A comprehensive history of arrhythmia treatment

At what point did surgical options become available for arrhythmia? How successful were these procedures?

The first surgical option for arrhythmia was implantation of a pacemaker. It has been highly successful for people whose  arrhythmia is due to the heart going too slowly.

Some cardiogists believe that pacemakers are underused because many people have a heart that is going slower than would be most efficient.

They are often held back by vague symptoms including fatigued or not sleeping well because the heart slows down too much which then causes the brain to speed up. This tells the heart by producing adrenaline, which in turn wakes the rest of the brain. As a result, people have disturbed sleep, similar to sleep aponea.

This then causes people to complain about feeling tired during the day and faint if they stand up suddenly.

Pacemakers have a success rate of almost 100%.  Unfortunately, they are not ofen recognised England, except for in more extreme cases.

Another surgical treatment, which was common in the 1980s and 1990s for dangerous arrhythmias was cutting out part of the heart that was creating problems.

It was possible during open heart surgery to map out in the heart where the electrical problem was occuring and cut that piece of heart out. In general, it was not hugely successful, however in some cases it was very successful. However, in modern society, cardiologists try to avoid this type of treatment.

Additionally, another treatment type used was ablation treatment. This is where a catheter is inserted into the heart through the blood vessels. It is a minimally invasive operation and an effective way to treat more complex arrhythmias.

Initially, cardiologists used ablation as treatment for wolf parknison white syndrome, as well as for other attacks of very rapid heart beats, where there was an extra connection in the heart that should not have been there and was previously operated on through open heart surgery.

Doctors discovered they could knock out these pathways with a wire going up into the heart. During this procedure there was a bang which destroyed the tissue that was causing the problem.

The procedure changed a little in 1990 and doctors began to use a gentle heating effect on the wire. They also found that they could use another, cold cathether and cooled it down to -30 degrees, effectively causing frostbite to kill off the tissue.

Cast ablation began with treating rapid, dangerous arrhythmia to treating what is now known as supraventricular tachycardia (SVT) episodes of rapid palpitations in young people, typically. It is now being applied to atrial fibrillation, the most common arrhythmia, particularly in young people. The long term success rate is roughly between 50% and 75%.

In some cases, such as with chronic atrial fibrillation, the long term success rate is not very high. There are some better treatment approaches to take, such as a pacemaker.

Surgery should not be the first line of treatment, except for with issues such as supraventricular tachycardia (SVT) or atrial fibrillation that is coming on as attacks in people whose hearts are otherwise structurally normal.