What Are Arrhythmias?
Arrhythmias (also called disrhythmias) are abnormal heartbeats usually caused by an electrical "short circuit" in the heart. The heart normally beats in a consistent pattern, but an arrhythmia can cause it to beat too slowly, too quickly, or irregularly. This can cause the heart to pump inconsistently, which can lead to symptoms like fatigue, dizziness, and chest pain
What Causes Them?
Your heart has its own electrical system that sends electrical signals around the heart, telling it when to contract and pump blood around the body. The electrical signals start in a group of cells, called the sinus node, located in the right atrium. The sinus node is the heart’s pacemaker and makes sure the heart beats at a normal and consistent rate. The sinus node normally increases your heart rate in response to exercise, emotions, and hormones, and slows your heart rate during sleep.
Arrhythmias can either be temporary or permanent and they can be caused by several things — but they can also happen for no apparent reason. Arrhythmias can be congenital, meaning a person is born with the condition. Other causes of arrhythmias include chemical imbalances in the blood, infections or other diseases that cause irritation or inflammation of the heart, medications (prescription or over-the-counter), and injuries to the heart from chest trauma or heart surgery. Other factors like illegal drugs, alcohol, tobacco, caffeine, stress, and some herbal remedies can also cause arrhythmias.
Signs and Symptoms
Palpitations (a feeling of fluttering or pounding in the chest)
Shortness of breath
Arrhythmias can be consistent, or they can come and go at random. Sometimes arrhythmias can cause no symptoms at all — in these cases, the arrhythmia can only be discovered during a physical exam or a heart function test, like an electrocardiogram (ECG/EKG).
How Are Arrhythmias Treated?
Many types of prescription anti-arrhythmic medications are available to treat arrhythmia. A doctor will determine which is best by considering the type of arrhythmia, possible underlying medical causes, and any medications you are taking.
A pacemaker is a small, battery-operated device implanted into the body (near the collarbone) through a surgical procedure. Connected to the heart by a wire, pacemakers can help treat bradycardia
Like a pacemaker, a defibrillator can deliver electrical impulses to the heart. A small battery-operated implantable cardioverter defibrillator (ICD) can be implanted into the body (near the left collarbone) through a surgical procedure.
"Ablation" literally means removal or elimination. In the case of catheter ablation, a catheter (a long, thin tube) is guided through a vein in the arm or leg and inserted into the heart for the purpose of eliminating the heart muscle cells that are triggering the arrhythmia.
Surgery is usually the treatment recommended only if all other options have failed. In this case, a person is put under anesthesia, the chest is opened, and the heart is exposed. Then, the tissue causing the arrhythmia is removed
When to Call the Doctor
Although many arrhythmias are minor and don’t represent a significant threat to a person’s health, some can indicate a more serious health problem. If you've been having symptoms like those listed above, call your doctor.
Types of Arrhythmias :-
Atrial fibrillation :
Atrial fibrillation is the most common type of arrhythmia, affecting nearly two million Americans. In atrial fibrillation, the atria beat in a rapid, unorganized rhythm. The heart can beat out of control at a rate of 150 to 200 beats per minute—well above the normal heart rate range of 60 to 100 beats per minute. Atrial fibrillation isn’t life-threatening, but it can lead to other health problems, including chronic fatigue and congestive heart failure. Sometimes a clot forms from blood that pools in the left atrium due to the atrium’s inability to empty blood completely into the left ventricle. If this clot enters the bloodstream and travels to the brain, it can block an artery and cause a stroke. People with atrial fibrillation have an increased risk of stroke.
Atrial flutter :
Atrial flutter is a fast heartbeat that originates most commonly in the upper right atrium. The condition is the result of an abnormality with the heart’s electrical pumping system. During atrial flutter, electrical activity doesn’t start with the sinus node as it should, but rather begins in another large circuit. This causes the atria to beat very rapidly—at a regular rate of 150 to 300 beats per minute.
Supraventricular tachycardia :
Supraventricular tachycardia refers to a fast, abnormal heart rhythm that involves both the atria and ventricles of the heart. The electrical problem originates either in the atria or an area in the middle region of the heart.
Bradycardia is an abnormally slow heartbeat, usually less than the normal range of 60 to 100 beats per minute, resulting from an abnormality in the heart’s electrical pumping system.
Ventricular tachycardia :
Ventricular tachycardia is characterized by a fast, steady abnormal heart rhythm coming from one of the ventricles. It is more serious than supraventricular tachycardia and can be life-threatening.
Ventricular fibrillation :
Ventricular fibrillation is characterized by an irregular, fast heartbeat coming from one of the two ventricles. It is extremely serious. Because it prevents the heart from functioning and pumping adequately, it can lead to sudden death without emergency medical attention.
Heart block :
Heart block is a term for a group of abnormally slow heart rhythms caused by different degrees of blockage as the electrical signal travels from the atrium to the ventricle. In first-degree heart block, the signal takes a little longer that average, producing a slower than average heartbeat. In second-degree heart block, the signal travels even more slowly, resulting in an even slower beat while in a third-degree heart block, the signal does not reach the ventricle at all. While a first-degree heart block may not cause symptoms, a second-degree block may produce troubling symptoms, and a third-degree heart block can be life-threatening.
Diagnosing Arrhythmias :
Tests used to diagnose arrhythmias include :-
Electrocardiogram (ECG or EKG), either a standard ECG or a Holter monitor
Electrophysiology studies (EPS)
Treating Arrhythmias :-
Eliminating caffeine, alcohol or other substances believed to be causing the problem may relieve an arrhythmia. Stress-reduction measures such as meditation, stress-management classes, exercise programs or psychotherapy may also help.
There are various types of drugs that may be used to treat arrhythmias. The choice of medication will be based on the type of arrhythmia, other conditions that may be present and other medicines the patient may be taking.
In this procedure, an electrical shock is delivered to the heart through the chest to stop very fast arrhythmias such as atrial fibrillation, supraventricular tachycardia or atrial flutter. The patient is connected to an ECG monitor that is also connected to the defibrillator. The electrical shock is delivered at a precise point during the ECG cycle to convert the rhythm to a normal one.
This procedure is performed in an operating-room environment. A catheter is inserted into a vessel in the groin and guided to the region of the heart from which the arrhythmia originates. Then high-frequency radio waves are focused through the catheter, destroying the heart cells responsible for the arrhythmia.
A permanent pacemaker is a small device that is implanted under the skin, usually in the shoulder area just under the collarbone, and sends electrical signals to start or regulate a slow heartbeat. A permanent pacemaker may be used to help the heart beat normally if the sinus node is not functioning properly or if electrical pathways are blocked. Pacemakers are typically used for slow arrhythmias such as bradycardia or heart block.
Implantable cardioverter defibrillator
An implantable cardioverter defibrillator (ICD) is a small device, similar to a pacemaker, that is implanted under the skin, most often in the shoulder area just under the collarbone. An ICD senses the rate of the heartbeat. When the heart rate exceeds a rate programmed into the device, it delivers a small electrical shock to the heart to slow the heart rate. Many newer ICDs are combined with a pacemaker to deliver an electrical signal to regulate a heart rate that is too slow. ICDs are used for fast arrhythmias such as ventricular tachycardia or ventricular fibrillation.
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