Overview of Current Electrical Treatments for Arrhythmias

As indicated previously, electrical therapy is becoming increasingly important as a method for treating arrhythmias.

Some techniques that are being increasingly used include22:

1. Pacing - highly effective for controlling heart rate when there is AV block, and generally for control of atrial or ventricular rate where necessary.

2. DC conversion to sinus rhythm - this is highly effective with typical conversion rates of 89% for AF, 97% for AT, 67% for paroxysmal supraventricular tachycardia (PSVT), and 95% for VT and/or VF

3. Ablation therapy - used where the site of the genesis of arrhythmias is known and is ablated by techniques of guided cryoablation, or radiofrequency ablation using intracardiac catheters, and x-ray guidance. By such means, anatomic or functional re-entry circuits can be abolished. It can be effective in up to 97% of cases of supraventricular tachycardia, and in 88-99% in cases of aberrant AV pathways such as occur in Wolf-Parkinson-White syndrome. It can also be effective in VT, but it has varying effectiveness for AF.

4. Implantable cardioverter defibrillators (ICDs or implanted defibrillators) - of great importance in the electrical control of arrhythmias since they are capable of both detecting an arrhythmia, and delivering an electroshock to revert the arrhythmia. Implantable ICDs reduce mortality in cases where ventricular tachycardia and/or fibrillation occur, and appear increasingly useful in atrial fibrillation.

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