Arrhythmia — Know It All!

Editorial

All you need to know about Irregular heartbeat.

Know your ailment well, so you can manage it better!!

Here we come with Dysrhythmia today!

What is Arrhythmia?

Arrhythmia is also known as Dysrhythmia and Irregular Heartbeat.

An arrhythmia is a pulse rate or rhythm problem. The heart can beat too rapidly, too slowly, or with an erratic rhythm during arrhythmia. The disorder is called tachycardia if the heart beats too rapidly. The disorder is called bradycardia if the heart beats too slowly.

Arrhythmia is caused by variations in the function and tissue of the heart or by electrical impulses that influence your heartbeat. Damage from cancer, illness, or genetics may affect these changes. There are sometimes no symptoms, although certain persons report an erratic pulse. You may feel sick or dizzy or you may have trouble breathing.

An electrocardiogram is the most common procedure used to detect arrhythmia (EKG or ECG). Your doctor will do other tests if necessary. She or he can prescribe medications to fix nerves that are overstimulating the heart, placement of a system that can resolve an abnormal heartbeat or surgery. The heart will not be able to pump enough blood into the bloodstream if the arrhythmia is left unchecked. The heart, the brain, or other organs may be affected by this.

What Causes Arrhythmia?

In many cases, the exact cause of appendicitis is unknown. Experts believe it develops when part of the appendix becomes obstructed, or blocked.

Many things can potentially block your appendix, including:

  • a buildup of hardened stool
  • enlarged lymphoid follicles
  • intestinal worms
  • traumatic injury
  • tumors

When your appendix becomes blocked, bacteria can multiply inside it. This can lead to the formation of pus and swelling, which can cause painful pressure in your abdomen.

What are the types of Arrhythmia?

Doctors not only categorise arrhythmias from where they come from (atria or ventricles), but also by the rate of heart rate they cause:

Tachycardia. This applies to a rapid heartbeat, a heart rhythm at rest greater than 100 beats a minute.

Bradycardia . Bradycardia. This corresponds to a sluggish heartbeat of less than 60 beats per minute with a resting heart rhythm.

Tachycardias or bradycardias do not all mean that you have heart failure. For example, it’s common to develop a rapid pulse during exercise when the heart speeds up to supply more oxygen-rich blood to the tissues. It isn’t uncommon for the heartbeat to be slower during sleep or periods of deep relaxation.

Tachycardias in the atria

Tachycardias originating in the atria include:

Atrial fibrillation.

Atrial fibrillation. Such signals result in rapid, uncoordinated, sluggish atrial contractions.

The erratic electrical signals assault the AV node, normally causing the ventricles to have an abnormal, fast rhythm. Atrial fibrillation can be temporary, but once treated, certain symptoms won’t stop.

Significant complications including stroke are associated with atrial fibrillation.

Atrial flutter.

Like atrial fibrillation, atrial flutter is close. More-organized and more-rhythmic electrical signals are the heartbeats in atrial flutter than in atrial fibrillation. Significant risks such as stroke can also lead to atrial flutter.

Supraventricular tachycardia.

A large term including several types of arrhythmia arising above the ventricles (supraventricular) in the atria or AV node is supraventricular tachycardia. This forms of arrhythmia tend to produce unexpected episodes of suddenly beginning and terminating palpitations.

Wolff-Parkinson-White syndrome.

There is an additional electrical pathway between the atria and the ventricles that is present at birth in Wolff-Parkinson-White syndrome, a form of supraventricular tachycardia. You do not, though, feel symptoms until you’re an adult. Without going through the AV node, this pathway can cause electrical signals to travel between the atria and ventricles, leading to short circuits and rapid heartbeats.

Tachycardias in the ventricles

Tachycardias that take place in the ventricles include:

Ventricular tachycardia.

Ventricular tachycardia is a fast, routine heart rhythm that originates in the ventricles with irregular electrical signals. The fast heart rate does not cause the ventricles to effectively fill and contract and pump enough blood into the body. If you have an otherwise stable heart, ventricular tachycardia does not cause severe complications, but it may be a medical emergency that needs immediate medical attention if you have heart failure or a weak heart.

Ventricular fibrillation.

Instead of pumping the requisite blood to the body, ventricular fibrillation happens when sudden, chaotic electrical impulses cause the ventricles to quiver ineffectively. This serious condition is catastrophic if, within minutes, the heart is not returned to a regular rhythm.

