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Arrhythmias: Medical Information on Causes, Diagnosis, Symptoms and Treatment

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arrhythmia and other heart abnormal rhythmsQuick Answers about Arrhythmias

  • Arrhythmia Overview
  • Atria-Associated Tachycardia
  • Ventricle-Associated Tachycardia
  • Arrhythmia Causes
  • Diagnosing Arrhythmia
  • Common Arrhythmia Medications
  • Lifestyle Changes
  • Electrical Cardioversion
  • Catheter Ablation and Heart Surgery


Arrhythmia Overview

Arrhythmia is an improper beating of the heart that could be beating too fast, too slow or irregularly. More than three million Americans are diagnosed with the treatable disease every year. While thought to be a disease that mainly affects older men and women, individuals of every age are affected and there are just as many children two years and younger suffering from the disease as people 60 years and older.

Irregular, fast or slow heartbeats are the result of improperly working electrical signals that coordinate heart rhythm. Many cases involving arrhythmia are harmless, where the individual experiences a fluttering or racing heart. Unfortunately, some irregular heartbeats are particularly abnormal and can weaken or damage the heart causing serious and sometimes potentially fatal problems.

In some cases, arrhythmia has no associated symptom. Other individuals experience dizziness, palpitations, and breathlessness. However, noticeable symptoms that could potentially be a serious problem include:

  • Bradycardia (slow beats of less than 60 heartbeats a minute when at rest)
  • Tachycardia (racing beats of more than 100 heartbeats a minute when at rest)
  • Fluttering occurring in the chest
  • Chest pain
  • Dizziness/lightheadedness
  • Syncope (painting or nearly fainting)
  • Shortness of breath
  • Sweating

Early diagnosis of some types of arrhythmia including ventricular fibrillation could save the patient’s life if the electrical impulses managing a rapid heartbeat becomes erratic. This type of arrhythmia causes the heart’s ventricles (pumping chambers) to quiver instead of pump, cutting off much-needed blood to the individual’s vital organs.

Not every case involving bradycardia and tachycardia means that the patient is suffering from heart disease. Deep relaxation and sleep can produce slower than normal heartbeats. However, urgent medical care is necessary if the individual experiences frequent or sudden symptoms including discomfort, chest pain or near fainting. A tachycardia attack can originate in the individual’s atria or in the ventricle that includes:

Atria-Associated Tachycardia

  • Atrial Fibrillation – This type of tachycardia results in rapid heartbeat caused by the atria experiencing chaotic electrical impulses. Usually, the atria of the heart is experiencing weak, uncoordinated and rapid contractions and can produce rapid, irregular ventricle rhythms. Often, this fibrillation is temporary. However, serious problems can result in unending episodes that if left untreated can cause serious complications including a stroke.
  • Atrial Flutter – Almost like atrial fibrillation, the atrial flutter heartbeat tends to be more rhythmic where the electrical impulses are more organized. However, like atrial fibrillation, atrial flutter has the potential of causing serious complications including a stroke.
  • Supraventricular Tachycardia – This term tends to be broad in nature and used to define numerous types of arrhythmia that originate in the supraventricular in the atria area above the ventricles.
  • Wolff-Parkinson-White Syndrome – This is a specific form of supraventricular tachycardia where the individual suffers from a genetically predisposed additional electrical pathway. However, not all individuals experience rapid heartbeat/short-circuit symptoms until their adult years.

Ventricle-Associated Tachycardia

  • Ventricular Tachycardia – This condition typically results in regular, rapid heartbeats originating in the ventricles with abnormal electric signals that often do not allow the ventricle to efficiently fill and contract so adequate blood is pumped to the body. Often, these episodes result in a medical emergency and if left untreated could become significantly worse and degrade to ventricular fibrillation.
  • Ventricular Fibrillation – Chaotic, rapid electrical impulses often produce quivering in the chest that can become potentially fatal if the heartbeat is not restored quickly to its normal rhythm. Usually, ventricular fibrillation often reveals an underlying heart disease or another factor that causes serious trauma, like a lightning strike.
  • Long QT Syndrome – Genetic mutations, using specific medications and medical conditions including congenital heart defects can cause Long QT syndrome heart disorder where the individual experiences chaotic, fast heartbeats.

