What is Arrhythmia?

Any irregularity in the heart rhythm; be it too fast, too slow or just unstable: all fall under Arrhythmia. Arrhythmia is one of the most common types of heart diseases. In fact, most of the people have experienced Heart Arrhythmia at some point of their lives. Heart Arrhythmia occurs when the heart’s normal electrical system is disrupted.

Cardiac Arrhythmia ranges vary widely in severity. Some of the Arrhythmia attacks are so mild that they don’t even have any consequences while some of them can be life-threatening.

Types of Arrhythmia

Arrhythmia or irregular heartbeat is often a symptom than a cause. Therefore, to start the treatment, the doctor must be sure what type of Arrhythmia the patient suffering is from:

Premature Heartbeats: In ‘Extra Beats Symptom’, the heart produces extra beats  in the atria of the heart. This condition is called Premature Atrial Complexes (PACs). If the extra beats arise to the ventricles of the heart, the condition is called premature ventricular complexes (PVCs). Both PACs and PVCs are generally inconsequential.

Bradycardia: When the heart rate is significantly slower than normal (fewer than 60 beats a minute), the condition is called Bradycardia. Bradycardia itself is not a problem unless it is not inviting other complications. Many people, especially the athletes often live normal lives with 40-50 beats heart rate.

  • Sinus bradycardia: This type of Bradycardia is caused by the sinus node. For most of the Sinus bradycardias, the treatment is implantation of a pacemaker.
  • Heart block: In more serious cases, the sinus nodes before reaching the ventricles generate electrical impulses. There, Cardiac Arrhythmia is a clear symptom of heart blockage. Right bundle branch block and Left bundle branch block are 2 common associated complications of heart blockage.

Tachycardia: When the heart rate is too high than the normal range (more than 100 beats a minute), it is called Tachycardia. There are 2 types of Cardiac Tachycardia:

  • Supraventricular tachycardia (SVT): This is a condition where the fast heartbeat either involves the atria or arises in the atria. The three most common Supraventricular Tachycardias are Atrial Flutter, atrial fibrillation and Wolff-Parkinson-White syndrome.
  • Ventricular fibrillation (VF) and Ventricular tachycardia (VT): These 2 types of Tachycardia are most life-threatening Arrhythmias and they are responsible for cardiac arrest in most of the cases. Patients, detected with severe Arrhythmia are treated with an implantable defibrillator to prevent sudden cardiac arrest.

Arrhythmia Symptoms

In a significant number of cases; due to the asymptomatic nature of this abnormality, the patients do not even know that they are suffering from Heart Arrhythmia till the doctor confirms. Surprisingly, the severity of symptoms is always not directly proportional to the seriousness of the health condition.

Though Arrhythmias can be of different types and reasons, here are few most common palpable symptoms:

  • Dizziness
  • Cardiac arrest
  • Skipping Heartbeats
  • Sweating (Bradycardia)
  • Palpitations
  • Shortness of breath
  • Fainting (Syncope) (Atrial fibrillation)
  • Chest pain
  • Confusion (Bradycardia)
  • Trouble in concentrating (Bradycardia)
  • Angina (chest pain) (Atrial fibrillation)

Treatments for Arrhythmia

Treatment for arrhythmia is generally not required till it aggravates into more serious complications.

The doctor first checks for any underlying cause of atrial flutter and Cardiac Arrhythmia. If any crucial underlying cause is found, that needs to be treated first. If no such condition is diagnosed, implanting a pacemaker is advisable.

The other treatments of Arrhythmia include:

  • Vagal Maneuvers: Stimulation of the vagus nerve in ways like holding breathe and bearing down, immersing the face in ice-cold water etc.
  • Cardioversion: Medication or electric shock is given to bring the heart rhythm back to normal
  • Maze procedure: Artificial formation of blocks in the heart by surgical incisions for helping the heart to beat more efficiently
  • ICD (Implantable Cardioverter-Defibrillator): Cardioverter-defibrillator is implanted near the left collarbone. This device detects the abnormality in the heart rhythm and stimulates the natural pumping of the heart.
  • Cardiac Ablation: In this therapy, catheters are sent to the inner heart through blood vessels. This minimally invasive Ablation procedure destroys abnormal tissues responsible for Arrhythmia.
  • Coronary Bypass Surgery: A healthy blood vessel from other parts of the body is transplanted in the coronary artery to bypass the original blocked and narrowed cardiac artery.
  • Ventricular Aneurysm Surgery: If Cardiac Arrhythmia is caused by bulging in the blood vessels, the aneurysm or bulging is surgically removed in this procedure.
  • Medications: Though medications don’t help in curing Arrhythmia directly, multiple medications can help in suppressing the symptoms.

Diagnosis of arrhythmia

The diagnosis of Arrhythmia often includes multiple rounds which include an interview with the patient, medical history checking, family history checking and multiple pathological tests. The clinical tests include:

  • EKG (electrocardiogram)
  • Holtermonitor
  • Electrophysiologic testing
  • Blood and urine tests
  • Chest X-ray
  • Heart catheterization
  • Echocardiogram
  • Tilt-table test

Risk factors for arrhythmia

Multiple risk factors influence and aggravate the condition of Arrhythmia. Few of the most significant risk factors are:

  • Age
  • Heart problem
  • Illegal drugs
  • Gene defect
  • Obstructive sleep apnea
  • Hypertension
  • Obesity
  • Hyperthyroidism and Hypothyroidism
  • Diabetes
  • Electrolyte imbalances
  • Too much intake of caffeine
  • Heavy alcohol consumption
Content Reviewed By: Dr Simmi Manocha