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Arrythmias
Description
Arrhythmia is a disturbance in impulse formation or conduction. Impulses are generated from the heart’s pacemaker (sinus node) situated in the upper part of the heart. An abnormality in the impulse formation or conduction will disturb the heartbeat. The heart may beat very fast (tachycardia), very slow (bradycardia), very early (premature contraction), or irregularly (fibrillation). There are many types of arrhythmias, mentioned below:
- Atrial fibrillation: Irregular and rapid contractions of atria (chamber of heart) resulting from the bombardment of impulses.
- Atrial flutter: Regular and rapid contractions of atria similar to atrial fibrillation.
- Supraventricular tachycardia: Regular and rapid contractions originating above the ventricles.
- Ventricular fibrillation: Irregular, rapid, and fluttering contractions of the ventricles resulting in inability to pump blood.
- Long QT syndrome: Delayed contraction and relaxation of the ventricles.
Causes
Any of the following causes may result in an irregular heartbeat:
- Congenital heart disease
- Imbalance of electrolytes such as sodium or potassium in the blood
- Injury after a heart attack
- Changes in the muscles of the heart
- Heart disease or coronary artery disease.
- stress, smoking, etc.
Risk factors
There are several risk factors, including:
- Heart diseases like Coronary artery disease, heart attack, heart failure, and cardiomyopathy
- Age increases the risk of developing arrhythmias
- Pre-existing conditions like diabetes, hypertension, and sleep apnea
- Drug abuse
- Obesity
- Thyroid problems.
Symptoms
-
Usually, arrhythmia is a silent disease, but the sign and symptoms may be noticeable in some patients. Including:
- Skipped heartbeat
- Pounding heart
- Breathing difficulties
- Fainting
- Dizziness (lightheadedness)
- Blurred vision
- Sweating
- Chest pain.
Diagnosis
Diagnosis includes history taking, physical examination and the following tests:
- ECG, or electrocardiogram may be used to check the electrical activity of your heart.
- Holter monitor, which measures electrical activity over a period of 1 or 2 days.
- Stress test, which measures the stress your heart can tolerate during some form of exercise.
- Event monitor, a device which records the activity of your heart for a few minutes on pushing a button.
- Other tests such as echocardiograms, cardiac catheterization, electrophysiology study, and head-up tilt table test may also be used.
Management
Following medicines may be advised by the doctor for the treatment of arrhythmias:
- Adenosine
- Atropine
- Calcium channel blockers
- Beta blockers
- Sodium channel blockers
- Digoxin
- Potassium channel blockers
- Non-pharmacological management:
- Implanting devices: Artificial pacemakers and cardioverter-defibrillator can be implanted for treating arrhythmias.
- Cardioversion: Electric shocks to heart; to restore normal rhythm.
- Vagal maneuvers: Special exercise to control the heart rhythm.
- Ablation therapy: Use of catheters in blood vessels to block the pathway or site causing arrhythmia.
When to consult a doctor?
- A doctor should be consulted if the prescribed treatment is no longer effective.
- If you experience a sudden shortness of breath, lightheadedness, chest pain, or an irregular heartbeat, you should go to a hospital immediately.
