Arrhythmia: Types, Symptoms And Treatments
Arrhythmia, A Medical Emergency!
Try to feel your pulse or heartbeat. Normally, the heart will beat at a consistent and constant rate at all times, where the heart will beat at a rate of 60 to 100 for a period of one minute although this rate may vary slightly according to your fitness level. If the heart beats at an uneven and inconsistent rate, this is called an arrhythmia.
Our heart is divided into 4 chambers, 2 are called the atrium and the other 2 are called the ventricles. Generally, electrical impulses will flow from one part of the atrium (sinoatrial node) and spread to the heart muscles to begin beating. If there is a change in the onset or conduction of this electrical impulse, an arrhythmia will occur.
Types of Arrhythmia
Now you have understood the wiring system in the heart. There are several types of arrhythmic conditions that can be divided into tachyarrhythmia and bradyarrhythmia. In a state of tachyarrhythmia, the surface of the heart other than the sinoatrial node will begin to release electrical impulses inconsistently.
The following are some of the categories of tachyarrhythmia;
Ventricular tachycardia
Ventricular fibrillation
Supraventricular tachycardia
In some cases, delays in the transmission of impulses can occur. These impulses can be blocked briefly or completely. This is called bradyarrhythmia.
What Are The Symptoms of Arrhythmia?
People with arrhythmia will experience different symptoms and one may not be the same as others. Some people get the sign as soon as they have an arrhythmia, while others only show non-specific symptoms. For example;
Tired or helpless to do daily activities
Shortness of breath
Dizziness or fainting
Difficulty breathing while exercising or at rest
Pain or pressure on the chest
Pulse becomes faster or slower and does not evenly
Excessive sweating
Dropping abruptly due to a heart attack
If you experience any of the symptoms as listed above, please consult a doctor immediately especially those of you who have high-risk factors as will be discussed below.
Are You At Risk of Arrhythmia?
Here are some causes of arrhythmia;
#Age
Age over 60 is a major risk factor for getting arrhythmias even though the symptoms are not clear and not specific at this age.
# Coronary artery disease
Coronary artery disease causes problems in the blood circulation to the ventricular muscle cells that also cause scarring or tissue deposits on the surface of the heart. Scars or deposits of these tissues are abnormal cells and interfere with the flow of impulses efficiently. As a result, these tissues can produce their own distinct impulses and cause arrhythmias such as atrial fibrillation.
#Disease of the heart valve or weak heart muscle
Both of these factors can cause changes in the structure of the heart either in the atrium or ventricles and cause an uneven heartbeat.
#High blood pressure
High blood pressure can cause arrhythmias as the heart needs to pump harder and becomes thick. This interferes with the flow of electrical impulses in these organs. Know your risk for high blood pressure here.
# Thyroid Disease
The production of too much or too little thyroid hormone will affect the autonomic nervous system. The autonomic nervous system serves to control the rate of acceleration of electrical impulses from the sinoatrial node and the flow of these impulses to all the heart muscles.
#Congenital heart disease
Congenital heart disease especially related to the anatomical structure of blood flow out of the heart can cause arrhythmias.
#Excessive use of alcohol or stimulants
Alcohol, caffeine and harmful stimulants can increase the body's metabolic rate and disrupt the human autonomic nervous system.
Diagnosis of Arrhythmia
Arrhythmia can be identified by a doctor using an electrocardiogram (ECG) to see the electrical activity in the heart. ECG will provide heart rhythm readings as well as heart rate. The Holter machine, a portable ECG device, is also one of the ways to see the heart rhythm. This device is used by patients for 24 hours to seven days to record heart rate and heart activity.
Once the arrhythmic disease is identified, the cause of this disease will be identified by using a series of laboratory studies and imaging such as echocardiogram and others.
Can Heart Arrhythmias Be Cured?
There are a few variations of arrhythmia treatment:
Tachyarrhythmia treatment
Unstable Patients | Stable Patients | |
Patients with symptoms such as confusion, chest pain, cold skin, and weak pulse. | Condition | Patients who do not have alarming symptoms |
Cardioversion, in which the shock will be delivered to the heart using patches or paddles to restore the heart rhythm to normal. The energy required to perform this cardioversion depends on the type of arrhythmia. For example, atrial fibrillation requires an energy of 120 to 150 Joules. | Treatment | The vagal maneuver can be used for supraventricular tachycardia. Apart from supraventricular tachycardia, other types of arrhythmia are usually treated using medications such as amiodarone and procainamide based on need. |
Treatment of bradyarrhythmia
Unstable Patients | Stable Patients | |
Patients who show symptoms such as confusion, chest pain, and weak pulse. | Condition | Patients who do not have alarming symptoms |
This patient will be started with a dose of atropine and if ineffective, "transcutaneous pacing" or other medications can be used | Treatment | Usually, stable bradyarrhythmia patients will be monitored and observed for further treatment |
Once the arrhythmia is treated at an emergency stage, the cause of the arrhythmia will be investigated and then treated. Some arrhythmia patients will be fitted with a pacemaker or "Implantable Cardioverter Defibrillator" under the surface of the chest skin to treat this problem.
Written By Lingheswaran Muniandy, Doctor of Medicine, MD Universiti Sains Malaysia on
Reviewed By DoctorOnCall Panel Doctor
