cardiac arrhythmia

Cardiac arrhythmia summary

To explain cardiac arrhythmia well, one should speak of cardiac arrhythmias. In fact, there are several types of arrhythmias, depending on the part of the heart where the arrhythmia occurs and the effect on the heart rate: is it speeding up, slowing down? Is it irregular? Arrhythmias are not dangerous for health and the person can live very well with atrial and ventricular extrasystoles arrhythmias, for example. This is not the case during ventricular fibrillation, where the prognosis may not be favourable. That is, in case of ventricular fibrillation, cardiac massage should be practiced and sometimes the use of a defibrillator to save lives.

The electrocardiogram is a tool used by the cardiologist to see heart function, including the electrical activity of the heart. Anatomically speaking, the heart is a muscle, a pump, which contracts and relaxes to pump blood and push it to the lungs so that it is oxygenated and then distributed to the different organs of the body. These heart contractions occur due to electrical impulses.

There are many treatments for heart rhythm disorders. In cases of bradycardia (decreased heart rate), a possible treatment is the pacemaker. Treatment will be tailored to the cause of each arrhythmia.

Definition

The heart is a muscle whose function is to pump blood throughout the body. The heart can be divided into two parts: the left side and the right side. Each side has two chambers, the atrium and the ventricle. The heart’s contractions respond to nerve impulses given by the sinus node, and this is the heartbeat. A healthy heart beats at a rate of 60-100 beats per minute.

It is important to note that the heart rate is normally accelerated by physical exertion or anxiety, for example. Heart rate also becomes lower than usual in athletes. In athletes, the heart rate can drop to 40 beats per minute. This is explained by the fact that the impulse given by the heart is greater. He is able to pump more blood at once. Thus, for a given volume of blood to be pumped, the athletes’ hearts need to beat less.

There is talk of arrhythmia when the heart rate stops in an unusual way. This is due to a disruption of the electrical impulses that control the heartbeat. The heart can beat very fast (more than 100 beats per minute, characterizing tachycardia) or very slow (below 60 beats per minute, characterizing bradycardia). Fast heartbeat is an arrhythmia. You should also take into account the fact that the rhythm may or may not be regular. An irregular rhythm does not allow the heart to perform its task, and it is as if it is paralyzed.

There are many types of arrhythmias, depending on the part of the heart where they occur (atrium or ventricle) and the effect produced (fast or slow heartbeat). The main arrhythmias are as follows:

Tachycardias: ventricular or atrial fibrillation, atrial flutter, supraventricular tachycardia, sinus or ventricular tachycardia, atrial or ventricular extrasystole, long QT syndrome.

Bradycardia: Sino-atrial node dysfunction and atrioventricular block.

– Atrial fibrillation is the most common type of cardiac arrhythmia. It is, as its name implies, an arrhythmia of the atrium. It is mainly found in the elderly, due to the age of the cardiac system, including that of the tissue that generates the electrical impulse. In atrial fibrillation, the heart beats more than 350 beats per minute and can even go as high as 600 beats per minute. The arrhythmia usually lasts for a few minutes, but it may persist for several hours.

– Ventricular fibrillation is a life-threatening arrhythmia. This time, the arrhythmia occurs in the ventricle, in a disorderly way and there is no regular rhythm. The ventricle has the function of pumping blood and expelling it to the body. When the fibrillation is ventricular, it cannot do its job. In case of ventricular fibrillation, it is necessary to revive the person, since the patient quickly loses consciousness. Then cardiac resuscitation is performed, which is sometimes assisted by a defibrillator.

– Atrial flutter: It is a type of atrial arrhythmia that makes the heart beat at a rate of 300 beats per minute, which is less than atrial fibrillation.

– Supraventricular tachycardia affects younger people and causes heart contractions of less than 200 beats per minute. It is due to improper conduction of the nerve impulse in the heart.

– Sinus tachycardia is an arrhythmia in which the heart rate is greater than 100 beats per minute. In case of stressful situation or consumption of stimulants, this tachycardia is normal.

