Arrhythmias are abnormal rhythms of the heart. The heartbeats function due to electrical impulses; an arrhythmia is any change in that system.
Arrhythmias have many types; the electrical impulses may happen too fast, too slow, or even in an erratic way. Within this article, you will find some of the most common questions like the types, the causes, and many others. Before reaching that point, there will be brief explanations about the basic concepts of the disease.
By reading this article, you will obtain critical insights about Arrhythmias, like the symptoms, complications, and treatment. Please continue reading to get pearls on this specific topic by the hand of a Doctor.
What is an arrhythmia?
The heart beat is a process that occurs thanks to an electrical impulse. This impulse has its origins in a heart structure that receives the name of the Sinoatrial or sinus node. This later goes through the heart tissue and gets to the atrioventricular or atrial node.
Moreover, the heart tissue has an exceptional condition that allows the electrical impulses to travel faster and more efficiently. The AV node goes to the bundle of His, to the left and right bundle branches, and eventually into the Purkinje fibers. This is the normal pathway of the heart’s electrical impulse and leads to the heartbeat and normal heart rhythm.
It is essential to know that the normal heart rhythm receives the name of the sinus rhythm. If a deviation from this pathway occurs, it results in an arrhythmia.
Arrhythmia refers to abnormal heart rhythm. This is caused by multiple factors that lead to an alteration of the transmission of the heart’s electrical impulses.
There are many types of arrhythmias, but all of them refer to a heart rhythm disorder.
Among the types of arrhythmias, the heart can beat too fast, precisely a heart rate over 100 beats per minute, receiving the name of tachyarrhythmia or tachycardia.
On the other hand, it can beat too slowly, with a heart rate of fewer than 60 beats per minute, receiving the name of bradyarrhythmia or bradycardia.
Importantly, there are other cases in which there is an abnormal or irregular rhythm but a heart rate within limits.
What are the causes of arrhythmia?
There are several conditions and risk factors that may lead to arrhythmias. The following list includes some of these conditions.
- Ongoing heart attack.
- Damage or scarring of the heart muscle from a previous heart attack.
- Changes to the heart structure like enlargement or cardiomyopathy.
- Blockage in the arteries of the heart, most commonly known as coronary artery disease.
- High blood pressure and untreated high blood pressure levels.
- Sleep apnea
- COVID-19 infection
Aside from this list, several risk factors may induce or may increase the risk of developing an arrhythmia. The following are:
- Coronary Artery Disease or other heart diseases: Narrowing or partial blockage of the heart arteries, a previous heart attack, abnormal heart valves, among others. These are risk factors for developing almost any type of arrhythmia: slow heartbeat or rapid heartbeat.
- High Blood Pressure: This is a condition that increases the risk of developing coronary artery disease. It is a condition that also causes the heart muscle of the left ventricle to enlarge, becoming thick and stiff. This causes a change in how the electrical impulses travel through the heart.
- Congenital heart disease
- Electrolyte imbalance: Within the blood, there are certain substances like potassium, sodium, calcium, and magnesium. These substances receive the name of electrolytes. Suppose the levels of these substances are too high or too low. In that case, it can affect the heart impulses and may contribute to developing arrhythmias.
- Drugs and supplements: Certain cough and cold medicines and other prescription drugs may induce arrhythmias.
- Alcohol Intake: Drinking and abusing of alcohol intake can affect the electrical impulses. This may lead to an increase in the chance of developing atrial fibrillation.
- Caffeine, nicotine, or illegal drugs: These are stimulants that cause the heart to beat faster and lead to serious arrhythmias.
What are the types of arrhythmias?
There are several types of arrhythmias. The classification of them mostly depends on the place where they originate. These can arise on the atria or the ventricles.
The atria are the heart’s upper chambers, and the ventricles are the lower chambers of the heart. The classification not only depends on the place of origin; it also depends on the heart rate’s speed. Therefore, the classification goes as the following:
Tachycardias in the Atria
- Atrial Fibrillation: This is a rapid heart rate caused by erratic and chaotic electrical impulses in the atria. This results in the atria’s rapid and weak contractions without coordination or the same atrial arrhythmia. The electrical impulses reach the AV node resulting in a ventricular arrhythmia as well. Atrial fibrillation episodes may be temporary; however, there are cases in which these episodes will not end without medication.
- Atrial Flutter: It is a very similar condition to the atrial fibrillation. It is a supraventricular arrhythmia as well that causes atrial tachycardia; nonetheless, the heartbeats have more organization and are more rhythmical.
- Paroxysmal Supraventricular Tachycardia: It is a rapid but regular rhythm that comes directly from the SA node affecting the atria. It is a type of arrhythmia that begins and ends suddenly.
- Wolf-Parkinson-White Syndrome: In this specific syndrome, there is an extra electrical pathway between atria and ventricles. It is a congenital anomaly; this means that it is present at birth. Nonetheless, the symptoms of this condition may present in adulthood. The electrical impulses go from the SA node to the ventricles without passing through the AV node. This leads to short circuits and rapid heartbeats.
Tachycardias in the Ventricles
- Ventricular Tachycardia: It is a type of cardiac arrhythmia that originates with abnormal electrical impulses from the ventricles. It has a rapid and regular heart rate that does not allow the ventricles to fill and contract efficiently. Individuals with a healthy heart will not necessarily have problems with this condition, although they will require assessment. On the other hand, patients with heart diseases or a weak heart require medical attention.