Many patients with ventricular fibrillation have an underlying heart condition or have undergone extreme trauma.

Syndrome with Long QT. A heart disease that brings an elevated risk of rapid, chaotic heartbeats is Long QT syndrome. Rapid heartbeats, which are caused by changes in the heart’s electrical system, can lead to fainting and can be life-threatening. In certain situations, the rhythm of the heart may be so irregular that it can cause accidental death.

With a genetic defect that places you at risk of long QT syndrome, you may be born. In comparison, long QT syndrome can be caused by multiple drugs. Long QT syndrome can also be caused by certain medical disorders, such as congenital heart defects.

Bradycardia — A slow heartbeat

While bradycardia is called a heart rhythm below 60 beats a minute when at rest, a low resting heart rate does not necessarily signify a concern. You can have a powerful heart, whether you are physically healthy, capable of pumping a sufficient supply of blood for less than 60 beats per minute at rest.

In addition, the heart rate can be reduced by some drugs used to treat other diseases, such as high blood pressure. However, you might have one of many bradycardias if you have a sluggish heart rhythm and your heart is not pumping enough blood, including:

Sick sinus syndrome.

The heart rate can alternate between too slow (bradycardia) and too high if your sinus node, which is responsible for setting the speed of your heart, does not transmit impulses properly (tachycardia). Sick sinus syndrome may also be caused by scarring at the node of the sinus that delays, disrupts or prevents impulses from moving. In older people, sick sinus syndrome is more prominent.

Conduction block.

In or near the AV node, which lies on the pathway between your atria and your ventricles, a block of your heart’s electrical pathways can occur. Along other paths to each ventricle, a block may also emerge.

The impulses between the upper and lower halves of your heart can be delayed or diverted, depending on the location and form of obstruction. If the signal is entirely blocked, a steady, but normally slower, pulse can be accomplished by some cells in the AV node or ventricles.

No signs or symptoms can be caused by certain blocks, and others can induce missed beats or bradycardia.

Premature heartbeats

And if it always sounds like a missed pulse, an additional beat is simply a premature heartbeat. Although you can notice an occasional early pulse, it rarely means you’re getting a more serious issue. Still, a premature beat, particularly in people with heart disease, may cause a longer lasting arrhythmia. A poor heart can result from repeated premature beats that last for many years.

When you are sleeping, premature heartbeats may occur or may often be induced by fatigue, strenuous exercise, or stimulants such as caffeine or nicotine.

What are the symptoms of Arrhythmia?

You may not have any symptoms of an arrhythmia. However, common signs can include:

  • feeling like your heart skipped a beat
  • a fluttering feeling in your neck or chest
  • rapid heartbeat
  • slow or irregular heartbeat

Talk to your doctor about your symptoms so they can effectively diagnose and treat your arrhythmia. You may also develop more serious symptoms from your heart not working properly, including:

  • chest pain
  • difficulty breathing
  • weakness
  • dizziness or lightheadedness
  • fainting, or almost fainting
  • fatigue
  • sweating

Seek medical care right away if you experience any of these symptoms.

What are the risk factors of Arrhythmia?

Your chance of experiencing an arrhythmia can be elevated by such factors. They include:

Coronary coronary disease, other complications with the heart and prior heart surgery. Ca factors for nearly any form of arrhythmia include compressed heart vessels, a cardiac attack, abnormal heart valves, previous heart surgery, heart disease, cardiomyopathy and other heart injury.

High blood pressure.

This raises the likelihood that you will develop coronary heart disease. It can also affect the stiffness and thickness of the walls of your left ventricle, which can modify how electrical impulses flow through your muscle.

Congenital heart disease.

Being born with a heart abnormality can impact the rhythm of your heart.

Problems of thyroids.

It may increase the chance of arrhythmias by developing an overactive or underactive thyroid gland.

Diabetes.

With untreated diabetes, the chance of having coronary heart disease and elevated blood pressure significantly rises.

Obstructive sleep apnea.

Your risk of bradycardia, atrial fibrillation and other arrhythmias will be elevated by this condition in which your breathing is disturbed during sleep.

Electrolyte imbalance.

Substances called electrolytes in your blood, such as potassium, sodium, calcium and magnesium, help activate and execute your heart’s electrical impulses. Electrolyte levels that are too high or too low will influence the electrical impulses of your heart and lead to the production of arrhythmia.

