When the normal rate or rhythm of heartbeat is disrupted, it is known as cardiac arrhythmia. Heartbeats can be slower or faster during an arrhythmia, and there may also be a missed beat, causing the rhythm to become irregular. Atrial flutter, atrial fibrillations, ventricular fibrillations, premature atrial contractions, premature ventricular contractions, ventricular tachycardiam,and sinus node dysfunction are all types of cardiac arrhythmias that are commonly seen.
While examining a patient with palpitations or shortness of breath, a doctor may discover an arrhythmia during the physical examination, mainly while listening to the heartbeat or feeling the pulse. The doctor may then order cardiac arrhythmia tests to confirm the diagnosis. Diagnostic tests could include blood tests, stress testing through an EKG, or an electrocardiogram may be done immediately on arrival to monitor the rhythm of the heart. Blood tests help to monitor the level of potassium and thyroid hormones in the blood as variations in these could cause arrhythmia. Echocardiography is used to get information on the functioning of the heart’s valves and the flow of blood to the heart.
Chest X-ray can highlight an enlarged heart. An electrophysiology study (EPS) may be done to record the electrical signals in the heart to check for arrhythmia. Tilt table testing is done on patients who have symptoms of dizziness along with arrhythmia. The physician may order an ankle/brachial index test to be performed if he/she suspects arthrosclerosis or plaque build-up and hardening of arteries to be the cause of the heart problem and arrhythmia. A computed tomography scan may also be done to check for heart problems that could be the cause of the arrhythmia.
Coronary artery disease, scarring of heart tissue caused by a heart attack, high blood pressure, diabetes, smoking, and stress are some of the common cardiac arrhythmia causes. Atrial fibrillation or flutter caused by tachycardia in the atria can be due to high blood pressure. Heart block or atrio-ventricular block could lead to a slow heart rate because the transmission of electrical impulses is delayed. Sick sinus syndrome, where the sinus node that regulates the pace of heart rate is affected, can lead to arrhythmia. When the heart rate picks up speed, accompanied by shortness of breath and dizziness and the condition lasts for a short period of time, it is called paroxysmal supraventricular tachycardia. Caused by alcohol or drug abuse, smoking, or stimulants like caffeine, this condition is more common among young people. Multifocal atrial tachycardia is a condition with a rapid heart rate caused by an excess of electrical impulses sent from one part of the heart to another, usually from the upper chambers of the heart to the lower chambers. Ventricular tachycardia, on the other hand, is a fast heartbeat caused by disruption of electrical impulses from the ventricles. Left untreated, it could lead to ventricular fibrillation, a life-threatening condition that lowers blood pressure and disrupts blood supply to vital organs of the body.
Among the main symptoms of arrhythmia are heart palpitations or a fluttering in the heart. People describe it as an unpleasant awareness of the heart beating very fast, as if it was pounding or racing. Premature heartbeats that occur often or in rapid succession may be due to premature atrial contractions, and they are considered quite harmless. Sometimes, premature beats may be caused by ingesting caffeine or even cold and asthma medication. Chest pain and pressure, difficulty in breathing or rapid breathing, and dizziness are serious symptoms that need urgent medical attention. It should also be remembered that not everyone with arrhythmia needs medication or has a serious heart problem. It is also true that there may be no noticeable symptoms in some people who have arrhythmias that may be life threatening. If, along with an irregular heartbeat and shortness of breath, fainting or change in level of consciousness or lethargy is noticed, it is best to get medical attention and get an electrocardiogram done to rule out cardiac problems. Rapid heart rate (tachycardia) is normal during exercise as the heart pumps more oxygen rich blood to meet the demand from the body. Tachycardia can occur in the atria or in the ventricles. Slow heart rate (bradycardia)is a condition where the heartbeat rate is below 60 a minute, and the arrhythmia may be caused by sick sinus syndrome. Heart block causing failure in the transmission of electrical signals to all parts of the heart can also lead to a slow heart rate. Low blood pressureand confusion or loss of consciousness for even a brief moment could also be due to this condition.
Cardiac arrhythmia treatment is necessary only when the symptoms like chest pain and dizziness are severe and when the arrhythmia increases the possibility of serious heart problems or a stroke. Medications known as antiarrhythmics are prescribed to stabilize a fast heart beat to a normal level. Surgery to install a pacemaker is common in the case of those with slow heartbeats. Other treatments include the implantation of a defibrillator for those with a risk of ventricular fibrillation to deliver an electric shock to the heart so that it resumes a normal heart beat when there is a life threatening arrhythmia. If the arrhythmia is caused by coronary artery disease, a coronary bypass surgery may be advised.