Whether aquatic, amphibian, or mammal, the heart is one of the most important organs in the body. This extraordinary organ is capable of pumping enormous quantities of oxygen-rich blood throughout the body using electrical impulses and the opening and closing of valves in its numerous layers, and the best part of it is that it operates automatically. Cardiac arrhythmia is a very common disorder, with over 3 million cases in the US every year. Any individual, regardless of their age, race, or gender, can experience a cardiac arrhythmia. The term "arrhythmia" refers to any problem in the rate or rhythm of a person’s heartbeat. During an arrhythmia, the electrical impulses may be too fast, too slow, or erratic, causing an irregular heartbeat.
Electrical System of the Heart
Before we delve into how arrhythmia affects the heart, let's learn how the heart works in the first place. The heartbeat (contraction) starts when an electrical impulse from the sinus node (also called the SA node) travels through the heart's muscle tissue. The SA node is alluded to as the heart's "normal pacemaker" since it begins the motivations for the heartbeat. The typical electrical sequence starts in the right chamber and spreads all through the atria to the atrioventricular (AV) node. Electrical impulses travel through the Purkinje fibers and down the Bundle of His from the AV node, causing the ventricles to contract. The ordinary heart beats in a normal way based on the electrical sequence that causes a grouping of coordinated constrictions. A healthy adult's heart beats between 60 and 100 times per minute. So, Arrhythmia occurs when the electrical sequence can no longer produce a regular contraction, hence leading to the development of this disorder.
Types of Arrhythmia
Heart arrhythmias are classified based on the rate at which the heart beats. Such as:
Tachycardia: A rapid heartbeat. The resting heart rate exceeds 100 beats per minute.
Bradycardia: A slow heartbeat. The heart rate at rest is less than 60 beats per minute.
Tachycardia (fast heartbeat):
Tachycardias are classified as follows:
A-fib (abbreviation for atrial fibrillation): It’s a fast, uncoordinated heart rate caused by chaotic heart signaling. Although the disease may be brief, certain A-fib episodes may persist unless addressed. A-fib is linked to major problems like stroke.
Atrial Flutter: A-fib is comparable to atrial flutter, but the heartbeats are more organized. Stroke is also associated with atrial flutter.
Supraventricular Tachycardia: Supraventricular tachycardia is a catch-all phrase for arrhythmias that begin above the lower heart chambers (ventricles). Supraventricular tachycardia generates pounding heartbeats (palpitations) that come and go quickly.
Ventricular Fibrillation: This type of arrhythmia occurs when rapid, chaotic electrical signals force the lower heart chambers (ventricles) to quiver instead of connecting in a coordinated fashion that pumps blood to the rest of the body. If a normal heart rhythm is not restored within minutes, this critical issue can result in death. Most people who suffer from ventricular fibrillation have a heart condition or have been in a significant accident.
Ventricular tachycardia: This rapid, regular heart rate is caused by incorrect electrical signals in the lower chambers of the heart (ventricles). The fast heartbeat prevents the ventricles from properly filling with blood. As a result, the heart is unable to supply enough blood to the body. Ventricular tachycardia may not cause major difficulties in normally healthy people. Ventricular tachycardia is a medical emergency that demands rapid medical attention for people who have heart problems.
Bradycardia (slow heartbeat):
Although a resting heart rate of less than 60 beats per minute is called bradycardia, a low resting heart rate does not usually indicate a problem. If you're physically healthy, your heart may be able to pump adequate blood to the body even if it's beating at less than 60 beats per minute at rest.
You may have bradycardia if your heart rate is slow and your heart isn't pumping enough blood. Bradycardias are classified as follows:
Sick sinus syndrome: The sinus node is in charge of regulating the heartbeat. If it fails to function properly, the heart rate may vary between being too slow (bradycardia) and being too fast (tachycardia). Scarring near the sinus node can produce sick sinus syndrome by delaying, interrupting, or stopping impulse travel. Sick sinus syndrome is particularly common among the elderly.
Conduction block: A blockage in the electrical circuits of the heart can cause the signals that trigger heartbeats to slow or halt. Some blockages create no symptoms, while others cause missed beats or bradycardia.
What raises the risk of arrhythmia?
Age: Heart changes like scarring and the effects of other chronic conditions can make us more likely to have arrhythmias as we get older. Arrhythmias can also be caused by conditions like high blood pressure, heart failure, diabetes, and thyroid disease, which are more common in older people. Children and young adults are more likely to suffer from arrhythmias due to congenital heart defects or other inherited conditions.
Genetics and family history: If a parent or other close relative has an arrhythmia, you may be more susceptible to certain types.