Other variables that can place you at greater risk of developing an arrhythmia include:

Drugs and supplements.

Any over-the-counter cough and cold medicines and some prescription medicines can contribute to the development of arrhythmia.

Drinking too much alcohol.

The electrical signals in your heart can be impaired by drinking so much alcohol which can increase the risk of experiencing atrial fibrillation.

Caffeine, nicotine or illegal drug use.

Caffeine, nicotine and other stimulants can trigger the heart to beat faster and can lead to more severe arrhythmias being created.

Illegal medications, such as amphetamines and cocaine, may have a profound impact on the heart, resulting in certain types of arrhythmias or premature death from ventricular fibrillation.

What are the complications of Arrhythmia?

Any arrhythmias will increase the likelihood that you will develop conditions such as:

Stroke.

Heart arrhythmias are related to an elevated chance of clots in the blood. It will move from your heart to your brain if a clot breaks out. It could block blood supply there, inducing a stroke. If you have heart arrhythmia, if you have an underlying heart condition or are 65 or older, the chance of stroke increases.

Some drugs will significantly reduce the risk of stroke or damage to other organs caused by blood clots, such as blood thinners. Based on the form of arrhythmia and the risk of blood clots, the doctor will decide if a blood-thinning drug is good for you.

Heart failure.

If the heart is beating ineffectively for a sustained time due to bradycardia or tachycardia, such as atrial fibrillation, heart failure may result. Controlling the rate of an arrhythmia that induces heart damage will also boost the function of the heart.

How is Arrhythmia diagnosed?

Your doctor will check your signs and family records for a diagnosis of cardiac arrhythmia and do a physical examination. Your doctor can inquire about conditions that may cause your arrhythmias, such as heart disease or a thyroid gland disorder, or monitor for them. Your doctor can also administer arrhythmia-specific cardiac screening examinations. This may include:

Electrocardiogram (ECG).

Sensors (electrodes) which can sense the heart’s electrical activity are connected to your chest and often to your limbs during an ECG. The timing and length of each electrical stage of your pulse are determined by an ECG.

Holter monitor.

To monitor the movement of your heart as you go through your day, this portable ECG gadget can be worn for a day or more.

Event recorder.

You keep this handheld ECG unit ready for intermittent arrhythmias, connecting it to your body and clicking a button while you have symptoms. This helps the doctor to monitor the rhythm of the heart when you have symptoms.

Echocardiogram.

Echocardiogram. A hand-held instrument (transducer) placed on your chest uses sound waves to create pictures of the scale, shape and motion of your heart in this noninvasive exercise.

Implantable loop recorder.

If your signs are very infrequent, an incident recorder can be inserted in the chest region under the skin to constantly monitor the electrical pulse of the heart to identify irregular rhythms of the heart.

If during these tests, your doctor does not find an arrhythmia, he or she can attempt to cause your arrhythmia with other tests, including:

Stress test.

Any arrhythmias are exacerbated by exercise or aggravated by it. You will be asked to work out on a treadmill or stationary bicycle during a stress test while the heart activity is tracked. If you are tested by physicians to see if arrhythmias may be caused by coronary artery disease, and you have trouble exercising, the doctor can use a drug to stimulate your heart in a way that is similar to exercise.

Tilt table test.

If you have had fainting fits, your physician can prescribe this examination. If you lay flat on a table, your pulse rate and blood pressure are tracked. As if you were standing up, the table is then rotated. Your doctor will look at how the heart and the nervous system that regulates it respond to the angle change.

Electrophysiological testing and mapping.

In this examination, doctors thread small, lightweight tubes (catheters) across your blood vessels to a number of locations inside your heart with electrodes. The electrodes will trace the spread of electrical impulses through the heart while in place.

In addition, the electrodes can be used by your cardiologist to induce the heart to pump at frequencies that can cause or interrupt an arrhythmia. This makes it easier for the doctor to see where the arrhythmia is localised, what could be causing it, and what medications may improve. If you have any disorders that raise the risk, your doctor can even use this test to determine the chance that you may experience an arrhythmia.

What is the treatment for Arrhythmia?

Arrhythmias frequently do not need specific care, but to determine whether you do or do not, it is necessary to get the arrhythmia medically examined.

A doctor will decide whether, before determining on medical plans, your arrhythmia will cause more severe symptoms or other problems.

