Arrhythmia – Symptoms, Causes and Treatment

What is arrhythmia?

An arrhythmia is a abnormal or irregular rythm the heart in which heartbeat became either too fast or too slow.

It occurs when electrical impulses that direct and regulate heartbeats don’t work properly. This makes the heartbeat:

  • too fast (tachycardia)
  • too slow (bradycardia)
  • too early (premature contraction)
  • too irragularly (fibrillation)

Almost everyone will experience an abnormal heart rhythm at least once in their life time. It may feel like your heart is racing or fluttering.

Arrhythmias are common and generally harmless, but some can cause serious complications. When an arrhythmia interferes with blood flow to your body, it can damage your:

  • brain
  • lungs
  • other vital organs

Arrhythmias can be life threatening if left untreated.

Symptoms

You may not experience any symptoms of an arrhythmia. However, commonly experienced symptoms can include:

  • feeling like your heart skipped a beat
  • a fluttering or racing feeling in your neck or chest
  • fast heartbeat
  • slow or uneven heartbeat

Consult your doctor about your symptoms so they can effectively diagnose and treat your arrhythmia. You may also develop more severe symptoms from your heart not working properly, such as:

Look up for medical care immediately if you face any of these symptoms. Find out more about arrhythmia symptoms and when to seek care.

Causes

Causes of arrhythmias can be  medical, physical, emotional, or genetic. There are some unknown Causes.

Some medications like antibiotics and other medications that can stimulate arrhythmia in some individuals. These may include medications that treat:

Changes in blood flow or physical alterations to the heart, such as shock scarring or stress can also lead to arrhythmia. Other medical conditions may also be the source which include:

Other physical or lifestyle factors can also lead to arrhythmia in some cases. These include:

  • exercise
  • coughing
  • emotions factors like anger, stress, or fright
  • alcohol intake
  • smoking

Treatment

Arrhythmias usually don’t require particular treatment, but it is necessary to  medically assess your arrhythmia evaluated to know if you do or don’t.

Your doctor will evaluate whether your arrhythmia may cause more severe symptoms or other conditions when determining on treatment options.

It’s necessary to exercise, follow a healthy diet, and control your blood pressure and cholesterol levels when you have arrhythmia. This can reduce your risk for problems like a heart attack or stroke.

If you feel a rapid heart rate without any other symptoms, your doctor may recommend that you try vagal maneuvers. They can cause your vagus nerve to lower your heart rate. Vagal maneuvers include:

  • soaking your face with cold water
  • coughing
  • gagging
  • holding your breath during straining

Other treatments for arrhythmia include medication and surgery.

Medication

Your doctor may give you medication to help you control your arrhythmia and prevent conditions like a heart attack.

Most of the medications come in the form of pill, but some come in the form if intravenous injections  for use during an emergency.

The medication they recommend depends on the type of arrhythmia along with other conditions you may have. Common types of medication are:

  • Antiarrhythmic drugs. These can treat tachycardia(fast heart beat) and premature heartbeats. They include amiodarone, lidocaine, quinidine, and more. However, they may lead to the troublesome side effect proarrhythmia, which can aggravate your arrhythmia or cause a new arrhythmia.
  • Calcium channel blockers. Calcium channel blockers, which include amlodipine,verapamil, nifedipine and more.aThey help in lowering your blood pressure and heart rate. They can be used for long term.
  • Beta-blockers. Beta-blockers  lowers your heart rate to treat tachycardia. Beta-blockers include acebutolol, bisoprolol, nadolol and others.
  • Anticoagulants. Anticoagulants  help prevent blood clots, which can occur because of atrial fibrillation. Blood-thinning medications like hiparin, warfarin,dabigatran , and more. A side effect may be severe or internal bleeding.

Make sure to take all medications as prescribed by your doctor and discuss about any side effects you are experiencing , particularly proarrhythmia.

Find out more about medications for arrhythmia.

Surgery

If medication or other treatments aren’t able to treat your arrhythmia, you may require a minor procedure or surgery. Several procedures and implantable devices are available which can help treat arrhythmia:

  • Catheter ablation: During catheter ablation, your cardiologist inserts flexible tubes called catheters through your blood vessels to the right area of your heart. An electrode at the end of one of the catheters releases radiofrequency waves, heat, or very cold temperatures to make a small scar. The scar tissue blocks the electrical waves that leads to arrhythmias.
  • Pacemaker: Your doctor can implant a pacemaker during a small surgery. After making a small cut near your shoulder, they insert small wires through your veins and place them in your heart. The wires connect to a small battery-powered generator transported near your clavicle(collerbone). If the generator observes an irregular heart rhythm, it can send an electrical pulse through the wire to help manage it.
  • Implantable cardioverter defibrillator (ICD): An ICD is similar to a pacemaker and may be implanted near your clavicle, sternum (breastbone) or ribs. It may help if your arrhythmias are very dangerous or life threatening or put you at risk of cardiac arrest. An ICD can send electric shocks to your heart to make its rhythm normal or resume your heart if it stops beating.

