What is arrhythmia and why it is a cause for concern
As Reported On health.india.com
December 19, 2013 at 1:49 pm
When your heart ‘skips a beat’ it might not be just a sign of excitement or nervousness, it could actually mean much more than that. Our heart beats a hundred thousand times a day – and that’s when it beats normally. There are times when the heart beats either too slowly, or too fast, or irregularly leading to a condition called arrhythmia.
Extremely common in today’s day-and-age, one of the most common symptoms of this condition is a fluttering feeling in the chest or neck.
A normal heartbeat ranges from 60 to 100 beats per minute while at rest, but in conditioned athletes, it may be as low as 60 beats per minute. This number may go up or beyond 100 beats if you are exercising.
If you are not a conditioned athlete and your heartbeat is less than 60 beats per minute, you are probably having arrhythmia called bradycardia. In the same way, if you are at rest and your heart rate is greater than 100 beats a minute, the arrhythmia is called tachycardia.
If this fluctuation in the heart rate is severe or lasts long enough — so that it affects how well the heart works — the heart may not be able to pump enough blood to the body. Leading you to feel tired, lightheaded or may make you pass out.
Know your heart
Your heart is like a well-oiled machine, it is divided into a left and right side by a muscular wall called the septum, and each section performs its own unique function.
Each side has two chambers – the upper one called the atrium and the lower one called ventricle. The atrium and ventricle are connected by a valve called mitral valve. This valve acts as a one-way portal, allowing blood to pass from the atria to the ventricles, and then closing to prevent back flow of the blood.
The blood picks up oxygen in the lungs and reaches the left atrium from where it is sent to the left ventricle and then to the body.
The cells use the oxygen and send the deoxygenated blood back to the right atrium. It then sends it to the right ventricle and from there into the lungs. This process is repeated non-stop while you live.
The atria and ventricles work together as a team to pump blood through the heart. A heartbeat is the pumping action that moves blood into the heart and out of the heart. It is triggered by special tissue, called the sinus node. This acts like a pacemaker for the heart and sends electrical impulses, causing the atrium to contract. Another cluster of cells in the region between the atrium and ventricle slow down the electrical signal giving sufficient time to atrium to pass the blood into ventricle. Finally, the signal reaches another group of specialised cells that tell the ventricle to contract. So, one heartbeat is a collection of all these signals. Now imagine that happening non-stop for the rest of your life!
Arrhythmia is fairly subjective and so are the symptoms. That being said, the common symptoms of arrhythmia are, bradycardia (slow heartbeat), tachycardia (fast heartbeat), or fluttering, shortness of breath, chest pain, lightheadedness or dizziness, fainting or feeling faint.
One might feel these symptoms intermittently and it might not mean that something is gravely wrong, but if these symptoms occur suddenly and frequently, you should see a doctor immediately.
More serious forms of this condition are:
One of the most deadly types of arrhythmia is ventricular fibrillation. Here, the ventricles begin to quiver instead of pumping blood. Because there is no effective heartbeat, blood pressure drops drastically cutting off blood supply to the organs leading to collapse and cardiac arrest. Death ensues if the person does not get medical attention immediately.
Another type is atrial fibrillation, which occurs when there is arrhythmia in the atrium. It’s a common type of arrhythmia where the electrical impulses becomes uncoordinated making your heart beat as fast as 300 times per minute. Atrial fibrillation can also be dangerous as the blood pools in the atrium because it doesn’t pump all the blood into the ventricle. This causes a blood clot (thrombus) to form. The clot can break off and travel to another part of the body leading to severe complications like a stroke.
Another complication of atrial fibrillation is heart failure. It occurs when the heart can’t pump enough blood to meet the body’s needs. Fatigue, shortness of breath, and fluid retention are common symptoms of this condition.
Know the triggers
Certain cardiovascular disorders such as CAD (coronary artery disease), cardiomyopathy, high blood pressure, a previous heart attack, and a recent heart attack, can all lead to arrhythmia. Apart from that, arrhythmia can also be caused due to diabetes, hyperthyroidism, stress, alcohol and drug abuse, smoking, certain medicines, dietary supplements and herbal treatment, air pollution and electric shock.
The steps to diagnosis
Before treating your arrhythmia, the doctor will first ask about any triggers you might have like heart disease or thyroid problem. After that he/she will try to find out where the arrhythmia starts in the heart and whether it’s abnormal through some diagnostic tests such as and ECG(electrocardiogram), Holter monitor, echo electrocardiogram, stress test where you will be asked to exercise on a treadmill or stationary bicycle while your heart activity is monitored), tilt table test (where you are asked to lie flat on a table and the table is then tilted as if you were standing up. Your doctor will observe how your heart responds to the change in angle) and electrophysiological testing and mapping (where your doctor will insert catheters in various parts of your body. At the tip of these catheters are electrodes that will collect information about your heart’s electrical impulses).
The method of treatment will depend on your age, if you have any pre-existing conditions, your family history, medications you might be taking, as well as the severity and symptoms of your arrhythmia.
There are a number of treatment options:
- Your doctor will ask you to make lifestyle changes that will keep your heart healthy. You may be advised to eat heart-healthy foods, exercise regularly, increase physical activity and cut down on stress, alcohol and caffeine.
- You may be advised to have certain medication, that when taken exactly as per prescription can help prevent heart attack, stroke, and prevent the progression of coronary artery disease. There are 4 types of medicines to treat arrhythmia: anti-arrhythmic drugs such as lidocaine, propranolol, etc. calcium channel blockers such asamlodipine and diltiazem beta blockers such as acebutolol and metoprolol to decrease heart rate anticoagulants or blood thinners (in addition to other medicines) such as aspirin and warfarin to make it harder for the blood to clot and to prevent stroke.
- Apart from the medication, there are minimally invasive methods such as cardiac ablation which can treat many types of arrhythmias. The procedure destroys or ablates specific cells in your heart that cause your arrhythmia.
- In case you suffer from atrial fibrillation, defibrillation is a procedure for you. In this, a mild electric shock is given to the heart to re-establish normal contraction rhythms of the heart.
- Implantable devices such as pacemaker for bradycardia and implantable cardioverter-defibrillator (ICD) for ventricular arrhythmias may also be used for treatment.
- Apart from all this there are surgeries to help ease your troubles, namely the maze procedure (here a number of incisions are made on the walls of the left and right atrium. These incisions form scar tissues that disrupt the uneven electrical impulses) and coronary bypass surgery.
Some arrhythmias may be life-threatening if not treated right away, so do not ignore your symptoms even if they seem harmless. Let your doctor be the judge of it.