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Arrhythmia

Arrhythmias are abnormal heart rhythms that make the heart beat in a way it should not, either too fast, too slow or erratically. They occur when the heart’s electrical impulses which coordinate the frequency of heartbeats, do not work properly.

There are various types of arrhythmias. The four main types of Arrhythmia include:

  1. Tachycardia occurs when the heart beats too fast
  2. Bradycardia occurs if the heart beats too slowly
  3. Premature contraction cause the heart to beat too early
  4. Fibrillation occurs if the heart beat is irregular

Other types of arrhythmias include:

  1. Atrial flutter is an arrhythmia caused by one or more rapid circuits in the atrium. This arrhythmia occurs most often in people with heart disease and in the first week after heart surgery. Atrial flutter often converts to Atrial fibrillation. Atrial fibrillation is the most common type of arrhythmia it occurs when haphazard electrical signals cause the heart’s two upper chambers to contract very fast and irregularly.
  2. Ventricular fibrillation is an erratic, disorganized firing of impulses from the ventricles. The ventricles quiver and are unable to contract or pump blood to the body. This is a medical emergency that must be treated with cardiopulmonary resuscitation (CPR) and defibrillation as soon as possible.
  3. Long QT syndrome – The QT interval is the area on the electrocardiogram that represents the time it takes for the heart muscle to contract and then recover, or for the electrical impulse to fire impulses and then recharge. When the QT interval is longer than normal, it increases the risk for “torsade de pointes,” a life-threatening form of ventricular tachycardia. Long QT syndrome is an inherited condition that can cause sudden death in young people. It can be treated with antiarrhythmic drugs, pacemaker, electrical cardioversion, defibrillation, implanted cardioverter/defibrillator, or ablation therapy.
  4. Sinus node dysfunction is a slow heart rhythm due to an abnormal SA (sinus) node. Significant sinus node dysfunction that causes symptoms can be treated with a Pacemaker implant.
  5. Heart block is caused by delay or complete block of the electrical impulse as it travels from the sinus node to the ventricles. The level of the block or delay may occur in the AV node or HIS-Purkinje system. The heart may beat irregularly and, often, more slowly. If serious, heart block is treated with Pacemaker implantation.

The causes of Arrhythmias include the following:

  • Abnormal (extra) signals may occur
  • Electrical signals may be blocked or slowed
  • Electrical signals travel in new or different pathways through the heart
  • Abnormal levels of potassium or other substances
  • Heart attack, or a damaged heart muscle from a past heart attack
  • Heart disease that is present at birth (congenital)
  • Heart failure or an enlarged heart
  • Overactive thyroid gland

Arrhythmias may also be caused by some substances or drugs, including:

  • Alcohol, caffeine, or stimulants such as amphetamines
  • Beta-blockers
  • Cigarette smoking (nicotine)
  • Drugs that mimic the activity of your nervous system
  • Medicines used for depression or psychosis

Common symptoms that may occur when the arrhythmia is present include:

  • Chest pain
  • Fainting
  • Light-headedness, dizziness
  • Paleness
  • Shortness of breath
  • Sweating

Exams and Tests that may be done to look at heart function include:

  • Coronary angiography
  • ECG (electrocardiogram)
  • Echocardiogram
  • Holter monitor (used for 24 hrs)
  • Electrophysiology study (EPS)

Treatment for Arrhythmias may include:

  • Electrical “shock” therapy (defibrillation or cardioversion)
  • Implanting a short-term heart pacemaker
  • Medications called anti-arrhythmic drugs given through a vein (intravenous) or by mouth
  • Cardiac ablation used to destroy areas in your heart that may be causing your heart rhythm problems
  • An implantable cardiac defibrillator is placed in people who are at high risk of sudden cardiac death

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