A cardiac arrhythmia, commonly referred to as a heart rhythm disorder, is a condition where the heart exhibits irregular beats. These irregularities stem from the improper or irregular transmission of electrical signals governing the heartbeat. Arrhythmias occur as a fast, slow, or irregular heartbeat and are usually considered benign. Nonetheless, there are instances where cardiac arrhythmias can lead to highly grave repercussions, significantly impacting one’s quality of life or, in the worst cases, posing a mortal threat. The evaluation and treatment of heart rhythm disturbances are within the domain of healthcare practitioners specialized in the realm of cardiology clinic.
What is a Heart Rhythm Disorder (Arrhythmia)?
Arrhythmia, also acknowledged as heart rhythm disorder, denotes the presence of irregular heart rhythms. This anomaly arises when the heart’s electrical signals fail to operate correctly, resulting in a heartbeat that can manifest as swift, sluggish, or erratic. In the domain of heart rhythm irregularities, the heart might portray tachycardia (excessive speed), bradycardia (unusually slow rate), or irregular sequences. Most arrhythmias, affecting approximately 1.5% to 5% of individuals, are usually considered harmless. However, there exist specific variations that carry severe consequences, potentially presenting life-threatening risks. An arrhythmia has the potential to hinder the heart’s effectiveness in distributing blood throughout the body, resulting in indications like breathlessness, fainting, loss of consciousness, and, in the gravest circumstances, abrupt fatality.
Occasionally, you may come across the term dysrhythmia employed in lieu of arrhythmia. It’s essential to clarify that there’s no distinction between these two expressions; they both signify an irregular or abnormal heartbeat. It’s also a pertinent moment to touch upon the concept of a resting heart rate, which is regarded as a standard and healthy parameter. In the case of most adults, a heart rate ranging between 60 to 100 beats per minute is deemed as the standard. If you happen to notice an irregular heartbeat, it’s prudent to promptly seek guidance from a healthcare professional to uncover the root cause and consider potential steps forward.
Symptoms of Arrhythmia
Arrhythmias may often be asymptomatic and are typically identifiable by your physician during a routine check-up.
Recognizable symptoms of arrhythmia include:
- Palpitations in the chest area
- Rapid heartbeat (tachycardia)
- Slow heartbeat (bradycardia)
- Chest pain
- Shortness of breath
- Fatigue and weakness
- Feeling dizzy or lightheaded
- Fainting (syncope) or near fainting.
Other arrhythmia symptoms include:
- Anxiety
- Blurred vision
- Sweating
- Difficulty focusing.
What Causes Heart Rhythm Disorder?
While coronary artery diseases and elevated blood pressure stand as the primary culprits behind cardiac arrhythmias, viral infections, alcohol and tobacco usage, strenuous physical exertion, excessive caffeine intake, as well as anxiety and stress, all contribute to the spectrum of factors that can trigger irregular heart rhythms. The causes of heart rhythm disorder can be listed as follows in general:
- Problems with electrical signals inside the heart
- Imbalance of electrolytes in the blood
- Coronary artery disease
- Heart diseases
- Heart attack
- Cardiomyopathy
- Recovery after heart surgery
- High blood pressure
- Changes in hormone levels
- Diabetes
- Covid 19 and infection
- Hyperthyroidism or hypothyroidism
- Some medicines, including antidepressants, decongestants, high blood pressure, some cold and allergy medicines
- Sleep apnea
- Substance abuse
- Excessive alcohol, smoking, and caffeine consumption
- Genetic factor
- Stress or anxiety.
Heart Rhythm Disorder Risk Factors
Several factors can elevate the likelihood of experiencing arrhythmia. These encompass the subsequent conditions:
- Heart disease and previous heart surgery: Narrow heart arteries, heart attack, abnormal heart valves, heart failure, cardiomyopathy and other heart damage are risk factors for arrhythmia.
- High blood pressure: High blood pressure increases the risk of developing coronary artery disease.