If not, sinus tachycardia should be investigated by doctors to verify that there is no heart problem.

– Ventricular tachycardia is due to heart disease. This is an arrhythmia of the heart ventricles, characterized by a constant rate of 120 to 250 beats per minute. The main complication of ventricular tachycardia is the occurrence of ventricular fibrillation, which is an emergency.

– Atrial or ventricular extrasystole is characterized by additional contraction. The heart beats against time. Atrial extrasystole occurs in the atrium, while ventricular extrasystole occurs in the ventricle. Note that ventricular extrasystole is more common than atrial. Extrasystoles can appear over time and are not, in themselves, serious. But if its frequency increases dramatically, the doctor will check that there isn’t an underlying health problem.

– Long QT syndrome: in the heartbeat it is possible to divide the functioning of the heart into several parts involving the contraction and relaxation of different parts of the heart. This is an image of the electrical impulse that passes through the heart and is visible on an electrocardiogram. The QT interval is the time between the electrical charge and discharge of the ventricles. These times are, in principle, well defined. However, some medications can have side effects such as QT prolongation, causing a racing and irregular heartbeat. Thus, we must avoid using drugs that have this effect, otherwise drug interactions that cause QT time prolongation can kill the patient.

– Sino-atrial node dysfunction can cause arrhythmia and a decrease in heart rate below 50 beats per minute. As its name suggests, the SA node is disrupted, mainly because of scars in the heart, which replace the SA node. The electrical impulse is thus deflected.

– Atrioventricular block occurs due to poor transmission of contractive nerve impulses to the heart. This time, this transmission acts between the atria and ventricles.

Causes

Cardiac arrhythmias can have several possible causes:

– Congenital malformation.

– Heredity.

– Thyroid problem (hyperthyroidism, hypothyroidism).

– Age (aging).

– Effort (sport, running).*

– Illness (flu, colds).*

– Stress.*

– Emotion, excitement.*

– Use of stimulants: alcohol, coffee, tobacco.*

– Dehydration.

– Heart problems (coronary heart disease, myocardial infarction).

– Problems in other organs (eg pulmonary embolism, bronchopneumonia).

– Use of illicit drugs.

– The side effects of certain medications.

Factors that cause arrhythmias marked by an asterisk (*) can cause heart acceleration naturally. Therefore, we are not going to treat these transitory “arrhythmias”.

In general, different triggers for arrhythmias can cause different types of arrhythmias, such as:

– Age (aging): the older a person is, the worse the electrical conduction by the nervous tissue that innervates the heart. From the age of 60, many people suffer from cardiac arrhythmia and, more often, from atrial fibrillation. Extrasystoles are also largely due to age, but they can also be the result of other heart problems.

– Efforts (sports, running) as well as the consumption of stimulants such as coffee and nicotine can cause arrhythmias. This is sinus tachycardia. Note that sinus tachycardia is also caused by dehydration and stress.

– Heart disease (coronary artery disease, myocardial infarction): the arrhythmia is caused by a poor blood supply to the heart (coronary artery disease), which causes the heart to not work well. Arrhythmias can also be the first sign of a myocardial infarction.

– Emotion, excitement: great emotions can also cause arrhythmias, usually without seriousness. This happens a lot in young people. In this case, the arrhythmia is often of the supraventricular tachycardia type due to a short circuit in the transmission of nerve impulses, causing cardiac contractions.

– Medications: Some medications can cause arrhythmias. This is very important in case of QT interval prolongation and can cause loss of consciousness and death of the patient. Thus, physicians must be very careful not to administer two drugs that prolong the QT interval to the same patient without monitoring the heart’s function carefully.

Groups of risk

There are many causes of arrhythmia, as well as many types. It is therefore understandable that many people can suffer from arrhythmia, in varying degrees of severity.

The people most likely to develop arrhythmias are:

– People are born with a (congenital) heart defect.

– People whose family member suffers or has suffered from arrhythmia (heredity).

– The elderly.

