Arrhythmia:
It is any change from the normal sequence of the heartbeat, which causes the heart to beat too fast, too slowly or irregularly. When the heart does not beat properly, it cannot pump blood effectively and this causes the lungs, brain and all other organs not to work properly. It may stop working or become damaged. Arrhythmias can affect all age groups. Most people with an arrhythmia can lead a normal life if diagnosed correctly. Often there are no symptoms, but some people feel a heartbeat, unsteadiness, feeling dizzy, fainting, or having trouble breathing.
Heartbeat rate:
- The normal rate for adults (18 years and above): 60-100 beats per minute.
- Rapid: more than 100 beats per minute in adults.
- Slow: less than 60 beats per minute.
Main types of arrhythmias:
- Atrial fibrillation "flutter": It is the most common type, in which the heart beats irregularly and faster than normal, and it is the common type in the elderly.
- Supraventricular tachycardia: Episodes of an abnormally fast heart rate at rest.
- Bradycardia: the heart beats slower than usual
- Ventricular fibrillation: a rare, rapid, and irregular heartbeat that rapidly leads to loss of consciousness and sudden death if not treated promptly.
- A patient may be at risk of developing an arrhythmia if heart tissue has been damaged by disease (having had a heart attack or had heart failure).
Causes:
Arrhythmia results from changes in the tissues of the heart. It can occur suddenly as a result of exertion or stress, an imbalance in the blood, medications, or problems with the electrical signals in the heart. An arrhythmia is usually caused by a trigger. Irregular heartbeat if there is a problem with the heart, and sometimes the cause is unknown.
Risk factors:
- Getting old.
- Family history.
- Certain medical conditions that weaken the heart (such as: diabetes, high blood pressure, and heart failure).
- Exposure to air pollutants, especially particulate matter and gases.
- Smoking or drug use.
- Surgeries of the heart, lungs or esophagus.
Some substances contribute to arrhythmias:
- Caffeine
- Smoking.
- Drugs (such as cocaine, marijuana, or methamphetamine).
- Cold and cough medicines
- Appetite suppressants
- Some medicines to treat some mental illnesses.
- Anti-arrhythmics (the same medicines used to treat arrhythmias can also cause arrhythmias).
- Beta-blockers for high blood pressure
Symptoms:
- Fatigue or weakness
- Dizziness or lightheadedness
- Blurred vision.
- Sweating.
- Fainting
- Rapid heartbeat or palpitations in the chest
- Shortness of breath
- Chest pain or pressure
- In extreme cases, sudden cardiac arrest.
The appearance of these symptoms does not always mean that a person has a heart rhythm problem.
When to see a doctor:
When there is pain or pressure in the chest.
Complications:
An unrecognized or untreated arrhythmia can cause complications that affect the heart and brain, sometimes life-threatening.
- Cognitive impairment and dementia: Alzheimer's disease and vascular dementia are more common in people with arrhythmias.
- Cardiac arrest: Repeated arrhythmias can lead to a rapid decrease in the ability of the lower chambers of the heart to pump blood.
- Stroke: This can happen in some patients with atrial fibrillation.
- Sudden cardiac arrest: The heart may suddenly and unexpectedly stop beating as a result of ventricular fibrillation.
Diagnosis:
Arrhythmias are carefully evaluated by various symptoms and medical history. The most effective way to diagnose an arrhythmia is an electrical recording of the heart's rhythm called an electrocardiogram (ECG). This may also involve wearing a small, portable ECG recorder for up to 24 hours or longer. This is called Holter monitoring or ambulatory EKG monitoring. Other tests used to diagnose arrhythmias include:
- Cardiac event recorder: A device for recording episodic symptoms over a period of time.
- Electrophysiology (EP): A test to identify problems with the electrical signals in the heart.
- Echocardiogram (echo): An ultrasound examination of the heart.
Treatment:
How to treat an arrhythmia depends on whether the arrhythmia is fast or slow, and any causes of the arrhythmia (such as heart failure) must be addressed. Treatments for arrhythmias include:
- Medicines: to stop or prevent an irregular heartbeat or control the rate of an arrhythmia
- Cardioversion: A treatment that uses electricity to shock the heart and return it to a normal rhythm during anesthesia.
- Treatment of tissues that cause arrhythmias.
- Pacemaker: A small device implanted in the chest that produces electrical signals to do the work of a normal pacemaker.
- Implantable cardioverter-defibrillator: A device similar to a pacemaker that monitors the heartbeat and restores the heartbeat to normal as needed.
Prevention:
It is not always possible to prevent the development of an arrhythmia, although a healthy lifestyle (e.g.: healthy eating, physical activity, achieving a healthy weight, quitting smoking, and managing stress) can reduce the risk of heart disease.
Instructions for patients with arrhythmias:
- Avoid triggers (such as caffeine or stimulant medications) that can make it worse.
- Obtaining an implantable or wearable defibrillator to prevent sudden cardiac arrest from an irregular heartbeat if you have a heart condition.
- Make heart-healthy lifestyle changes (e.g.: healthy eating, physical activity, achieving a healthy weight, quitting smoking, and managing stress).