Lifestyle habits such as smoking Use illegal drugs, such as cocaine or amphetamines. Drinking alcohol more often and more than is recommended (no more than 2 drinks per day for men and 1 drink per day for women)
What are the symptoms of arrhythmia?
Symptoms of heart arrhythmia include:
Palpitations in the heart
Feeling dizzy or lightheaded.
Episodes of fainting.
Breathing difficulty.
Discomfort in the chest.
Weakness or exhaustion.
A cardiac arrhythmia might be "silent" and produce no symptoms.
How is an arrhythmia identified and diagnosed?
During an examination, a healthcare expert can detect an irregular heartbeat by checking your pulse and listening to your heart. They may request diagnostic tests after examining your symptoms and completing a physical examination to help determine that you have an arrhythmia. This can also aid in determining the root cause. You may also want to consult an electrophysiologist, who is a cardiologist with additional specialized training in the diagnosis and treatment of heart rhythm abnormalities.
Among the tests that can be used to detect an abnormal heart rhythm and associated disorders are:
ECG, or EKG, stands for electrocardiogram.
Blood tests might be used to evaluate your electrolyte levels or to look for a genetic problem.
Ambulatory monitoring devices
The stress test
Echocardiogram.
Cardiac Catheterization
EPS (electrophysiology study)
Tilt table experiment
CT scan (computed tomography)
MRI (magnetic resonance imaging) of the heart
What is the treatment for an arrhythmia?
Treatment is determined by the nature and severity of your arrhythmia. In some circumstances, there is no need for treatment. Treatment options for heart arrhythmia include:
Medications.
Lifestyle changes.
Therapies.
Devices.
Surgery.
1. Medications
Arrhythmias can be treated with a variety of drugs. Because everyone is unique, you may need to experiment with several drugs and dosages to discover the one that works best for you. Treatments for heart arrhythmias include:
Antiarrhythmic medications that either convert an arrhythmia to sinus rhythm (normal rhythm) or prevent an arrhythmia
Medications that regulate your heart rate.
Anticoagulant or antiplatelet therapy medications (such as warfarin or aspirin) that lower the risk of blood clot formation
Drugs are used to address disorders that may be causing an irregular heartbeat.
2. Lifestyle Changes
Simple lifestyle adjustments can help with arrhythmias. These modifications may include:
Keeping blood pressure and blood sugar levels in check
Tobacco products should be avoided.
Reducing alcohol consumption.
Caffeine and stimulants should be avoided.
Trying to maintain a healthy weight.
3. Therapies
Some people require therapy in addition to medicine to manage or eradicate abnormal heart rhythms. Among the therapies are:
Cardioversion: An electrical impulse synchronizes your heart and helps it to resume its usual rhythm.
Catheter ablation: It involves the delivery of high-frequency electrical energy through a catheter to a tiny area of tissue inside your heart to "disconnect" the aberrant rhythm's route. Most SVTs, atrial flutter, atrial fibrillation, and some atrial and ventricular tachycardias can be treated by ablation.
Pulmonary vein isolation: This type of ablation involves the formation of scar rings to isolate locations that may induce atrial fibrillation. This can benefit those who have atrial fibrillation on a regular, paroxysmal, or permanent basis.
4. Devices
Your cardiologist may use certain equipment in an electrophysiology lab during your procedure. Devices used to treat arrhythmias include:
Permanent pacemaker: This device sends small electrical pulses to the heart muscle to maintain a normal heart rate and prevent the heart from beating too slowly.
Implantable cardioverter defibrillator (ICD): This device constantly monitors your heart's rhythm. When it detects an abnormal heart rhythm that is too fast, it supplies energy to the heart muscle so that it beats at a normal rhythm. This device treats two life-threatening heart rhythms: ventricular tachycardia and ventricular fibrillation.
Biventricular (B-V) pacemakers and defibrillators (also called cardiac resynchronization therapy or CRT): These devices help synchronize the contractions of the left ventricle. In addition to the leads that lead to the right side of the heart, there are also leads that lead to the left ventricle. This may be necessary for people with heart failure or uncoordinated left ventricular contractions.
5. Surgery
People with arrhythmia may need heart surgery for the following reasons:
Treatment for heart conditions that can cause arrhythmias, such as valve surgery or coronary artery bypass graft surgery.
Labyrinth surgery can correct atrial fibrillation that does not respond to drug or non-surgical treatments.
In some cases, doctors may use minimally invasive or surgical techniques to place biventricular pacemaker leads (small wires) into the heart.
Written By: Tarleen Chhatwal
What is an Arrhythmia? (2023, April 5). www.heart.org. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia
Heart arrhythmia - Symptoms and causes - Mayo Clinic. (2023, April 21). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/symptoms-causes/syc-20350668
Professional, C. C. M. (n.d.). Arrhythmia. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/16749-arrhythmia
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