Which arrhythmias need to be treated?

  Arrhythmias are very common cardiac abnormalities, especially premature beats (premature beats) are quite common. Almost everyone has experienced premature beats in their lifetime. Some people have more premature beats with panic symptoms, while others have occasional premature beats that go unnoticed. So, how should arrhythmias be treated correctly? How should I take care of myself after an arrhythmia occurs?  When an arrhythmia occurs, most people have symptoms of panic and chest tightness, which attract the patient’s attention and go to the hospital, where the arrhythmia is detected by electrocardiogram. A small number of people have no symptoms and occasionally have an arrhythmia found during a physical examination. When an arrhythmia is diagnosed, the first step is to go to a doctor, preferably a cardiologist, to get a detailed understanding of the onset of the arrhythmia and to perform the necessary tests and make a specific analysis of the background of the arrhythmia. Because arrhythmia is not an independent heart disease, it is an abnormal manifestation of electrocardiology. Any heart disease can have arrhythmias, and normal people can sometimes have arrhythmias. A 24-hour ambulatory ECG recording of a normal person will reveal that more than half of the population has a documented arrhythmia. Arrhythmias can also be triggered by many external stimuli, such as fatigue, emotional stress, smoking, alcohol abuse, and strong tea and coffee. Therefore, the basis of the arrhythmia should first be analyzed to determine whether the arrhythmia occurs on the basis of some heart disease or is caused by external factors, i.e., whether the arrhythmia is functional or organic. Functional arrhythmias have a good prognosis, do not affect health, and do not require special treatment with drugs. The majority of organic arrhythmias are also benign, i.e., they do not pose a risk of cardiac arrest or sudden death. Only a few organic arrhythmias are malignant and require special treatment.  The treatment of functional arrhythmias lies mainly in the removal of triggers and psychotherapy. Some people have suggested that functional arrhythmias should be classified as cardiac neurosis, and there is some truth to this. Psychological disorders are the main cause of many functional arrhythmias. Therefore, you should cooperate with your doctor to carefully analyze the onset of each episode and find out the mental factors leading to arrhythmia, which may be multifaceted, such as high work pressure, emotional tension, family conflicts, and disharmony in married life. If necessary, a psychologist can be called for psychological counseling, which can help the patient to get out of the situation after several times of counseling and guidance. The cultivation of our own psychological quality is also very important, we should establish the “contentedness and happiness”, “helping others”, “self-gratification” view of life, and strive to cultivate a stable and optimistic mood. Some risk factors that can easily trigger arrhythmia should be eliminated, such as smoking, alcoholism, strong tea and coffee. If necessary, you can take some sedative and calming Chinese or Western medicine. Appropriate physical activity can help to adjust the plant nervous function and stabilize the mood.  Most arrhythmias can disappear or improve after the primary disease is cured. If the arrhythmia is compared to a seed, the underlying heart disease is the soil, and the triggering factors are the rain. The seed will germinate and grow only when it encounters the right rain in the soil. The removal of triggers is quite important in the treatment of arrhythmias. Generally, for benign arrhythmias, only the primary disease needs to be treated and the triggers removed, without the need for anti-arrhythmic drugs. Only if the arrhythmia is more severe and the symptoms are more pronounced, antiarrhythmic drugs with fewer side effects should be considered for short-term treatment.  Malignant arrhythmias must receive special treatment. The so-called malignant arrhythmias are patients who have had cardiac arrest and have been successfully resuscitated by cardiopulmonary resuscitation, as well as patients who have severe organic heart disease with severe arrhythmias and are predicted to be at risk of sudden death from cardiac arrest after special tests. This group of patients must be screened for one or two effective anti-arrhythmic drugs for long-term use while treating the primary disease, or be fitted with a special pacemaker.  Many non-cardiac diseases can also be accompanied by arrhythmias, such as thyroid, hepatobiliary diseases, cranial trauma or tumors, adrenal diseases and the application of drugs toxic to the myocardium, such as antimony, adriamycin, digitalis, etc. The key to the treatment of these arrhythmias is to remove the primary disease, and care must be taken not to focus only on the heart because of the arrhythmia, delaying the timely detection and treatment of the primary disease.  Blindly taking anti-arrhythmic drugs can be harmful. The United States has made such a trial, after myocardial infarction with more serious ventricular arrhythmia patients randomly grouped, given a placebo or a certain anti-arrhythmic drug treatment, the purpose is to prevent the occurrence of cardiac arrest and sudden death, the results found that, after 1 year of treatment, the mortality rate of patients taking anti-arrhythmic drugs, but higher than patients taking placebo. All antiarrhythmic drugs have varying degrees of arrhythmogenic effects and must be taken under the guidance of a physician after a thorough weighing of the pros and cons.