Arrhythmia

Arrhythmia is any disturbance in the normal rhythm or rate of the heart’s activity. Normally, the heart beats in a regular rhythm at a rate of 60 to 100 beats per minute at rest.

Arrhythmia occurs when the electrical impulses that coordinate heartbeats do not function properly. This can lead to a heart that beats too fast (tachycardia), too slow (bradycardia), or irregularly (irregular rhythm). Most arrhythmias are harmless, but some can be serious and life-threatening.

Types and Causes

Arrhythmias are classified based on where they occur – in the atria (e.g., atrial fibrillation) or in the ventricles (e.g., ventricular tachycardia). The causes can vary, including heart diseases such as ischemic disease, high cholesterol, high blood pressure, previous heart attack, or heart failure. Other factors include stress, excessive caffeine consumption, alcohol, smoking, or certain medications. A common but typically benign form is extrasystoles – premature beats.

Symptoms and Consequences

Symptoms vary significantly. Some people have no complaints, while others experience:

• Palpitations: A feeling of skipping, flipping, or pounding heartbeats.
• Dizziness or light-headedness.
• Shortness of breath and weakness.
• Chest pain.
• In severe cases – fainting or loss of consciousness.

The most serious consequence is the risk of stroke, particularly with atrial fibrillation, as the irregular rhythm can lead to blood clot formation in the heart.

Diagnosis and Treatment

Diagnosis begins with a physical exam and is confirmed through an electrocardiogram (ECG). Holter monitoring (24-hour or longer ECG recording) is often used to capture arrhythmias that do not occur during a short exam.

Treatment depends on the type of arrhythmia, the severity of symptoms, and the presence of underlying heart conditions:

• Medications: Antiarrhythmic drugs are used to restore normal rhythm, and anticoagulants (blood thinners) are used to prevent clot formation and stroke.
• Cardioversion: Electrical shock to restore normal rhythm.
• Ablation: A procedure that uses radiofrequency energy or cryotherapy to destroy a small area of heart tissue responsible for generating irregular impulses.
• Pacemaker or Defibrillator: Implantation of devices that maintain heart rhythm or terminate life-threatening tachycardia.

Synonyms: Arrhythmia, Extrasystoles, Atrial fibrillation