Cardiac arrhythmia

Cardiac arrhythmia

Cardiac arrhythmia is a disorder of the heart rate (pulse) or heart rhythm, such as heartbeats that are too fast (tachycardia), too slow (bradycardia), or with an irregular pattern. Now most cardiac arrhythmias can be cured. Early diagnosis and appropriate treatment are important. And if there is an underlying heart disease, minor surgeries can be performed. Pacemakers or defibrillators are also applied.

Cardiac arrhythmia
It is a disorder of the heart rate (pulse) or heart rhythm

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 it contracts (compresses) in an orderly manner.

The electrical impulse that signals the heart to contract begins in 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 finally 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 mobilized easily or 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, atrioventricular nodal reentry tachycardia (AVRNT).
  • Heart or atrioventricular block (multifocal atrial tachycardia).
  • Paroxysmal supraventricular tachycardia.
  • Sick sinus syndrome ventricular fibrillation, ventricular tachycardia: a heart rate that originates in the lower chambers (ventricles).
  • Wolff-Parkinson-White syndrome. The risk of suffering from 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.
  • Psychotropics

Sometimes antiarrhythmic medications, prescribed to treat one type of arrhythmia, can actually cause another type of arrhythmia.

Symptoms

An arrhythmia may be present all the time or it may 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 can be severe or even life-threatening. Common symptoms include:

  • Chest pain.
  • Fast or slow heartbeat (palpitations).
  • Dizziness, vertigo.
  • Difficulty breathing.
  • Intermittent heartbeats: changes in pulse pattern.

Signs and tests

The doctor will listen to the heart with a stethoscope and feel the pulse. Blood pressure may be low or normal. The following tests may be performed to identify arrhythmias:

  • Ambulatory cardiac monitoring with a Holter monitor (worn for 24 hours), an event monitor, or an implantable recorder (which can be worn for two weeks or longer).
  • Coronary angiography. ECG echocardiography.
  • Electrophysiological study (EEF). If an arrhythmia is detected, various tests can be performed to confirm or rule out possible causes. Electrophysiology testing 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 require urgent treatment to restore normal rhythm. This may include:

  • Electric shock therapy (defibrillation or cardioversion).
  • Implantation of a temporary pacemaker to interrupt the arrhythmia.
  • Medicines through a vein (intravenous), sometimes getting better treatment for your angina or heart failure will decrease your chance of having an arrhythmia.
  • Medicines may be used to prevent an arrhythmia from occurring again or to prevent your heart rate from becoming too fast or 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. Extirpate means destroy. An implantable cardioverter defibrillator is placed in people who are at high risk of 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 not pumping blood very well.

As soon as the arrhythmia starts, the ICD sends a shock to stop it or a burst of pacing. Pacemakers may be used for people who have 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 overall pumping capacity of the heart (ejection fraction).
  • Whether heart disease (coronary artery disease, heart failure, or valvular heart disease) occurs and how well it can be treated.

Some types of arrhythmias can be fatal if not treated quickly and properly. With bradycardias that are treated with a permanent pacemaker, there is generally a good prognosis.

Complications

  • Heart attack.
  • Heart failure.
  • Sudden death.
  • Situations that require medical assistance.

Consult 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 developing an arrhythmia. These measures cover:

  • Eat a well-balanced, low-fat diet.
  • Do physical exercise regularly.
  • No Smoking.

 

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