What is an Arrythmia?
What is an Arrhythmia?
An arrhythmia is an abnormality of the heartbeat. The heart could beat too fast, too slow, skip a beat, or beat irregularly.
Why do Arrhythmias Occur?
A variety of conditions can trigger arrhythmias. Those with heart disease are more prone to arrhythmias, however, some arrhythmias may occur in people with no apparent heart disease. It is important to identify any underlying heart disease, family history of arrhythmias, or role of medications as a cause for an arrhythmia in an individual patient.
What are the Different Types of Arrhythmias?
Arrhythmias are broadly classified based upon their site of origin or abnormality in the heart.
Originating in the atrium:
Sick Sinus Syndrome
Sick Sinus Syndrome (SSS) or Sinus Node Dysfunction results from a malfunctioning SA Node, the natural pacemaker of the heart. It usually presents as an inappropriately slow heart rate and may cause weakness, fatigue, or syncope (fainting). Occasionally, it can present as rapid heart beat, e.g. atrial fibrillation.
SSS occurs due to Hypertension (high blood pressure), Coronary Artery Disease (clogging of the arteries of the heart), or degenerative disease of the node as a result of aging or other unclear reasons. Certain medications, such as beta-blockers or calcium channel blockers, can often cause or worsen the symptoms of SSS.
SSS is easily treated with permanent pacemakers. It accounts for over half of all permanent pacemakers implanted in the United States.
Premature Atrial Contractions (PAC's)
Sometimes, a different site in the atrium starts a cardiac impulse before the normal beat. The natural pause following this early beat gives the patient the feeling of a "skipped beat".
Conditions such as increased caffeine or alcohol intake, stress, or infections can cause PACs. Usually, PACs do not need treatment.
Paroxysmal Supraventricular Tachycardia
(SVT or often called PAT)
This occurs when an abnormal site in the atrium causes a fast heartbeat. Such arrhythmias often start and end suddenly, but may need intervention if they persist.
There are various types of SVT:
1. Atrial Flutter
Atrial flutter is a regular rapid heartbeat (tachycardia) resulting from abnormal circuit in the right atrium (upper chamber). This arrhythmia usually occurs in the setting of an underlying diseased heart. Untreated, atrial flutter can lead to atrial fibrillation, palpitations, shortness of breath, heart failure or fainting (syncope). It is highly curable by radiofrequency ablation.
2. Atrial Fibrillation
Atrial fibrillation is the commonest form of rapid heart rhythm in hospitalized patients in which the heart beats rapidly and irregularly due to the cardiac impulse originating from several abnormal pacemakers in the atria (upper chambers).
While atrial fibrillation can occur in some people without apparent heart disease, it is usually seen in the presence of hypertension (high blood pressure), coronary artery disease, valvular heart disease, or thyroid gland disease.
Atrial fibrillation can potentially cause several problems:
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The rapid heart rate can cause palpitations, shortness of breath, weakness, fainting, heart failure, or ultimately cause weakening of the heart pump.
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Pooling of blood in the atria can cause clots to form in them. These clots can break off, and go via the bloodstream to the brain and other vital organs causing catastrophic events like strokes.
Treatment involves:
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