– People with heart disease (congestive heart failure or who have had a myocardial infarction).

– Hypertensive.

– People with diabetes.

– People suffering from thyroid disease (hyperthyroidism).

– Overweight people.

– Dehydrated people.

– People who use illicit or abused drugs.

– People who use drugs with side effect such as QT interval prolongation.

Of course, any other heart defects (congenital, hereditary or acquired) make the heart not work as well. The electrical impulses that cause the heart to contract may be affected and cause dysrhythmias.

Symptoms

The main symptoms of arrhythmia are:

– Fast pulse.

– Slow pulse.

– Irregular heartbeat.

– Palpitations.

– Drop in blood pressure (hypotension).

– Dizziness, vertigo.

– Loss of consciousness (syncope).

– Weakness, fatigue.

– Shortness of breathe.

– Chest pain.

It is important to note that arrhythmias are not always accompanied by symptoms. Whether or not symptoms appear does not indicate the severity of an arrhythmia. Thus, symptoms such as strong palpitations, for example, are not indicative of potentially fatal arrhythmias. Likewise, arrhythmia without symptoms does not mean it is harmless. Therefore, people who detect arrhythmias by measuring blood pressure should talk to their doctor (modern electronic devices exist today that indicate the presence or absence of an arrhythmia).

However, important symptoms such as strong palpitations accompanied by chest pain and sudden arrival should be taken to the emergency room, as there is a risk of myocardial infarction. Myocardial infarction when untreated can be fatal. Likewise, a person suffering from severe palpitations with dizziness should be taken to the doctor.

Diagnosis

Cardiac arrhythmias may or may not be felt by the patient. The main symptoms are palpitations, shortness of breath and fatigue. Depending on the severity of the symptoms, the doctor may go beyond the patient’s medical history and do additional tests to diagnose the severity of the arrhythmia, as well as prescribe medication if necessary.

Sometimes arrhythmias are asymptomatic, making the diagnosis more difficult. Sometimes it is during a routine examination that the doctor can discover the existence of an arrhythmia.

Because there are many causes of arrhythmias, as well as many types of arrhythmias, tests will help your doctor correctly diagnose arrhythmias.

The tests that can be done by the doctor are:

– Analysis of the patient’s symptoms and clinical history.

– Electrocardiogram.

– Echocardiogram.

– The stress test.

– Cardiac Holter.

Electrocardiogram (ECG)

The electrocardiogram is a device that allows you to enhance the electrical activity of the heart.

Echocardiogram

In the echocardiogram, sound waves are used. Just as ultrasound allows you to see the structures of the uterus and baby during a gynecological examination, an echocardiogram will show the structures of the heart.

stress test

Stress testing is also performed with an electrocardiogram, but under conditions of physical stress.

Holter cardiac

The cardiac holter is a portable device, indicated as an extension of the electrocardiogram. The goal is to measure the electrocardiogram for 24 hours straight. The person has the device all day.

Complications

Complications depend on the type of arrhythmia. In fact, when the arrhythmia is in the form of atrial fibrillation, it only affects the atria (the transmission of the electrical impulse is, fortunately, not completely interrupted in the ventricles). The atria contract in such a way that it prevents the blood from flowing normally. In general, atrial fibrillation lasts from a few minutes to a few hours.

Thus, during the period of fibrillation, blood stagnates and can form clots. These clots can cause myocardial infarction, block blood vessels and cause a stroke, when a brain vessel is blocked, for example.

Note that atrial fibrillation is the most common type of arrhythmia. In fact, it mostly affects the elderly, often due to the wear and tear of the heart’s conductive tissue (the tissue that coordinates electrical impulses and therefore prevents the heart from beating). Thus, about 10% of people over 80 suffer from atrial fibrillation.

In case of ventricular fibrillation, the complications are more serious, because the ventricle is responsible for pumping blood from the heart to the organs and, in this case, it cannot perform its function properly. The patient loses consciousness. Then it is necessary to revive the patient quickly with cardiac massage or use of a defibrillator so that the patient does not die.

