Sometimes Medical Management Is Best

copy of istock 643764514 1 300x300 1 For some patients, Dr. Smith may feel it’s best to simply manage the arrhythmia, rather than performing more dramatic treatments such as cardiac ablation. This is known as medical management, and it usually involves placing the patient on a cardiovascular medications.

Here are the four basic categories he will prescribe.

  • Beta blockers— Beta blockers decrease the heart rate and cardiac output, which lowers blood pressure by blocking the effects of adrenalin.
  • Anti-arrhythmic medications— These drugs may be used to prevent arrhythmias from happening or to convert an abnormal rhythm back to a normal rhythm. They may also be used to treat symptomatic tachycardias and premature beats. These drugs either suppress the abnormal firing of pacemaker tissue or depress the transmission of impulses in tissues that either conduct too rapidly or participate in reentry. Dr. Smith can monitor the effectiveness of antiarrhythmic drug therapy through electrocardiographic monitoring, with a Holter monitor, or with electrophysiologic testing.
  • Calcium channel blockers— These drugs, also known as calcium antagonists, work by interrupting the movement of calcium into heart and blood vessel tissue.
  • Anticoagulants— These blood thinners work by making it harder for the blood to clot. They don’t dissolve existing blood clots. They prevent new clots from forming or existing clots from getting larger. The variation in rhythm with atrial fibrillation can allows clots to form, as the blood is stationary longer than it should be at times.

Side effects

The downside to medical management usually involves two areas: side effects and the necessity for the patient to be consistent with taking the drugs. Side effects are a part of any medication, but antiarrhythmic drugs can have particular side effects that can be a challenge. They include proarrhythmia, the more-frequent occurrence of preexisting arrhythmias or the appearance of new arrhythmias as bad or worse than those being treated.

As for the patient’s part in this, it’s necessary to take these drugs every day and usually indefinitely. That demands consistency on the part of the patient for the drugs to be effective.

If you suffer from arrhythmia, please call Birmingham’s heart rhythm expert, Dr. Smith, at (205) 510-5000 to schedule your appointment.

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I am thrilled to announce I will be moving to Grandview full-time to join Alabama Cardiovascular Group. Grandview and ACG are dedicated to providing the highest quality heart rhythm treatment being recognized and accredited by the Heart Rhythm Society as a leader of heart rhythm treatment in the Southeast. 

- Macy C. Smith, Jr., MD, FACC, FHRS


Grandview Medical Center
3680 Grandview Parkway,
Suite 200
Birmingham, AL 35243
(Building A)


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