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An arrhythmia is a heartbeat that is irregular. It indicates that your heart is not beating normally.
Your heart may feel like it missed a beat, added a beat, or is "fluttering." It may feel as if it is beating too quickly (tachycardia) or too slowly (bradycardia) (called bradycardia). You might not notice anything at all.
Arrhythmias can be life-threatening or innocuous. If you notice anything unusual about your heartbeat, seek medical attention immediately so that doctors can determine what is causing it and what you should do about it.
WHAT ARE THE TYPES OF ARRYTHMIAS?
Arrhythmias are classified based on where they occur. They are referred to be ventricular if they begin in the ventricles, or bottom chambers of your heart. They are referred to as supraventricular when they begin in the atria, or upper chambers.
Doctors also classify them according on how they affect your resting heart rate. Bradycardia is defined as a heart rate of less than 60 beats per minute. Tachycardia is defined as a heart rate of more than 100 beats per minute.
Supraventricular arrhythmias include the following:
- Premature atrial contractions: These are the first extra beats. They are normally harmless and do not require treatment.
- AFib (atrial fibrillation): Your heart's upper chambers contract in an odd way. Your heart may beat up to 400 times each minute.
- Atrial flutter: This is typically more organized and consistent than atrial fibrillation. It occurs more frequently in persons with cardiac problems and in the first week following heart surgery. It frequently progresses to atrial fibrillation.
- PSVT (paroxysmal supraventricular tachycardia): This is a fast heart rate with a steady beat. It starts and ends abruptly.
- Accessory pathway tachycardias: An additional channel between your heart's upper and lower chambers can create a fast heart rate. Consider it an additional road on your trip home in addition to your usual path. When this occurs in your heart, it can result in a rapid rhythm.
- AV nodal reentrant tachycardia (AVNRT): This is caused by an extra pathway through your heart known as the AV node. It can result in palpitations, fainting, or cardiac failure.
Ventricular arrhythmias include the following:
- PVCs (premature ventricular contractions): These are the most prevalent types of arrhythmias. They are the "skipped heartbeats" that many of us experience from time to time.
- V-tach (ventricular tachycardia): This is a fast cardiac rhythm that begins in the bottom chambers of your heart. Your heart cannot fill with enough blood because it is beating too quickly. This is a dangerous arrhythmia, particularly in those with cardiac problems, and it may be associated with other symptoms.
- V-fib (ventricular fibrillation): This occurs when the lower chambers of your heart quiver and are unable to contract or pump blood to the rest of your body. It is a medical emergency that must be handled as soon as possible with CPR and defibrillation.
- Long QT syndrome: Lower chambers of your heart take far too long to contract and release. This can lead to serious rhythm difficulties and even death.
Another type of arrhythmia is bradyarrhythmia, which is characterized by a slow rhythm caused by disease in your heart's electrical system or by medicine. It may cause you to faint out or make you feel as if you will. Bradyarrhythmias are classified as follows:
- Sinus node dysfunction: This is due to an issue with your heart's sinus node, which serves as its natural pacemaker.
- Heart block: The electrical impulse is delayed or blocked as it passes from your heart's sinus node to its lower chambers.
WHAT ARE THE SYMPTOMS OF ARRYTHMIA?
An arrhythmia might be silent, which means you are unaware of any symptoms. During a physical checkup, your doctor may notice an irregular heartbeat.
If you have symptoms, they could be as follows:
- Heart palpitations (a feeling of skipped heartbeats, fluttering, or "flip-flops")
- A pounding in your chest
- Feeling dizzy or lightheaded
- Fainting
- Breathing difficulty
- Pain or tightness in the chest
- Weakness or exhaustion (feeling very tired)
- Anxiety
- blurry vision
- Sweating
WHAT ARE THE CAUSES OF ARRYTHMIA?
Even if your heart is healthy, you could develop an arrhythmia. It could also happen as a result of:
- Heart disease
- Incorrect electrolyte balance (such as sodium or potassium) in your blood
- Heart damage or alterations, such as decreased blood flow or stiff heart tissue
- The recovery period following cardiac surgery
- Fever or infection
- Certain drugs
- Problems with your heart's electrical signals
- Emotional intensity, stress, or surprise
- Things in your daily life, such as alcohol, tobacco, coffee, or exercise
WHAT ARE THE RISK FACTORS FOR ARRYTHMIA?