Surgery can also treat severe types of arrhythmias, such as atrial fibrillation.

In the maze procedure, your surgeon makes minor cuts on the upper half of your heart to create scar tissue. The scars block electrical activity that can cause abnormal heart rhythms.

Types

Arrhythmias are named and classified  on the basis of three points:

  • rate (whether it is very slow or very fast)
  • origin (whether it’s in the ventricles or the atria)
  • regularity

In a normally beating heart, electrical impulses follow the right pathways through the heart. These signals synchronize the activity of the heart muscle so that blood pumps in and out of the heart.

Any disturbance in these pathways or impulses can lead to the irregular heartbeat, resulting in an arrhythmia. These can begin in the sinus node, the ventricles (the heart’s lower chambers), or the atria (the upper chambers).

A premature heartbeat can also sometimes cause irregular heartbeat.

Premature heartbeats feel like your heart has skipped a beat. In actuality, your normal heart rhythm has been interfered by a too-early beat, and you’re experiencing an extra beat between two normal heartbeats.

Sinus arrhythmia

The sinus node uses electrical impulses to help control the rythm of your heartbeat. If your sinus node doesn’t delivers the impulses appropriately, your heart may pump too slowly or irregularly. This results in sinus arrhythmia.

There are two types of sinus arrhythmia:

Sinus arrhythmia is one type of sick sinus syndrome, a group of disorders associated with the sinus node.

Scarring near the sinus node because of heart disease or a heart attack may reduce or block the electrical impulses as they travel through the heart. This can lead to an arrhythmia and other disorders.

Sinus arrhythmia is a common condition in many people. However, it may lead to heart complications for some people.

Learn more about sinus arrhythmia.

Ventricular arrhythmia

Ventricular arrhythmia starts in the ventricles, or the lower chambers, of the heart.

There are two types:

  • ventricular tachycardia
  • ventricular fibrillation

Both may need to be treated urgently, particularly if you have other heart conditions.

Ventricular tachycardia (VT) usually happens in people who have had heart disease or heart-associated problems, like coronary artery disease or a heart attack. It can lead to a heart rate of 170 beats per minute or more.

VT is dangerous when it lasts more than a few seconds. It may also lead to more severe ventricular arrhythmias, such as ventricular fibrillation.

Ventricular fibrillation (VF) includes immediate, quick, irregular, and chaotic heartbeats in the ventricle. These irregular electrical impulses, sometimes triggered by a heart attack, cause your heart’s ventricles to tremble.

When you have this kind of arrhythmia, your ventricles can’t pump blood into your body, and your heart rate slows down suddenly. This can lead to sudden cardiac arrest and death without urgent treatment.

Atrial arrhythmia

Atrial arrhythmias, also called supraventricular arrhythmias, start in the atrium or upper chamber of the heart. They include:

  • supraventricular tachycardia
  • atrial fibrillation
  • atrial flutter

Supraventricular tachycardia (SVT) includes different forms of arrhythmias that starts above the ventricles. SVTs are generally recognized by a burst of rapid heartbeats that may start and end quickly.

These bursts can last a few seconds or many hours and may lead your heart to beat more than 160 times per minute. The most common SVTs are:

  • atrial fibrillation
  • atrial flutter

If you have atrial fibrillation, also known as AF or AFib, your atria beat very fastly as around 400 beats per minute. The atria move so quickly that they aren’t able to contract completely. Instead, they quiver, or fibrillate.

Your risk of developing AF increases past age 65 and if you have other medical conditions. AF can cause more serious conditions, such as stroke if not treated property.

In atrial flutter (AFl), the heartbeats are more rhythmic and regular than in atrial fibrillation. You may not experience any symptoms with either type of arrhythmia.

Atrial flutter is most common in people with heart disease, though it’s less common than AF. It also often noticed in the first weeks after heart surgery. Like AF, atrial flutter can be very serious or fatal.

Arrhythmia vs. dysrhythmia

Dysrhythmia is another word for arrhythmia. While there’s a little medical distinction between the two, generally both are used interchangeably to refer to an uneven heartbeat.

ECG

An electrocardiogram, also called an ECG or EKG, is usually used to diagnose arrhythmia. Your doctor fixes electrodes to your chest, arms, or legs that measure and graph your heart’s electrical activity.

ECG measurements tell if the electrical activity is atypically fast, slow, or irregular. The test can also reveal if your heart is enlarged or has decreased blood flow.

Your doctor may perform an ECG while you are at rest or when you are practicing exercise on a stationary bicycle or treadmill. A portable monitor can also take ECGs to check abnormalities over a longer period of time.

ECGs have slight or no risk.