- Ventricular fibrillation: It is very similar to the atrial fibrillation. It is a condition in which there are chaotic electrical impulses without coordination. This leads to ineffective contraction of the ventricles and leads to inadequate pumping of blood to the body. Most of the patients who experience this condition have underlying heart conditions.
- Long QT Syndrome: It is a heart rhythm problem that carries an increased risk of fast and unsynchronized heartbeats. These rapid heartbeats may lead to fainting, and it can be a life-threatening condition. There are cases in which the heart rhythm becomes so erratic that it can cause sudden cardiac arrest (the heart just stops functioning).
There are cases in which a heart rate below 60 beats per minute does not refer to a problem. People who are physically fit may have a normal heart, which is very efficient when pumping blood. However, when a low heart rate coexists with an inefficient blood pumping, it becomes a problem.
Some of the bradycardias are the following.
- Sick Sinus Syndrome: The sinus node is responsible for setting the pace of the heart. If the sinus node does not send electrical signals properly, the heart rate can become too fast or too slow. The sick sinus syndrome can also happen after scarring near the sinus node. This can lead to a slowing, disruption, or even blockage of the impulses. It is essential to know that sick sinus syndrome is widespread among older adults.
- Conduction blockage: This condition occurs in the AV node or near it; it can also happen along other pathways to the ventricles. There are different types of blockage, it may be partial, or it may be complete. It also depends on the location that can make a slower heartbeat.
What are the symptoms of arrhythmias?
Generally, arrhythmias are silent and do not cause any symptoms to the patient. While on a regular visit to the doctor, he or she may find that the patient has an arrhythmia.
This means that the doctor may find it before the patient even knows. The doctor may know by just simply taking the pulse or hearing the heart. However, symptoms exist, and if they occur, they may include the following:
- Heart palpitation: The patient may feel that the heart goes too fast, skip in heartbeats or fluttering in the chest.
- Chest pain
- Pounding in the chest
- Shortness of breath
- Weakness or fatigue
- Fainting or near fainting
How are heart arrhythmias diagnosed?
There are several ways to diagnose arrhythmias; it can be easily found while doing a physical examination on routine evaluation. However, after this finding, several tests may help to give an exact diagnosis of it.
Among them, we can find the following:
- Electrocardiogram (ECG): It is a test that uses electrodes that can detect the heart’s electrical activity. It measures the duration of each electrical phase in the heartbeat of the patient.
- Holter Monitor: It is a portable ECG that a patient uses to record heart activity while doing daily tasks.
- Echocardiogram: It is a non-invasive test that produces images of the heart. It enables the doctor to see the heart’s size, structure, and motion.
- Stress test: Some arrhythmias may appear while doing exercise. The doctors ask the patient to run on a treadmill or do exercise on a stationary bike on this specific test. At the same time, they record heart activity with an ECG.
- Electrophysiological testing and mapping: Doctors use flexible tubes or catheters with electrodes on the tip through the blood vessels. These electrodes will go to a variety of spots within the heart. After they are all in place, the doctor may know the electrical spread of electrical impulses through the heart.
What are the possible complications of an arrhythmia?
Two main complications can cause an arrhythmia; these are the following.
- Stroke: While having arrhythmias, the risk of developing blood clots increases. When these blood clots break, it can travel from the heart to the brain. The blood clot will block the blood flow to the brain, causing a stroke. People with arrhythmias over 65 years old are at risk of developing strokes. These people should visit a doctor periodically and receive treatment for prevention. Blood thinners are perfect for lowering the chances of blood clotting.
- Heart Failure: This condition can result from long periods of ineffective pumping of the blood. The ineffective pumping may be due to bradycardia or tachycardia. Atrial fibrillation is a condition that may cause this condition. By controlling arrhythmia, the heart function may improve in the long term.
What are the treatments for heart arrhythmia and palpitations?
Arrhythmia treatment can be very variable. Among the treatment options, there are medications, lifestyle changes, and invasive therapies.
The following are:
- Medications: Doctors use antiarrhythmic drugs to convert the arrhythmia to normal sinus rhythm. These medications also help to prevent future episodes of arrhythmias. The use of anticoagulant or antiplatelet drugs like warfarin or aspirin, respectively, is also widespread. These drugs help to prevent the development of blood clots.
- Lifestyle Changes: Certain factors may induce arrhythmia, which is why doctors recommend eliminating them. For example, stop smoking, limit alcohol and caffeine intake, avoid using stimulants, and do not consume illicit drugs.
- Invasive Therapies: Two primary therapies can help from electrical devices like the implantable cardioverter-defibrillator or the pacemaker. These are the electrical cardioversion and the cardiac ablation or catheter ablation. The first one uses electrical shock on the chest wall to synchronize the heart and allow the normal rhythm to restart. The cardiac ablation uses the radiofrequency ablation technique. This means that through a catheter with electrodes at the tips, it can use heat, cold, or radiofrequency to damage a small spot in your heart. This damage causes an electrical block along the pathway that causes the arrhythmia.
Do you feel you have an arrhythmia?
This tool is an arrhythmia symptoms checker. It gathers the most important signs, symptoms, and risk factors for this condition. Therefore, the tool will tell anybody who uses it the likelihood that their symptoms are because of arrhythmia. Similarly, this tool has all the risk factors for developing an arrhythmia. So, it will also be positive for patients with high-risk of developing it in the future.
It is free and would only take a few minutes to complete it. Stay safe.