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Arrhythmia: Causes, Symptoms, Diagnosis And Treatment

Everyone might have experienced an abnormal heart rate at least once and it is usually felt as the heart is racing or fluttering. Arrhythmia or irregular heartbeat is common and generally doesn't cause a problem until and unless it interferes with the blood flow in the body causing damage to the lungs, brain, and other organs. If arrhythmia isn't treated on time, it may be life-threatening.

What Causes Arrhythmia

Arrhythmia, also known as irregular heartbeat or cardiac dysrhythmia, is a heart disorder that affects the rhythm at which the heart beats. It occurs when the electrical impulses, which regulate heartbeats don't function properly, causing the heartbeat to be irregular, too slow or too fast. It can sometimes lead to stroke or cardiac arrest [1] .

Other causes of arrhythmia:

  • High blood pressure
  • Diabetes
  • Hyperthyroidism
  • Hypothyroidism
  • Congestive heart failure
  • Drug abuse
  • Mental stress
  • Alcohol abuse
  • Smoking
  • Drinking too much caffeine
  • Stress
  • Sleep apnoea
  • Scarring of heart tissue from a previous heart attack
  • Coronary artery disease
  • Certain medications and supplements

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Types Of Arrhythmia

  • Atrial fibrillation - When the atria (the upper chambers of the heart) contract irregularly [2] .
  • Bradycardia - When the heart rate is slow and is below 60 beats per minute [3] .
  • Tachycardia - When the heart rate is fast and is more than 100 beats per minute [4] .
  • Ventricular fibrillation - When the heartbeat is rapid, erratic and disorganized leading to unconsciousness and sudden death [5] .
  • Premature contraction - It is characterized as an early heartbeat which originates in the heart's upper and lower chambers [6] .

Symptoms Of Arrhythmia [7]

Some patients don't have any symptoms, but during an ECG, arrhythmia can be detected. The symptoms depend on the type of arrhythmia which are the following:

Symptoms of atrial fibrillation

  • Dizziness
  • Palpitations
  • Breathlessness
  • Chest pain
  • Fainting
  • Weakness
  • Symptoms of bradycardia
  • Chest pain
  • Dizziness
  • Confusion
  • Having trouble in concentrating
  • Difficulty when exercising
  • Fatigue
  • Shortness of breath
  • Lightheadedness
  • Sweating
  • Symptoms of tachycardia
  • Dizziness
  • Chest pain
  • Fainting
  • Breathlessness
  • Fluttering in the chest
  • Sudden weakness

Symptoms of ventricular fibrillation

  • Fainting spells
  • Dizziness
  • Palpitations
  • Fatigue
  • Chest pain
  • Shortness of breath
  • Premature contraction often doesn't cause any symptoms, however, when they occur it feels like a skipped beat sensation in the chest.

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Risk Factors Of Arrhythmia [8]

Some factors increase the risk of arrhythmia, which include the following:

  • High blood pressure
  • Coronary artery disease
  • Thyroid problems
  • Congenital heart disease
  • Diabetes
  • Electrolyte imbalance
  • Drinking excess caffeine and alcohol
  • Sleep apnoea

Complications Of Arrhythmia

  • Stroke - When the heartbeat is abnormal, the heart is unable to pump blood properly and this causes blood clots to form. If a blood clot leaves the heart and travels to the brain, it can block an artery. This prevents oxygen from reaching the brain, thus causing stroke.
  • Heart failure - Atrial fibrillation can lead to heart failure.

Diagnosis Of Arrhythmia [9]

The doctor will first ask about your symptoms and your medical history and conduct a physical examination. The doctor will then perform other tests which are as follows:

  • Electrocardiogram (ECG) - Sensors are attached to your chest to detect the electrical activity of your heart. ECG measures the timing and duration of each electrical activity in your heart.
  • Echocardiogram - A hand-held device is placed on your chest which uses the sound waves to show images of your heart's structure, size and motion.
  • Holter monitor - It is a portable ECG device which records your heart's activity as during your daily routine.
  • Event monitor - It is another ECG device attached to your body which allows you to press a button when you have symptoms. This lets your doctor know your heartbeat when the symptoms occur.

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Treatment Of Arrhythmia

The treatment methods are as follows.

  • Cardioversion - If you have atrial fibrillation, the doctor may use cardioversion to restore your normal heart rhythm. In this procedure, the doctor places electrodes on your chest to send electric shocks to the heart [10] .
  • Pacemaker - It is an implantable device that is placed under the skin of the chest or abdomen to control the irregular heartbeat. Pacemakers use electrical pulses that trigger your heart to beat at a normal rate [11] .
  • Catheter ablation - The doctor threads one or more catheters through the blood vessels of your heart to ablate (stop) the abnormal electric pathways that cause arrhythmia [12] .
  • Medications - Certain medications are prescribed by the doctor to control your heartbeat or restore a normal heartbeat.
  • ICD (Implantable Cardioverter-Defibrillator) - The device is implanted under the skin near the collarbone. Once it detects an abnormal heartbeat, it transmits low or high energy shocks to bring the heart back to normal rhythm [13] .
  • Coronary bypass surgery - The treatment is done to improve the blood flow to the heart [14] .
  • Maze procedure - The doctor will make a series of surgical incisions into the heart tissue to create a maze of scar tissue. As scar tissue doesn't carry electricity, they stop the stray electrical impulses from causing atrial fibrillation and thereby, preventing arrhythmia [15] .

Prevention Of Arrhythmia

View Article References
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  5. [5] Lown, B., & Verrier, R. L. (1976). Neural activity and ventricular fibrillation.New England Journal of Medicine,294(21), 1165-1170.
  6. [6] OTTO, H. L., & GOLD, H. (1926). PERSISTENT PREMATURE CONTRACTIONS: A CLINICAL STUDY.Archives of Internal Medicine,38(2), 186-205.
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  8. [8] Gatzoulis, M. A., Balaji, S., Webber, S. A., Siu, S. C., Hokanson, J. S., Poile, C., ... & Webb, G. D. (2000). Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study.The Lancet,356(9234), 975-981.
  9. [9] Martins, J. L., Fox, K. F., Wood, D. A., Lefroy, D. C., Collier, T. J., & Peters, N. S. (2004). Rapid access arrhythmia clinic for the diagnosis and management of new arrhythmias presenting in the community: a prospective, descriptive study.Heart,90(8), 877-881.
  10. [10] Botkin, S. B., Dhanekula, L. S., & Olshansky, B. (2003). Outpatient cardioversion of atrial arrhythmias: efficacy, safety, and costs.American heart journal,145(2), 233-238.
  11. [11] Stieber, J., Hofmann, F., & Ludwig, A. (2004). Pacemaker channels and sinus node arrhythmia.Trends in cardiovascular medicine,14(1), 23-28.
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Story first published: Thursday, October 31, 2019, 20:00 [IST]
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