catheters use a laser, radio waves, or cold temperatures to scar a small area and disrupt electrical signals.
The procedure lasts several hours.When finished, health professionals will monitor the patient to make sure there are no complications. It’s usually a very safe procedure, but it is possible for there to be side effects. Some of the possible side effects are bleeding, infection, blood vessel damage, damage to the heart, blood clots, arrhythmia, and heart attack. If you are concerned about these side effects and plan to have this procedure, don’t hesitate to ask your doctor about the risks.
Implantable Cardioverter Defibrillator (ICD)
Before surgery, a patient will usually consult with a doctor about whether they need an ICD and whether there are different models to choose from. If the patient decides to go through with the surgery, anesthetics are administered to numb the area before inserting the device. The device is inserted either under the breastbone or along the ribs. After the sensors connected to the device are properly inserted so they can pick up the heart’s activity, the doctor will test the device. If the test is successful, then the cut will be sewed up. The whole surgery only takes a few hours.
The surgery has a quick recovery time; once the medicine wears off, the patient can go home. After the surgery, most patients will have to avoid driving for about a week and physically strenuous activities for about a month. As with the other procedures, this surgery is safe, but there are possible complications. These can include a collapsed lung (very rare), heart damage, internal bleeding, swelling, and infection.
Pacemaker
Pacemaker surgery is very similar to implanting an ICD. The doctors will administer anesthesia to numb the area where the pacemaker will be inserted. The pacemaker needs wires that lead into the heart to analyze the heart rate. Using an X-ray, the doctors will guide the wires through a large vein to enter them into the heart.
The device is then placed into the chest and connected to the wires. The doctor will test the pacemaker and, if working, will stitch up the cut. Most patients will stay overnight so doctors can make sure they are recovering properly. For a few weeks after the surgery, strenuous activity should be avoided.
As with most of these procedures, the operation is safe, but complications can sometimes arise. This can include bleeding and infection where they placed the pacemaker, blood vessel damage, (very rarely) a collapsed lung, and bleeding inside the heart (also very rare).
- Photo courtesy of SteadyHealth
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