A Guide to Drugs for Arrhythmia
Medications for arrhythmia include antiarrhythmic drugs that restore the heart's normal rhythm by affecting the heart's electrical current.
Calcium channel blockers can help manage arrhythmia, angina, and high blood pressure by widening blood vessels and slowing the heart rate.
Anticoagulants are prescribed to reduce the risk of blood clots and stroke in people with arrhythmia, but they require monitoring for internal bleeding.
Introduction
An arrhythmia is a condition in which the heart beats too quickly, too slowly, or irregularly.
In many cases, the arrhythmia may not be serious or require any treatment at all. However, if your doctor finds that the arrhythmia could lead to more serious heart problems, they may prescribe medication.
Several types of medication can help control or resolve an arrhythmia. The type that's right for you depends on the kind of arrhythmia you have.
Here's what to know about drugs that treat arrhythmia.
Antiarrhythmic drugs
Antiarrhythmic drugs may be prescribed if you have tachycardia (fast heart rate) or premature or extra heartbeats. These medications work to correct the rhythm of your heart. They restore a normal heart rhythm by changing the electrical current that makes your heart beat.
Most antiarrhythmic drugs come in pill form and are typically used long-term. In emergencies, some can be given intravenously. The most common medications in this class are:
amiodarone (Cordarone, Pacerone)
flecainide (Tambocor)
ibutilide (Corvert), which can only be given through IV
lidocaine (Xylocaine), which can only be given through IV
procainamide (Procan, Procanbid)
propafenone (Rythmol)
quinidine (many brand names)
tocainide (Tonocarid)
While these medications can help correct an arrhythmia, there's also a risk that they can cause the arrhythmia to occur again or more often. This is called a proarrhythmia. If you develop a proarrhythmia while taking an antiarrhythmic drug, call your doctor right away.
Calcium channel blockers
If you have angina (chest pain), high or low blood pressure, and an arrhythmia, your doctor may prescribe a calcium channel blocker. These drugs dilate your blood vessels. This allows more blood to flow to the heart, which helps ease chest pain and decrease blood pressure.
These drugs can also slow your heart rate. A reduced heart rate and lowered blood pressure reduce the strain on your heart and reduce your risk of an arrhythmia.
Most calcium channel blockers come in pill form, but some are also available in intravenous (IV) form. Calcium channel blockers are for long-term use.
Examples of common calcium channel blockers include:
amlodipine (Norvasc)
diltiazem (Cardizem, Tiazac)
felodipine
isradipine
nicardipine (Cardene SR)
nifedipine (Procardia)
nisoldipine (Sular)
verapamil (Calan, Verelan, Covera-HS)
The side effects of these medications vary. Some people have tachycardia, dizziness, constipation, and headaches. Other people more serious side effects include rash or swelling in the legs and feet.
Beta blockers
If you've been diagnosed with tachycardia, your doctor may prescribe a beta-blocker.
Beta-blockers stop the action of the hormone adrenaline. This can relieve your tachycardia by slowing your heart rate. It can also lower your blood pressure and decrease the stress on your heart. Examples of beta blockers include:
acebutolol (Sectral)
atenolol (Tenormin)
bisoprolol (Zebeta)
metoprolol (Lopressor, Toprol-XL)
nadolol (Corgard)
propranolol (Inderal LA, InnoPran XL)
The side effects of beta-blockers include tiredness, cold hands, and headache. Sometimes these medications affect your digestive system as well. Some people report stomach issues, constipation, or diarrhea.
Anticoagulants
An anticoagulant is a blood-thinning medication. Your doctor may prescribe an anticoagulant if your arrhythmia puts you at risk of clots or stroke caused by a clot.
For some people, an abnormal heart rhythm changes how the blood flows through their system. For instance, atrial fibrillation may cause blood to pool in the heart, which may result in blood clots.
Anticoagulants don't fix your heart rhythm problem. They only help reduce the risk of blood clots caused by certain arrhythmias.
Warfarin (Coumadin) is one of the most common anticoagulants. However, non-vitamin K oral anticoagulants (NOACs) are now recommended over warfarin unless you have moderate to severe mitral stenosis or an artificial heart valve. NOACs include:
dabigatran (Pradaxa)
rivaroxaban (Xarelto)
apixaban (Eliquis)
edoxaban (Savaysa)
Anticoagulants are effective, but they can also make your body less able to stop bleeding. For this reason, you should watch for any signs of internal bleeding, such as bloody stool, multiple bruises, and vomit that looks like coffee grounds.
Your doctor may prescribe aspirin instead of warfarin if they find that you have a lower risk of a blood clot. Aspirin is not as powerful of a blood thinner as warfarin is. However, it has a lower risk of causing bleeding.
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