The cardiac arrhythmia is a disorder of the heart rate (pulse) or heart rhythm, such as beating too fast (tachycardia), too slow (bradycardia) or an irregular pattern. Most cardiac arrhythmias can now be cured. Early diagnosis and proper treatment are important. And if there is a basic heart disease you can do minor surgeries. Pacemakers or defibrillators are also applied.
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Summary
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- 1 Causes, incidence and risk factors
- 2 Symptoms
- 3 Signs and tests
- 4 Treatment
- 5 Expectations
- 6 Complications
- 7 Prevention
- 8 Alternative Names
- 9 Sources
Causes, incidence and risk factors
Normally your heart is able to pump blood to the body without working harder than necessary. To help this happen, your heart has an electrical system that ensures that it contracts (compresses) in an orderly fashion.
The electrical impulse that signals the heart to contract begins at the sinoatrial node (also called the sinus node or SA node), which is the body’s natural pacemaker.
The signal leaves the sinoatrial node and travels through the two upper chambers (atria). The signal then passes through another node (the atrioventricular node) and eventually travels through the lower chambers (ventricles).
Different nervous messages signal the heart to beat slower or faster.
Arrhythmias are caused by problems with the heart’s electrical conduction system. Other areas of the electrical system can also send signals. Other times, electrical signals cannot be easily mobilized or not mobilized at all. When an arrhythmia occurs, your heartbeat may be:
- Too slow (bradycardia).
- Too fast (tachycardia).
Problems can occur anywhere along the conduction system, causing various arrhythmias. Examples can be:
- Atrial fibrillation or flutter tachycardia due to reentry into the atrioventricular node (AVRNT).
- Heart or atrioventricular block (multifocal atrial tachycardia).
- Paroxysmal supraventricular tachycardia.
- Sick sinus syndrome ventricular fibrillation, ventricular tachycardia – a heart rate that originates from the lower chambers (ventricles).
- Wolff-Parkinson-White syndrome. The risk of tachycardia or bradycardia varies greatly, depending on:
- Imbalances in blood chemistry, such as abnormal potassium levels.
- Cardiomyopathy, change or weakening of the myocardium.
- Heart failure.
- Overactive thyroid gland previous heart attack.
Arrhythmias can also be caused by some substances or drugs, such as:
- Caffeine .
- Cocaine .
- Beta blockers.
- Psychotropic
Sometimes antiarrhythmic medications, prescribed to treat one type of arrhythmia, can actually cause another type of arrhythmia.
Symptoms
An arrhythmia can be present all the time or it can be intermittent. You may or may not feel symptoms when the arrhythmia is present, or you may only notice them when you are more active.
Symptoms can be very mild when they occur, or they can be severe or even life-threatening. Common symptoms include:
- Chest pain
- Fast or slow heartbeat (palpitations).
- Dizziness, vertigo.
- Difficulty breathing.
- Intermittent beats: changes in pulse pattern.
- Sweating
Signs and tests
The doctor will listen to the heart with a stethoscope and feel the pulse. Blood pressure can be low or normal. The following tests may be done to identify arrhythmias:
- Outpatient cardiac monitoring with Holter monitoring (used for 24 hours), an event monitor, or an implantable recorder (which can be worn for two weeks or more).
- Coronary angiography. ECG echocardiography.
- Electrophysiological study (EEF). If an arrhythmia is detected, various tests can be performed to confirm or rule out possible causes. An electrophysiological study can be done to find the arrhythmia and determine the best treatment, especially if you are considering a pacemaker or catheter ablation procedure.
Treatment
When an arrhythmia is serious, you may need urgent treatment to restore your normal rhythm. This may include:
- Electric shock therapy (defibrillation or cardioversion).
- Implantation of a temporary pacemaker to interrupt the arrhythmia.
- Medications through a vein (intravenous), sometimes getting a better treatment for your angina or heart failure will decrease the chance of having an arrhythmia.
- Medications can be used to prevent an arrhythmia from recurring or to prevent your heart rate from becoming too fast or too slow.
These are called antiarrhythmic drugs. Some of these medications may have side effects. Not all arrhythmias respond well to medications.
Cardiac ablation is a procedure to destroy areas in the heart that may be causing heart rhythm problems. To extirpate means to destroy. An implantable cardioverter-defibrillator is placed in people who are at high risk for sudden cardiac death.
You may need a defibrillator if you have had life-threatening attacks of ventricular tachycardia (VT) or ventricular fibrillation (VF), or if your heart is weakened, too large, and does not pump blood very well.
As soon as the arrhythmia begins, the ICD sends a shock to stop it or a burst of cardiac pacing. Pacemakers can be used for people with heart problems that cause their heart to beat too slowly (bradycardia). Some pacemakers can be used to stop a heart rate that is too fast (tachycardia) or irregular.
Expectations
The result depends on several factors:
- The type of arrhythmia: whether it is supraventricular tachycardia or a more dangerous arrhythmia such as ventricular tachycardia or ventricular fibrillation.
- The general pumping capacity of the heart (ejection fraction).
- Whether heart disease (coronary artery disease, heart failure, or heart valve disease) is present and how well it can be treated.
Some types of arrhythmias can be fatal if not treated quickly and appropriately. With bradycardias that are treated with a permanent pacemaker, there is generally a good prognosis.
Complications
- Heart attack.
- Heart failure.
- Sudden death.
- Situations requiring medical assistance.
Check with your doctor if:
- Develop any of the symptoms of a possible arrhythmia.
- You have been diagnosed with an arrhythmia and your symptoms get worse or do not improve with treatment.
Prevention
Taking steps to prevent coronary artery disease can decrease the chance of an arrhythmia. These measures cover:
- Eat a well-balanced, low-fat diet.
- Get regular physical exercise.
- No Smoking.
Alternative names
- Abnormal heart rhythms
- Bradycardia; tachycardia