Diagnosis

To diagnose arrhythmias, your doctor can ask for:

  • your medical and family history
  • physical exam
  • a range of tests to diagnose arrhythmias

Along with an ECG, your doctor may also perform a chest x-ray or echocardiography to check:

  • the shape and size of your heart
  • the condition of the valves that help control the flow of blood through your heart

Since arrhythmias can be uneven and may not occur while you’re at the doctor’s clinic, your doctor may have you use a heart monitor at home. Types of monitors are:

  • Holter monitor. holter monitor is a transportable monitor that records your heart’s rhythm over the period of one or two days.
  • Event recorders. Event recorders are handheld monitors that can be used to record your heartbeat when you feel an abnormality or irregularity.
  • Implantable loop recorder. Your doctor may implant a loop recorder under your skin to constantly monitor your heartbeat and record unusual arrhythmias.

Other tests can also determine for an arrhythmia in various situations. These include:

  • Stress test. A stress test helps your doctor to monitor your heartbeat during your exercise to see if exertion leads to an arrhythmia. They can also use medication to increase your heart rate for the test if you have difficulty exercising.
  • Sleep study. A sleep study can show whether sleep apnea is the reason behind your arrhythmia.
  • Tilt table test. A tilt table test may be used if your arrhythmia has caused you to faint in the past. Your doctor will check your heart rate and blood pressure as you lie on a table that’s tilted between different positions.
  • Electrophysiological testing. Your doctor will insert thin electrode catheters through your veins to different areas on your heart to map electrical signals during electrophysiological testing. The electrodes can also lead to arrhythmias, which may help your doctor diagnose them and recomend treatments.

Your doctor may also perform blood tests to check the level of magnesium, calcium, thyroid hormone, and other substances in your blood that may affect arrhythmia.

Prevention

Arrhythmias can occur from a variety of causes, some of these Causes may can’t be prevented. Still, you can work to avoid triggering your arrhythmia or making it worse.

First, it is necessary to know the cause of your arrhythmia so you can avoid triggers. Some triggers can be prevented which include:

  • stress or anxiety
  • smoking
  • caffeine
  • alcohol
  • certain medications
  • some street drugs

Consult your doctor if you think any medications are causing your arrhythmia. Don’t make any chnage in your medication on your own.

A healthy lifestyle is also helpful for preventing or controlling arrhythmia. Make an effort to:

  • follow a healthy diet with low salt and fat
  • if you smoke, quit smoking
  • exercise constantly
  • maintain a range of healthy weight
  • limit stress
  • reduce alcohol intake
  • maintain healthy blood pressure and cholesterol levels

Develop a plan with your doctor to help you control your arrhythmia, including steps you can follow regularly when you experience symptoms.

Risk factors

Your family history, health conditions, age, lifestyle, mental status and more can be cause for developing arrhythmia.

Medical conditions or events, especially ones associated with your heart, may increase your risk. They include:

Other common risk factors include:

  • older age
  • certain medications, mainly stimulants and antihistamines some of which can be found over the counter
  • air pollution
  • family history of arrhythmia
  • caffeine
  • alcohol
  • smoking
  • street drugs, especially cocaine or amphetamines

Lifestyle changes may help reduce your risk of having an arrhythmia.

Complications

Different types of arrhythmias, particularly when not treated, may cause life threatening complications. These complications include:

  • heart failure
  • stroke
  • dementia(loss of cognitive functions)
  • cardiac arrest
  • arrhythmias that worsen over time or lead to other symptoms

2014 study suggested that several conditions, including arrhythmia, were strongly related to dementia in adults older than 64 years of age.

Home remedies for arrhythmia

Making lifestyle changes at home, including practicing regular exercise and taking healthy diet, can help improve your heart health and help you control arrhythmia.

Other alternative or complementary treatments may help manage your arrhythmia, though more research is required. A 2013 study found that yoga lowered atrial fibrillation episodes and improved blood pressure and anxiety.

Acupuncture may also be useful for the treatment for arrhythmia, according to a 2017 research review. However, the review noted that current research is confined.

Two research reviews published in 2017 indicated that magnesium and vitamin C supplements may decrease or prevent atrial fibrillation after heart surgery.

Still, there wasn’t enough confirmation to suggest supplements for other arrhythmias.

Discuss any alternative treatments, particularly about supplements, with your doctor.

There are several types of heart arrhythmias. Most are not dangerous, and nearly everyone has an arrhythmia at one time or another. Usually they are not noticed.

It’s also normal to have an increased heart rate while exercising, when your heart is working hard to provide your tissues with oxygen-rich blood so you don’t get tired too fastly.

Some arrhythmias are not harmless, though and some can be life threatening.Your outlook depends on the type and seriousness of your arrhythmia. If you think you have an arrhythmia, talk to your doctor.

Even the most severe arrhythmias can often be treated successfully. Most people with arrhythmia can live a normal life.

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