One has but to refer to the enumerated causes of irregular heart
action to determine the treatment. In that caused by extrasystole,
the treatment has just been suggested. In irregular heart caused by
serious cardiac or other lesions the treatment has already been
described, or is that of the disease that has a badly acting heart
as a complication. If the irregularity is caused by toxins, the
treatment is to stop the ingestion of the toxin and to promote the
elimination of what is already in the system; how much of the
irregularity was due to the toxin and how much is inherent
disturbance in the heart can then be determined. If the cause of a
toxemia developed in the system, perhaps most frequently from
intestinal putrefaction, increased elimination and a regulation of
the diet will cure the condition.
The valvular lesions most apt to cause irregular action of the heart
are mitral insufficiency or mitral stenosis. The lesion which is
most apt to cause auricular fibrillation and more or less
permanently irregular heart is perhaps mitral stenosis. Another
frequent cause of more or less permanent irregularity is the
excessive use of alcohol.
While an irregular pulse and an irregular heart are always of more
or less serious import, still, as the extrasystoles of the auricle
are better understood and more frequently recognized, and the habits
and life of the patients (most frequently men) are regulated and
revised, frequently a pulse and heart which would be rejected by any
medical examiner for an insurance company becomes, in a few weeks or
a few months, a perfectly acting heart, and remains so sometimes for
years. It also is not quite determinaible whether a heart that is so
misbehaving has a recurrence of such misbehavior more readily than a
heart which has never been so affected. However this may be, the
cause having been determined or presumed by the physician, it should
be so impressed on the patient that he does not again repeat the
insult to his heart.