When you have an arrhythmia, it is necessary to exercise, keep a balanced diet, and control your blood pressure and cholesterol levels. This will lower the risk of injuries such as a stroke or heart attack.

Your doctor can recommend you try vagal manoeuvres if you have a high heart rate and no other symptoms. Your vagus nerve may be urged to slow your heart rate. Manoeuvres of Vagal include:

  • soaking your face with cold water
  • Coughing Normally
  • Gagging
  • Keeping your breath while exerting pressure

Some arrhythmia therapies require medicine and surgery.

Medication

Most of the drugs come in tablet form, but for use during an emergency, others come in intravenous form.

The treatment they administer depends on the type of arrhythmia you might have, as well as other factors. Types of traditional medicine include:

Antiarrhythmic drugs.

These can treat premature heartbeats and tachycardia. Amiodarone, propafenone, and others are found in them. They can, though, have the troublesome side effect of proarrhythmia, which can make your arrhythmia worse or start a new arrhythmia.

Calcium channel blockers.

Calcium channel blockers, including amlodipine and diltiazem, help reduce the heart rate and blood pressure. We will use them in the long run.

Beta-blockers.

To treat tachycardia, beta-blockers slow the heart rate. Acebutolol, metoprolol, and other drugs include beta-blockers.

Anticoagulants. Anticoagulants, which may stem from atrial fibrillation, help avoid blood clots. Medications for blood-thinning include warfarin,

Rivaroxaban, plus there’s more. Excessive or internal bleeding can be a side-effect.

Made sure all drugs are taken as prescribed. Inform your doctor of any side effects, especially arrhythmia.

Find out all about arrhythmia drugs.

Surgery

You may need a small operation or surgery if medicine or other therapies are not enough to help the arrhythmia. Arrhythmia can be treated with many treatments and implantable devices:

Catheter ablation:

A cardiologist loops flexible tubing called catheters across your blood vessels to the right location of your heart during catheter ablation. To produce a tiny scar, an electrode at the end of one of the catheters emits radio-frequency waves, heat, or extremely cold temperatures. The electrical waves that cause arrhythmias are blocked by the scar tissue.

Pacemaker

During minor surgery, your physician can instal a pacemaker. They lead short wires through your veins after making a small cut near your shoulder, and put them in your centre. The wires connect to a small generator inserted near your collarbone, operated by a battery. When an erratic heart rate is sensed by the generator, it will transmit an electrical pulse through the wire to better stabilise it.

Implantable cardioverter defibrillator (ICD):

An ICD may be inserted near the collarbone, breastbone, or ribs and is similar to a pacemaker. If the arrhythmias are life-threatening or place you at risk for heart arrest, it can help. To fix its rhythm, an ICD will give electrical shocks to your heart or restart your heart if it stops beating.

Extreme kinds of arrhythmias, such as atrial fibrillation, may also be treated by surgery.

Your surgeon makes minor cuts on the upper half of the heart to create scar tissue in the maze operation. The electrical activity that can induce abnormal heartbeats is blocked by the scars.

Home remedies and lifestyle modifications for Arrhythmia?

Your doctor may suggest that, in addition to other treatments, you make lifestyle changes that will keep your heart as healthy as possible.

These lifestyle changes may include:

  • Eat heart-healthy foods. Eat a healthy diet that’s low in salt and solid fats and rich in fruits, vegetables and whole grains.
  • Exercise regularly. Aim to exercise for at least 30 minutes on most days.
  • Quit smoking. If you smoke and can’t quit on your own, talk to your doctor about strategies or programs to help you break a smoking habit.
  • Maintain a healthy weight. Being overweight increases your risk of developing heart disease.
  • Keep blood pressure and cholesterol levels under control. Make lifestyle changes and take medications as prescribed to correct high blood pressure or high cholesterol.
  • Drink alcohol in moderation. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.
  • Maintain follow-up care. Take your medications as prescribed and have regular follow-up appointments with your doctor. Tell your doctor if your symptoms worsen.

References:

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https://medlineplus.gov/arrhythmia.html

https://www.nhlbi.nih.gov/health-topics/arrhythmia

https://www.medicalnewstoday.com/articles/8887

https://my.clevelandclinic.org/health/diseases/16749-arrhythmia

https://www.healthline.com/health/arrhythmia

https://www.mayoclinic.org/diseases-conditions/heart-arrhythmia/symptoms-causes/syc-20350668