An arrhythmia is when your heart is not beating at a regular rhythm. Your heart may beat too fast (tachycardia), too slowly (bradycardia), or irregularly (such as your heart skipping a beat).
A heart attack, smoking, and congenital heart problems are all factors that might disrupt your heart’s rhythm. Arrhythmias can be life-threatening or harmless, which is why you should seek medical attention if you notice something strange about your heartbeat. Medicines, implanted devices, or surgery may be used to restore a normal cardiac rhythm.
What are the symptoms of arrhythmias?
Arrhythmia may cause no symptoms, but if you do experience symptoms, they could include:
- Dizziness or fainting
- Chest pain
- Shortness of breath
- Weakness or fatigue
What are the types of arrhythmias?
Heart arrhythmias are divided into different categories based on the rate at which the heart beats:
Tachycardia: a rapid heartbeat with a resting heart rate greater than 100 beats per minute.
The following are examples of tachycardia:
- Atrial fibrillation; is a condition in which the heart beats irregularly due to chaotic heart signals. Although the disease may be transient, some episodes may not go away unless treated.
- Atrial flutter is a condition similar to atrial fibrillation, but the heartbeats are more structured. It occurs more frequently in people with heart problems and during the first week following heart surgery. This condition may progress to atrial fibrillation and is also associated with strokes.
- Supraventricular tachycardia refers to arrhythmias that begin above the lower heart chambers (ventricles). It is characterized by short bursts of hammering heartbeats starting and ending suddenly.
- Ventricular fibrillation is a condition in which rapid, chaotic electrical signals force the lower heart chambers to quiver instead of connecting in a coordinated fashion that pumps blood to the rest of the body.
- Ventricular tachycardia is a condition in which rapid, regular heart rate is caused by faulty electrical signals in the lower heart chambers. The ventricles are unable to fill correctly due to the fast heart rate. As a result, the heart fails to pump blood throughout the body.
Bradycardia: a slow heartbeat with a resting heart rate of less than 60 beats per minute.
The following are examples of bradycardia:
Sick sinus dysfunction is a condition in which the heart rate may oscillate between too slow and too fast. Scarring near the sinus node (which controls the heart’s rate) can produce sick sinus syndrome by delaying, interrupting, or stopping impulse travel.
Heart block is a condition in which the signals that trigger heartbeats slow down
Premature heartbeats: extra beats that occur once at a time and sometimes alternate with the normal heartbeat. The extra heartbeats could originate in the top (premature atrial contractions) or bottom (premature ventricular contractions) heart chambers.
If you have a premature heartbeat, it may feel like your heart skipped a beat. These extra beats are usually harmless, but can cause a longer-lasting arrhythmia for people with cardiac problems. In some cases, premature heartbeats that occur regularly and linger for several years can result in a weak heart. Stress or strenuous exercise can trigger premature heartbeats.
How are arrhythmias diagnosed?
During your consultation, the cardiologist will review your medical history and perform a physical examination. They may perform tests to confirm an irregular heartbeat and to determine the cause of arrhythmias, including:
- Electrocardiogram (ECG or EKG): This test involves attaching small electrode patches to your chest, arms, and legs to detect the electrical activity of your heart.
- Holter monitor: This test includes using a portable device that you can wear for a day or longer to record the activity of your heart while you go about your daily activities.
- Echocardiogram: In this test, sound waves are used to produce images of the heart’s size, structure, and motion and examine your heart muscles and valves.
- Stress test: This test is performed to determine how much stress your heart can withstand before developing a rhythm problem or failing to receive enough blood. The activity of your heart is monitored while you ride a stationary bicycle or walk on a treadmill.
- Tilted table test: Our doctor may recommend this test if you’ve had fainting spells. As you lie flat on a table, your heart rate and blood pressure are monitored to examine whether your fainting spells are caused by your electrical, neurological, or vascular systems.
- Electrophysiological testing and mapping: The doctor inserts thin, flexible tubes (catheters) tipped with electrodes through the blood vessels to different regions within the heart in this test. The electrodes can map the propagation of electrical impulses across the heart once they are in place.
- Heart catheterization: During this procedure, the physician implants a catheter (a long, thin tube) into a blood vessel in your arm or leg. They will use a sophisticated X-ray machine to direct it to your heart. Then, using the catheter, they’ll inject dye to aid in creating X-ray videos of your heart valves, coronary arteries, and chambers.
How are arrhythmias treated?
Some heart arrhythmias do not require treatment and can be monitored with regular checkups. Treatment for arrhythmia is usually only needed if the irregular heartbeat is causing substantial symptoms or putting you at risk for other heart problems. The type of arrhythmia you have will determine your treatment options.
Your doctor may recommend one or more of these treatment options:
Medical treatment. Your doctor may prescribe medications such as adenosine, beta-blockers, calcium channel blockers, and digoxin.
- Vagal maneuvers: Our doctor may recommend this therapy if you have a very rapid heartbeat owing to supraventricular tachycardia. Vagal movements cause your heart rate to slow by affecting the neurological system that governs your heartbeat (vagus nerves).
- Cardioversion: If you have a specific type of arrhythmia, such as atrial fibrillation, our doctor may suggest this therapy. A shock is delivered to your heart using paddles or patches on your chest during the cardioversion operation. The current alters your heart’s electrical impulses and can help you restore your its normal rhythm.
The following are some of the procedures used to treat cardiac arrhythmias:
- Catheter ablation: The doctor inserts one or more catheters into the blood arteries to the heart during this surgery. Electrodes at the catheter tips produce microscopic scars in your heart with heat or cold energy to block aberrant electrical signals and restore a normal heartbeat.
- Pacemaker: A pacemaker is a tiny implanted device often placed at the collarbone. One or more electrode-tipped cables extend from the pacemaker to the inner heart through the blood arteries. This device regulates your heart rate by sending electrical impulses to your heart muscle.
- Implantable cardioverter-defibrillator (ICD): An ICD is a battery-powered device inserted under the skin around the collarbone. The ICD sends one or more electrode-tipped wires through veins to the heart. Your cardiac rhythm is regularly monitored by the ICD. If the ICD identifies an aberrant heart rhythm, it provides low- or high-energy shocks to the heart to bring it back to normal.
- Maze procedure: A surgeon creates a pattern (maze) of scar tissue by making a series of incisions in the heart tissue in the upper half of your heart in this procedure. Scar tissue doesn’t conduct electricity; therefore, it gets in the way of stray electrical impulses that produce arrhythmia.
- Coronary bypass surgery: This procedure involves bypassing the coronary arteries to improve blood flow to the heart. The doctor may recommend this surgery if you have severe coronary artery disease and cardiac arrhythmia.
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