- Congenital heart disease: Being born with a heart abnormality can affect the rhythm of your heart.
- Thyroid problems: Having an overactive or underactive thyroid gland can increase the risk of arrhythmias.
- Uncontrolled diabetes
- Obstructive sleep apnea: This disorder in which you stop breathing during sleep can increase your risk of bradycardia, atrial fibrillation, and other arrhythmias.
- Age: The risk of developing arrhythmias increases with age.
- Lifestyle: Caffeine, nicotine, alcohol, and other stimulants can make your heartbeat faster and contribute to the development of more serious arrhythmias.
- Environment: Things in your environment, such as air pollution, can increase the chance of arrhythmias.
- Genetics: You may be more likely if you have a family history of arrhythmias.
Types of Arrhythmias
Cardiac arrhythmias can be categorized depending on where they originate, whether it’s in regions like the atria or ventricles. Additionally, they can be organized according to how they disrupt the heart’s inherent rhythm:
Supraventricular arrhythmias occur within the heart’s upper chambers, specifically in the atria. This category encompasses:
- Paroxysmal Supraventricular Tachycardia (PSVT)
- Accessory Road Tachycardias
- AV Node Reentrant Tachycardia (AVNRT)
- Atrial Tachycardia
- Atrial Fibrillation
- Atrial Flutter
Ventricular arrhythmia: Rhythm disturbances originating in the ventricles. Ventricular arrhythmias include:
- Premature ventricular contractions
- Ventricular tachycardia
- Ventricular fibrillation
- Long QT syndrome
Bradyarrhythmias: Slow heart rhythms caused by problems in the heart’s conduction system, such as the sinoatrial node (SA), atrioventricular node (AV) or His-Purkinje network. Types of bradyarrhythmia include:
- Sinus node dysfunction
- Heart block
How are Heart Rhythm Disorder Diagnosed?
If you suspect you have a heart arrhythmia or experience unusual symptoms, seeking consultation with a cardiologist and undergoing essential diagnostic assessments is of paramount importance for early identification and treatment. To diagnose a heart rhythm disorder, your physician will initiate with a physical evaluation, inquire about your medical background and symptoms, assess your pulse, and auscultate your heart.
Subsequent assessments may be employed to validate the irregular heart rate and explore factors that could give rise to arrhythmias.
Here is an outline of several tests utilized in the process of diagnosing heart rhythm disorders:
- Electrocardiogram (ECG): An ECG, which captures the heart’s electrical activity, entails affixing electrodes capable of detecting this activity to the chest, and at times, the arms or legs.
- Holter monitor: The Holter monitor, a portable ECG device, is to be worn for 1-2 days or, in some cases, up to a span of 2 weeks to document heart activity.
- Echocardiogram: Utilizing sound waves, an echocardiogram involves positioning a transducer on the chest to generate images portraying the heart’s dimensions, structure, and motion.
- Implantable loop recorder: In situations where symptoms occur infrequently, an event recorder may be implanted beneath the skin in the chest region for continuous monitoring of the heart’s electrical activity and the assessment of irregular heart rhythms.
- Cardiac catheterization: This medical intervention entails the introduction of a catheter into a blood vessel, usually under local anesthesia, and its careful navigation to reach the heart.
- Stress test: During a stress test, the heart’s performance and mobility are continuously monitored while the individual engages in activities like cycling on a stationary bike or walking on a treadmill.
- Head-up tilt table test: Doctors use this test to find out what causes fainting spells. While reclined on an examination surface, the heart rate and blood pressure are vigilantly observed. Subsequently, the surface is inclined to simulate an upright posture. The doctor tries to observe how your heart and the nervous system that controls it react to the change in angle.
- Electrophysiological study: This test records the electrical activity and pathways of your heart. The doctor passes thin, catheters tipped with electrodes through the blood vessels to different parts of the heart. Once the electrodes are in place, the propagation of electrical impulses through the heart is mapped and evaluated for the diagnosis of a heart rhythm disorder.
