Arrhythmias
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1- Introduction
2- Physiological Overview
3- Symptoms
4- Treatment
Introduction
Physiological Overview
Arrhythmias are disruptions in the normal electrical activity of the heart, which coordinate its rhythmical pumping action. Normally, the heart’s electrical system generates impulses that regulate the heart rate and rhythm, ensuring that it beats in a coordinated manner to pump blood effectively throughout the body.
Physiologically, arrhythmias can manifest in several ways. Tachycardias involve abnormally fast heart rates, often exceeding 100 beats per minute, which can result from conditions like atrial fibrillation or supraventricular tachycardia. Conversely, bradycardias involve a heart rate that is too slow, typically below 60 beats per minute, and can be caused by issues such as sinus node dysfunction or heart block.
Arrhythmias can also lead to irregular heartbeats, where the heart may beat inconsistently or with extra beats between normal beats (ectopic beats). These irregular rhythms can disrupt the heart’s pumping function, potentially reducing blood flow to vital organs and causing symptoms such as palpitations, chest discomfort, dizziness, or fainting.
Symptoms
Palpitations: Sensations of fluttering, racing, or irregular heartbeat sensations in the chest.
Chest discomfort or pain: This can range from mild discomfort to severe chest pain, often resembling a heart attack.
Dizziness or lightheadedness: Feeling faint or dizzy, especially during physical exertion or when standing up quickly.
Shortness of breath: Difficulty breathing, often accompanied by a feeling of being unable to catch one’s breath.
Fatigue: Unusual tiredness or weakness, even with normal daily activities.
Syncope (fainting): Sudden loss of consciousness, which can occur if the heart rate becomes dangerously slow or if there is a sudden onset of arrhythmia.
Pounding in the chest: Sensation of a strong or irregular heartbeat that may be uncomfortable.
Anxiety: Feeling anxious or uneasy, sometimes due to the awareness of palpitations or irregular heartbeats.
Treatment
Medications: Antiarrhythmic medications are often prescribed to help regulate the heart’s rhythm and prevent arrhythmias from occurring. These medications work by affecting the electrical impulses that control the heartbeat.
Cardioversion: This procedure is used to restore a normal heart rhythm when the arrhythmia is persistent or life-threatening. It can be done either electrically (electrical cardioversion) or with medications (chemical cardioversion).
Catheter ablation: In this procedure, a thin, flexible tube (catheter) is inserted into the heart through a blood vessel in the groin or arm. The tip of the catheter delivers energy (such as radiofrequency or cryotherapy) to destroy small areas of heart tissue that are causing the abnormal electrical signals responsible for the arrhythmia.
Implantable devices: Devices like pacemakers or implantable cardioverter-defibrillators (ICDs) may be implanted under the skin to help control heart rhythm:
- Pacemakers are used to treat bradycardias by sending electrical impulses to maintain a normal heart rate.
- ICDs monitor the heart rhythm and deliver electric shocks to restore normal rhythm if a life-threatening arrhythmia such as ventricular fibrillation occurs.
Lifestyle changes: Adopting a healthy lifestyle can help manage arrhythmias and reduce the risk of complications. This includes maintaining a healthy weight, exercising regularly, quitting smoking, limiting alcohol and caffeine intake, and managing stress.
Surgery: In some cases, surgical procedures may be recommended to treat certain types of arrhythmias or underlying heart conditions that contribute to arrhythmias.