The following factors may increase your chances of developing an arrhythmia:
- Age: As you become older, your odds improve.
- Genes: If a close family has experienced an arrhythmia, your chances are increased. Some types of cardiac disease can also be passed on through families.
- Lifestyle: Tobacco, alcohol, and recreational substances can all increase your risk.
- Medical problems: Heart rhythm abnormalities can be caused by a variety of illnesses, including high blood pressure, diabetes, low blood sugar, obesity, sleep apnea, and autoimmune disorders.
- Environment: Air pollution, for example, can increase the likelihood of an arrhythmia.
WHAT ARE THE COMPLICATIONS OF ARRYTHMIA?
An irregular cardiac beat, if left untreated, can lead to serious complications such as:
- Dementia and Alzheimer's disease: These cognitive impairments may occur as a result of your brain not receiving enough blood over time.
- Heart failure: Following repeated arrhythmias, your heart may not pump as well as it should.
- Stroke: Blood that persists in your atria has the potential to clot. A stroke can occur if a clot goes to your brain.
- Cardiac arrest: Your heart could stop if you have V-fib.
HOW IS ARRYTHMIA DIAGNOSED?
Doctors utilize tests such as: to identify an arrhythmia or determine its cause.
- EKG: The electrical activity of your heart is recorded by an electrocardiogram. For the short, painless test, you wear small electrode patches on your chest, arms, and legs at your doctor's office.
- Holter monitor: This is a portable EKG (also known as a "ambulatory electrocardiogram" or ECG) the size of a postcard or digital camera that you will use for 1 to 2 days, or up to 2 weeks. The test detects the passage of electrical signals or waves via your heart. These messages instruct your heart to contract (squeeze) and pump blood. Electrodes will be taped to your skin. It's painless, though the tape used to secure the electrodes to the chest can cause slight skin irritation in some people. While wearing the electrodes, you can do anything except shower or bathe. You'll return to your doctor after the test period is over. They will download the data.
- Event monitor: If your symptoms do not occur frequently, your doctor may recommend that you wear one of these for about a month. When you press a button, your heart's electrical activity is recorded and stored for a few minutes. When you see symptoms, try to acquire a reading. The results will be interpreted by your doctor.
- Implantable loop recorder: This is implanted beneath your skin by your doctor and continuously records the electrical activity of your heart. It has the ability to send data to your doctor's office.
- Cardiac catheterization: A catheter, which is a long, thin tube, will be inserted into a blood vessel in your arm or leg by your doctor. They'll use a sophisticated X-ray machine to direct it to your heart. The dye will then be injected through the catheter to aid in the creation of X-ray videos of your heart valves, coronary arteries, and chambers.
- Electrophysiology study: This test monitors the electrical activities and pathways of your heart. It can assist in determining what is causing your cardiac rhythm problems and determining the best treatment for you. Your doctor will safely induce your unique heart rhythm during the test. Then they may offer you drugs to discover which one works best for you or to determine what treatment or device you require to treat it.
- Stress test: There are various types of stress testing. The idea is to see how much stress your heart can withstand before experiencing a rhythm problem or not receiving enough blood. The most popular type of stress test is walking on a treadmill or pedaling a stationary bike while your heart rate and blood pressure are monitored. Technicians gradually increase the intensity of your workout.
- Echocardiogram: Ultrasound is used in this test to examine your heart muscle and valves.
- Head-up tilt table test: This test is used by doctors to determine what is causing fainting spells. It calculates the difference in heart rate and blood pressure between standing and lying down. This test will be administered in a laboratory. You'll lie on a stretcher at various positions while an EKG is performed and doctors monitor your blood pressure and oxygen level. This determines whether your passing out symptoms are caused by your electrical system, neurological system, or vascular system.
WHAT ARE THE TREATMENTS FOR ARRYTHMIA?
The type of arrhythmia you have will determine your treatment. One or more of these may be recommended by your doctor.
Medications
Among the medications used to treat irregular heartbeats are:
- Adenosine (Adenocard)
- Atropine (Atropen)
- Beta-blockers
- Calcium channel blockers
- Dioxin (Digitek, Digox, Lanoxin)
- Potassium channel blockers
- Sodium channel blockers
Vagal maneuvers
These approaches relax your body by altering your vagus nerve, which regulates your heart rate. Your doctor may advise you to:
- Gag or cough
- Hold your breath and press on (Valsalva maneuver)
- Lay down
- Cover your face with a cold, wet towel.
