Arrhythmias are heart rhythm disturbances that may be always present or intermittent and are caused by problems in the electrical conduction system of the heart. If this rhythm is, normally, at rest, between 60 and 100 beats per minute (bpm), above 100 bpm the heart rate is rapid and is called tachycardia; and below 60 bpm slow, which is why it is called bradycardia. Plus, there are also the extra beats.
Causes of arrhythmias
Hypertension is one of the many causes
The heart consists of four chambers: two atria and two ventricles. The atria are the upper ones and the ventricles are the lower ones. The electrical impulse of the heart begins in the sinus node, located in the right atrium, and is a natural pacemaker. From there it passes through the atria to the atrioventricular node, located at the junction of the atria with the ventricles and reaches the ventricles through the bundle of His or atrioventricular fasciculus, which is a centimeter-long cord of muscular nature. Finally, this stimulus is conducted through the ventricles through the Purkinje system; one of the structures that conduct the electrical impulse at high speed.
Arrhythmias appear if the electrical impulse is not generated properly, if it originates in the wrong place, or if the pathways that carry the electrical impulse are altered.
Types of tachycardia in the atria (more than 100 bpm):
– Atrial fibrillation. The heart rate is altered by chaotic electrical impulses in the atria. It can have serious complications.
– Atrial flutter. It is similar to atrial fibrillation but the impulses are more organized and rhythmic. It can also have serious complications.
– Supraventicular. Many forms of arrhythmias originating in the atrioventricular. One of them is Wolff-Pakinson-White Syndrome; This is an additional electrical pathway between the atrium and ventricles that allows the electrical impulse to bypass the atrioventricular node, which is already present at birth but may not be detected until adulthood.
Types of tachycardia in the ventricles (more than 100 bpm):
– Ventricular. Regular heart rate accelerated by abnormal electrical signals in the ventricles. It must be attended to urgently.
– Ventricular fibrillation. The accelerated and chaotic electrical impulses fail to pump the necessary blood to the body. It is fatal if the heart does not return to beating normally within a few minutes.
– Long QT syndrome. Rapid and chaotic heartbeats caused by changes in the electrical system of the cardiac organ. They can cause fainting or even sudden death.
Types of bradycardias (less than 60 bpm):
– Sinus dysfunction syndrome. The sinus node, the heart’s natural pacemaker, does not send impulses correctly. The frequency can be low, high or decelerate intermittently.
– Blockage of electrical conduits that produce constant but slower heartbeats.
– Extra beat: It looks like a skipped beat but it is actually an extra beat. The most common causes are stress, excess exercise and stimulants such as caffeine and nicotine.
There are many factors that can cause or lead to an arrhythmia, for example:
– A heart attack
– Scarring of heart tissue from a previous heart attack
– Changes in the structure of the heart
– Coronary artery disease
– Hypertension
– Hyperthyroidism
– Hypothyroidism
– Smoke
– Excess alcohol or caffeine
– Drug abuse
– Stress
– Certain medications and supplements
– Diabetes
– Sleep apnea
– Genetics
Symptoms of arrhythmias
Palpitations can be a symptom of arrhythmia
Feeling palpitations, dizziness, syncope, chest pain, difficulty breathing or fainting can be symptoms of cardiac arrhythmia but they can also go unnoticed and be detected during a diagnostic check-up or during the performance of a diagnostic test.
Diagnosis of arrhythmias
The electrocardiogram is the reference test
To make the diagnosis it is necessary to demonstrate that there is an alteration in cardiac electrical activity. The reference test is the electrocardiogram, which records the electrical activity of the heart with each beat. It has the disadvantage that it can only show if there are arrhythmias in case they occur during the test.
If there is suspicion of an arrhythmia related to physical effort, a stress test is performed and in cases where it is necessary, a Holter test can be performed, a device that records the electrical activity of the heart for 24 or 48 hours. An attempt can also be made to reproduce arrhythmias through an electrophysiological study.
To check if there is a structural alteration of the heart, an echocardiography is usually performed.
Treatment and medication of arrhythmias
It depends on the type of arrhythmia and the patient
In the treatment of bradycardia, non-cardiac causes must first be resolved; Later, if the patient’s characteristics allow it, a pacemaker can be placed that records the electrical activity of the heart and stimulates it if necessary.
In tachycardias, the predisposing factors or factors that may aggravate them, such as cardiac ischemia, inadequate blood oxygenation or heart failure, must first be treated. Once these situations are resolved, tachycardias are treated with drugs that control the heart rate and restore normal heart rhythm.
Sometimes electrical cardioversion may be necessary to eliminate the arrhythmia; To do this, after putting the patient to sleep, an electric shock is administered using paddles that are placed on the thorax. Catheter ablation may also be performed to remove a small area of heart tissue to bypass the area where the arrhythmia occurs.
If you suffer from atrial fibrillation, the cardiologist may prescribe anticoagulants and recommend implanting an implantable cardioverter defibrillator (ICD) to constantly monitor the heart rhythm and which can send a high or low shock to restore the abnormal heart rhythm.
Other options are surgical treatments such as the labyrinth procedure or coronary bypass surgery.
Prevention of arrhythmias
Healthy foods, avoiding overweight and exercise
In the prevention of arrhythmias it is recommended:
– Follow a diet of heart-healthy foods such as walnuts, broccoli, dark chocolate, strawberries, green tea, olive oil, salmon or legumes
– Maintain regular and moderate physical activity
– No smoking
– Avoid overweight and obesity
– Do not consume or limit the consumption of caffeine and alcohol
– Reduce stress
– Do not take over-the-counter medications, such as flu medications, that can cause a rapid heartbeat.
#Arrhythmias #affect #heart #treatments
