Expert Article: How To Identify If Arrhythmias Are Life-threatening?

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'Arrhythmia' as the name suggests, is something that is not in rhythm. A cardiac (heart) arrhythmia in simple terms means a heart rhythm that is either too fast or too slow.

Normal heartbeat ranges between 60-100 and anything less or more can be considered abnormal. The heart is a very specific organ that functions rhythmically, any non-rhythmic activity is a sign that everything is not ok with the heart.

Cardiac arrhythmias can either be benign (harmless) or life-threatening. The arrhythmias that do not cause any symptoms, or lead to any severe complications are called benign arrhythmias.

Whereas, life-threatening arrhythmias lead to complications such as stroke, heart attack or cardiac arrest. Moreover, arrhythmias can also be asymptomatic or symptomatic. It is crucial to identify where the patient fits into and the potential risks involved if any.

When symptomatic, patients may present with complaints of palpitations, giddiness, discomfort in the chest, shortness of breath, weakness, fatigue, and episodes of fainting. In cases where the heartbeat is too fast loss of consciousness and syncope may also be seen.

Arrhythmias can be caused due to various factors including:

• blockages in the heart vessels (coronary artery diseases)
• structural defects in the heart (valve defects)
• issues with the heart muscle (cardiomyopathy)
• electrolyte imbalance in the body
• excessive caffeine or high-energy stimulant drink intake
• excessive alcohol consumption

Although arrhythmias are common with progressing age, it is important to know that, people of all age groups can have arrhythmias.

• The risk is particularly higher in people with hypertension and diabetes.
• Gender-wise, arrhythmias are more common in men than in women as the male sex hormone testosterone triggers a faster heart rate.

A simple ECG is capable of identifying an arrhythmia. The human heart has four chambers, two upper and two lower, usually, arrhythmias of the upper chambers are benign. However, arrhythmias from the lower chambers may not always be benign and need specific evaluation. A simple ECG may not always suffice.

If an arrhythmia is detected during ECG, it is important to consult a cardiologist. The cardiologist would likely suggest a 24-hour Holter Monitor test. In this test, a small mobile device is connected to your chest that keeps recording your heart activity as you resume your routine work. At the end of 24 hours, the heart activity is assessed for risk quantification.

Other tests a cardiologist might suggest include a stress test, echocardiogram, or cardiac MRI.

Conclusion

Arrhythmias may be asymptomatic or symptomatic, benign or life-threatening. Anybody can get affected, but the risk is particularly higher in people with hypertension and diabetes, or any other established cardiac causes, and age above 70 years.

It is important to consult a cardiologist in case there is a sudden change in the heartbeat pattern (for example - heartbeat raises for a few minutes or hours and returns to normal), to get the risk assessed.