Arrhythmia Causes

There are many factors that can cause or lead to life-threatening arrhythmias that include:

  • An ongoing heart attack
  • Scarred heart tissue that was damaged in a previous heart attack
  • High blood pressure
  • Changes in the structure of the heart caused by varying factors including cardiomyopathy
  • Drug abuse
  • Smoking
  • Hypothyroidism (underactive thyroid gland)
  • Hyperthyroidism (overactive thyroid gland)
  • Stress
  • Sleep apnea
  • Coronary Artery Disease that blocks the heart arteries
  • Diabetes
  • Genetics
  • A reaction to nutritional supplements, allergy drugs, and over-the-counter medications.

Diagnosing Arrhythmia

A diagnosing doctor will use various tests to detect an arrhythmia and determine its obvious or underlying cause. Common tests used for diagnosing arrhythmia include:

  • Electrocardiogram
  • Echocardiogram
  • Event monitor
  • Holter monitor
  • Head-up tilt table test
  • EPS (electrophysiology test)
  • Cardiac catheterization
  • Stress IQ test

Treating Arrhythmia

Successfully treating arrhythmia depends on the severity and type of the condition. Some individuals do not require any treatment for their arrhythmia while others must take prescription medication, undergo surgical procedures and/or make lifestyle changes.

Common Arrhythmia Medications

  • Beta-Blockers and other antiarrhythmic drugs are used to control heart rate.
  • Anti-Platelet Therapy and Anticoagulation Drugs can reduce the risk of stroke and blood clots. These can include aspirin and blood thinners (like warfarin) to prevent strokes in individuals with atrial fibrillation.

Often, the physician must try various drugs and doses to find the appropriate combination that works best for that individual’s case.

Lifestyle Changes

The doctor may recommend specific lifestyle changes to help manage the arrhythmia that includes:

  • Avoid Arrhythmia Triggers that could happen during certain activities.
  • Smoking Cessation (Quit Smoking)
  • Alcohol Intake Limitation
  • Caffeine Cessation (stop or limit the use of caffeine)
  • Avoid Cold and Cough Medications that tend to stimulate and produce irregular heart rhythms

Electrical Cardioversion

In some cases, prescription medications cannot control the individual’s persistent irregular heartbeat, that might or might not involve atrial fibrillation. When the doctor has no way to manage the patient’s irregular heartbeat using medication, cardioversion is often required. This procedure involves administering short-term anesthesia followed by the delivery of an electrical shock to the patient’s chest wall. This shock helps to synchronize the heart to produce a normal rhythm.

Additionally, the doctor can install a pacemaker device to deliver small logical impulses to the muscle of the heart to maintain an ideal heartbeat. However, pacemakers are designed to assist the heart muscle from beating too slowly by using a pulse generator.

ICDs (Implantable Cardioverter Defibrillators) are sophisticated heart rhythm devices doctors use to treat ventricular fibrillation and ventricular tachycardia through constant monitoring of the patient’s heart rhythm. The device can easily identify an abnormal, very fast heart rhythm and return it to a normal rhythm by delivering an electrical impulse or low-energy shock.

Catheter Ablation and Heart Surgery

Installing a catheter into a small area of heart tissue allows the doctor to ablate the area using high-frequency electrical energy to disconnect the pathway causing the abnormal rhythm. Ablation techniques are ideal for treating atrial fibrillation, atrial flutter, and some ventricle and atrial tachycardia conditions. Ablation is often used in combination with other procedures.

The doctor may recommend heart surgery because it might be the only effective solution for treating the heart disease that causes the arrhythmia. These procedures often confine the heart’s electrical impulses to the left and right atria and require that the patient wears a pacemaker following the procedure.

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