In summary, complications of arrhythmias include:

– Cardiac insufficiency.

– Loss of consciousness.

– Stroke.

– Embolism (in the lung, for example).

– Syncope.

– Death.

Treatments

There are several types of medications to treat different types of cardiac arrhythmias. The diagnosis of cardiac arrhythmias is important to determine where the cause of the arrhythmia lies. The doctor can then give you the right medication.

Note that even in the presence of arrhythmias, the doctor may not prescribe medication, as some arrhythmias are not always life-threatening and may even go unnoticed.

This is obviously not the case with all arrhythmias, such as ventricular tachycardia, for example, which can be devastating. Thus, the doctor will provide treatment in individual cases and consider whether drug treatment is necessary to reduce very troublesome symptoms that can lead to serious complications.

The drugs used in the treatment of arrhythmia are:

– Beta-blockers.

– Sodium inhibitors.

– Calcium and potassium inhibitors.

– Digoxin.

These medicines will allow the heart to slow down and regain its normal rhythm.

During ventricular fibrillation, we must practice emergency cardiopulmonary resuscitation (also called cardiac massage). It is sometimes necessary to use a defibrillator, a device that is placed on the chest and sends an electrical current to restart the heart.

In cases where bradycardia requires treatment, your doctor may suggest a pacemaker. A pacemaker is a device used to pace the heart by stimulating it with an electrical current.

If arrhythmia is due to nervous causes, it is possible to take hawthorn , an herb that has effects on the heart rate level. The Latin name for hawthorn is “Crataegus”.

Surgery
In some cases of cardiac arrhythmia, surgery may be performed.

Tips

During cardiac arrhythmia, the doctor will prescribe the necessary medications to treat the disease. Thus, an antiarrhythmic drug for one person may not be suitable for another person. It is very important not to let your neighbor advise you, for example.

Some drugs, such as digitalis (digoxin), have a narrow therapeutic range and can quickly become toxic if not used correctly. When drug doses are within the therapeutic range, the dose is effective and non-toxic. When the therapeutic range is wide, there is little risk of poisoning. This is not the case when the therapeutic range is narrow, because you can quickly reach the toxic dose. In these cases, it is very important to have good adherence to treatment, that is, that the patient takes the medication correctly, as prescribed by his doctor. If you forget whether to take your medication that day and inadvertently take two, there is a high risk of drug toxicity.

So, remember how important it is to get the right treatment and especially not to stop without consulting your doctor.

If the effects seem excessive or the treatment is not enough, we must always talk to the doctor to control the medication.

Prevention

Arrhythmia is a heart disease. To reduce your risk of arrhythmia, you need to reduce your risk factors and improve your lifestyle. These are the same recommendations that are given for a healthy heart to prevent heart disease.

Thus, it is advisable:

– Monitor your diet.

– Practice physical activity regularly.

– Avoid stress at work. Practice relaxation.

– Do not smoke.

– Avoid stimulants like coffee and alcohol.

Paying attention to your diet

A good basis for a balanced diet is to follow the recommendations according to the food pyramid. People don’t need to deprive themselves of anything, but it’s important to understand priorities and take care. First, it is very important to stay hydrated. So drinking water, herbal teas and other liquids is ideal. It is also important to respect the three main meals and avoid eating between meals. Food portions must respect the proportions of carbohydrates, proteins and fibers. Vegetables and fruits can be eaten throughout the day. On the other hand, sweets and fats should be limited.

regular physical activity

By physical activity we mean a basic activity such as walking, climbing stairs, gardening or housework. Activity for 30 minutes a day is enough to keep fit. It is therefore evident that one should not practice high-impact sports. From 1 to 2 times a week it is recommended to practice a sport a little more intense, at least 1 to 2 hours.

Stress, smoking, stimulant

By avoiding these three aggravating factors, you avoid overloading the heart, which keeps it clean and fit for a long time. Stress can be reduced by playing sports, relaxing or meditating.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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