An arrhythmia is a condition in which the heart has a too fast, too slow, or irregular heartbeat. In many cases, the arrhythmia may not be serious or require any treatment at all. However, you may need medication to control or resolve the arrhythmia if your doctor finds that the arrhythmia can lead to more serious heart disease. There are several types of medications you can take depending on the cause of your arrhythmia.
Antiarrhythmic drugs are sometimes prescribed for tachycardias and people who have premature or extra beats. They come in pill form for long-term use or can be given intravenously (IV) if there is an emergency. These medications work to correct the rhythm of the heart and restore it to normal. 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 trade names)
- tocainide (Tonocarid)
While these medications can help correct an arrhythmia, there is a risk that an individual can develop other types of arrhythmias (proarrhythmias) or even cause the arrhythmia to occur more often. Some newer medications are being developed to reduce this risk of proarrhythmia.
Calcium channel blockers are another class of medications. These are given to people who have chest pain (angina) and blood pressure issues as well as treating arrhythmias. There are different calcium channels throughout the body and particular calcium channel blockers may target one type over other ones. Calcium channel blockers for arrhythmia work by blocking the calcium from moving into the heart. Most of these come in pill form and some are also available in an IV formulation. You might take a calcium channel blocker to relieve pain quickly or over a long period to correct an arrhythmia. Some common calcium channel blockers are:
- amlodipine (Norvasc)
- diltiazem (Cardizem, Tiazac)
- nicardipine (Cardene SR)
- nifedipine (Procardia)
- nisoldipine (Sular)
- verapamil (Calan, Verelan, Covera-HS)
The side effects of these medications vary. Some people experience fast heart beat (tachycardia), dizziness, constipation, and headaches. Other more serious side effects include swelling and rash. You should also avoid eating grapefruit if you are being treated for arrhythmia
Your doctor may prescribe a beta blocker if you are diagnosed with a tachycardia. This type of medication blocks the action of adrenaline, which can slow down your heart rate, lower your blood pressure and decrease the stress on your heart. Examples of beta blockers include:
- acebutolol (Sectral)
- atenolol (Tenormin)
- aisoprolol (Zebeta)
- metoprolol (Lopressor, Toprol-XL)
- nadolol (Corgard)
- propranolol (Inderal LA, InnoPran XL)
The side effects of beta blockers include feeling tired, cold hands, and headache. Sometimes these medications have an effect on your digestive system as well. Some people report stomach issues, constipation, or diarrhea. Beta blockers usually aren’t given to people with diabetes or asthma as they may make these conditions worse.
For some people, an abnormal heart rhythm changes how the blood flows through your system. For example with atrial fibrillation, blood may pool in a section of the heart. The sluggish flow may result in blood clots. If you are at risk for clots or a stroke, your doctor may prescribe an anticoagulant, which is a blood thinning medication. Warfarin (Coumadin) is one of the most common anticoagulants. Anticoagulants are not anti-arrhythmic medications. They do not change the heart rhythm. They are given because of the increased risk of clots with certain arrhythmias.
While warfarin is effective, you have to be careful when you take it because it reduces your body’s ability to stop bleeding. Alternatively, some doctors may prescribe aspirin, which has a blood thinning effect without the side effects of warfarin. However, there is controversy with respect to whether aspirin is an appropriate alternative to other anticoagulants such as warfarin.
Your heart is a very important organ, so medications that have an effect on the heart have to be monitored very closely. Work with your doctor to understand the medications that have been prescribed to you. Take them only as directed. Call your doctor right away if you notice anything abnormal or have serious symptoms. Because people with arrhythmias may be prescribed more than one medication, it’s important to know how these interact with each other. Make sure to follow up with your doctor on a regular basis and check before taking any other medications, supplements, or vitamins.