Electrical cardioversion
If medications fail to correct an irregular cardiac rhythm (such as atrial fibrillation), you may require cardioversion. Doctors sedate you and then deliver an electrical shock to your chest wall to reset your heart's usual beat.
Pacemaker
To maintain a stable heart rate, this gadget transmits mild electrical impulses to your heart muscle. It consists of a pulse generator that houses the battery and a small computer, as well as wires that transfer impulses to the heart muscle.
Implantable cardioverter defibrillator (ICD)
ICDs are mostly used by doctors to treat ventricular tachycardia and ventricular fibrillation, two potentially fatal heart rhythms.
Your cardiac rhythm is regularly monitored by the ICD. When it identifies a very fast, irregular rhythm, it sends an electric shock to the heart muscle to force it to beat normally again. The ICD is made up of two parts: leads and a pulse generator. The wires and sensors in the leads monitor the heart rhythm and give energy for pacing or defibrillation. The generator houses the batteries as well as a small computer. The battery stores energy until it is needed. The computer uses the data from the leads to assess how fast the heart is pounding.
Your doctor configures the ICD to do one or more of the following functions:
- Anti-tachycardia pacing (ATP): A sequence of tiny electrical shocks delivered to the heart muscle restores normal pace and rhythm.
- Cardioversion: To reestablish regular rhythm, you may receive a low-energy shock at the same time your heart beats.
- Defibrillation: When your heartbeat becomes dangerously fast or irregular, it receives a higher-energy shock to reestablish a regular rhythm.
- Anti-bradycardia pacing: Many ICDs provide backup pacing to keep the heart beat from becoming excessively sluggish.
There are various types of ICDs, including:
- Single-chamber ICD: In the right ventricle, a lead is attached. Energy is provided to the ventricle if necessary to restore normal heart rhythm.
- Dual-chamber ICD: In the right atrium and right ventricle, leads are attached. Energy can be given to the right atrium and then the right ventricle, allowing your heart to be paced normally.
- Biventricular ICD: Leads are placed in the right atrium, right ventricle, and coronary sinus next to the left ventricle. This method, which is specifically used for people with heart failure, helps the heart beat more efficiently.
Your doctor will advise you on the appropriate type of ICD for you. Ask your doctor what medications you can take before having your ICD placed. Before the operation, your doctor may instruct you to stop using certain medications. You will be given detailed instructions.
You may not experience a low-energy shock once it has been inserted. It could also feel like a flutter in your chest. The high-energy jolt lasts only a second, yet it can be painful. Some compare it to being hit with a baseball bat or kicked by a horse. Most people feel it in their back rather than their chest. If you experience a shock, sit or lie down since you may pass out.
Consult your doctor about what to do if you are surprised. If you are surprised, call your doctor right away.
Catheter ablation
Consider this treatment to be rewiring to repair an electrical fault in your heart.
A catheter will be inserted into your leg by your doctor. It sends high-frequency electrical energy to a small portion of your heart that is causing the irregular beat. This energy "disconnects" the odd rhythm's pathway.
Most PSVTs, atrial flutter, atrial fibrillation, and some atrial and ventricular tachycardias are treated by ablation.
Heart surgery for arrhythmias
A type of surgery used to treat atrial fibrillation is the maze operation. Your surgeon makes a "maze" of cuts in the upper chambers of your heart. The idea is to keep your heart's electrical impulses restricted to specific routes. Following that, some people require a pacemaker.
Other treatments, such as a coronary bypass, may be recommended by your doctor to address other types of heart disease.
HOW CAN ARRYTHMIA BE PREVENTED?
Arrhythmias cannot always be avoided. Regular checks with your doctor might help prevent further heart rhythm disorders. Make sure they are aware of all medications you are taking. Some cold and cough medications might cause arrhythmias, so consult your doctor before using them.
They may also advise you to make the following lifestyle changes:
- Maintain a nutritious diet. Consume plenty of fruits and vegetables, as well as fish and plant-based proteins. Saturated and trans fats should be avoided.
- Maintain a healthy level of cholesterol and blood pressure.
- You should not smoke.
- Maintain a healthy weight.
- Regular exercise is essential.
- Control your tension.
- Caffeine and alcohol should be avoided.