March 11, 2025
Arrhythmia is the HCMA topic for March

Some arrhythmias are harmless, while others are serious and need treatment. 

by Sabrina Cuddy

An 
arrhythmia is a problem with the rate or rhythm of your heartbeat. It means that your heart beats too quickly, too slowly, or with an irregular pattern. This can be scary, but many arrhythmias are harmless, and others are very treatable!


Some common arrhythmias in HCM are atrial flutter/fibrillation, ventricular tachycardia/fibrillation, left or right bundle branch block, PVC, PAC, and others. Some arrhythmias are harmless, while others are serious and need treatment. 


Your doctor may use tests such as EKG/ECG, Holter / Event Monitor, or an implantable loop recorder to diagnose an arrhythmia.


Which treatment your arrhythmia needs depends on where and what the problem is. Your cardiologist may send you to an electrophysiologist to help diagnose and treat arrhythmia.


Some arrhythmias can be controlled with medications, while others require ablation procedures. AFIB might be treated with cardioversion. Some arrhythmias require a pacemaker, and the most dangerous arrhythmias are best treated with an internal cardioverter-defibrillator (ICD).


Implantable devices used to treat arrhythmias


A transvenous ICD is a small battery-powered electronic device connected to the heart with wires called "leads." ICDs can shock your heart out of dangerous arrhythmias, especially ventricular tachycardia or fibrillation. Some ICDs can act as pacemakers and treat an arrhythmia before it becomes dangerous, thus avoiding a shock. 


A subcutaneous ICD (S-ICD) is a newer type of ICD implanted under the skin on the side of the chest below the armpit. It's designed to prevent sudden cardiac arrest by delivering a shock if it detects a dangerous arrhythmia. It can't act as a pacemaker. 


pacemaker prompts the heart to beat at a regular rate. You may need a pacemaker if you have bradycardia - a slow heart rate. You might need a pacemaker if you have a heart block - the ventricle's electrical signal is partly or totally blocked. A pacemaker can't shock you out of a dangerous rhythm.


Ablation for Arrhythmia 


When medications don't control arrhythmia, treatment with ablation is sometimes possible. This is particularly common for atrial fibrillation (AFIB). Two types of ablation are radio-frequency/cryoablation and pulmonary vein isolation


Sometimes, ablation can be done for other types of arrhythmias but may not be as effective as those for AFIB. If you have myectomy surgery and have AFIB, sometimes a procedure called MAZE is done during surgery to treat the arrhythmia.


HCMA Blog

April 30, 2025
Medical Management means using medicines and other non-invasive therapies to relieve symptoms. It's exciting that new treatments for HCM are being studied and that the FDA approved Camzyos in 2022! HCM can cause various symptoms depending on how stiff the heart is, how much scarring (fibrosis) there is, and whether there is obstruction. Some people have no noticeable symptoms. Common symptoms are chest pain/pressure, shortness of breath, lightheadedness, fatigue, palpitations, and brain fog. Syncope (fainting) is dramatic but not as common as the other symptoms. Medications are the first-line treatment for symptoms of HCM. If patients can't take one class of medication, they can try a medication from a different class. Here are some medications used to treat HCM and what they're for: Beta Blockers - make your heart beat slower and relax better. They allow the heart to fill more completely between beats. They can lower blood pressure and relieve symptoms. Calcium Channel Blockers - used to lower blood pressure and slow the heart rate. May reduce symptoms from obstruction in HCM. Myosin Inhibitors - cause the heart to beat with less force. They may reduce obstruction and septal thickness in some patients. Camzyos (mavacamten) is the first of this class of medication. For more information, click HERE . Antiarrhythmics - help to restore normal rhythm in the heart. Blood Thinners - anticoagulants and anti-platelets make it harder for blood to clot. They are prescribed to reduce the risk of stroke. This risk is higher in patients with afib, aflutter, and artificial heart valves. Diuretics , or "water pills," help the kidneys get rid of extra water and salt, reducing swelling in the body. Sodium Channel Blockers - may reduce gradient in obstructive HCM and can treat chest pain. Some also act as antiarrhythmics. Antibiotics - treat or prevent bacterial infections. In HCM, they may be given before dental work to prevent infective endocarditis. To learn more and see the side effects of these medications, click HERE .
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