Cardiac arrhythmias are alterations in the rhythm of the heart which can be presented in various ways, from palpitations and dizziness up to syncopechest pain or loss of consciousness. Sometimes, these irregularities go unnoticed and are only detected during medical examinations, according to the Dr. Moisés Rodríguez Mañerofrom the University Clinical Hospital of Santiago de Compostela, on the website of the Spanish Heart Foundation.
What is an arrhythmia?
An arrhythmia is an alteration of the heart rhythm. To better understand this phenomenon, it is essential to know how and why the heart beats.
heartbeatsas explained from Mayo Clinicare the result of electrical impulses that cause the atria and ventricles to contract in a synchronized and rhythmic manner. Normal heart rate is between 60 and 100 beats per minute (bpm) and follow this sequence:
The electrical impulse begins in the sinus node, located in the right atrium.
It then passes through the atria atrioventricular nodelocated at the junction of the atria with the ventricles, and reaches the ventricles through the bundle of His.
Finally, the stimulus is transmitted through the ventricles through the Purkinje system.
Causes of arrhythmias
Cardiac arrhythmias can appear for one of three reasons:
The electrical impulse is not generated correctly.
The electrical impulse originates in the wrong place.
The paths for electric driving are altered.
Classification of arrhythmias
Arrhythmias are classified according to their origin, heart rate and mode of presentation:
By its origin:
Supraventricular: They originate in the atria or in the atrioventricular node.
Ventricular: Originate in the ventricles.
By your heart rate:
Rapid or tachycardia: Frequency greater than 100 bpm.
Slow or bradycardia: Rate below 60 bpm.
Due to its mode of presentation:
Chronicles: Permanent in nature.
Paroxysmal: They occur on specific occasions.
Symptoms of cardiac arrhythmias
Arrhythmias can cause palpitations, dizziness, syncope, chest pain or loss of consciousness, but they can also go unnoticed and be detected during medical examinations.
Diagnosis
To diagnose an arrhythmia, as reported by the Mayo Clinic, it is necessary to demonstrate an alteration in the electrical activity of the heart. The main test is the electrocardiogram, although it only records activity at the time it is performed. Other tests include:
Holter: Monitors electrical activity over an extended period.
Implantable Holter: Device that is placed under the skin to record activity for years.
Stress test: Evaluates the cardiac response to physical effort.
Electrophysiological study: It records and stimulates the electrical activity of the heart.
Echocardiography can also be performed to detect structural alterations of the heart.
Prognosis of an arrhythmia
The prognosis of an arrhythmia depends on the type and baseline status of the patient. Generally, bradyarrhythmias have a good prognosis after treatment, while supraventricular tachyarrhythmias have a more favorable prognosis than ventricular ones.
Treatment
Treatment varies depending on the type of arrhythmia, its cause and the patient’s characteristics:
Bradyarrhythmias: They may require a pacemaker if non-cardiac causes are not resolved.
Tachyarrhythmias: They require treatment of predisposing factors and can be managed with drugs, electrical cardioversion or ablation, depending on the case.
Types of arrhythmias
In general, arrhythmias are grouped by the speed of the heart rate:
Tachycardia: Frequency greater than 100 bpm.
Bradycardia: Frequency less than 60 bpm.
Fast heartbeat (tachycardia)
Atrial fibrillation: Rapid and uncoordinated heartbeat.
Atrial flutter: Fast and organized beats.
Supraventricular tachycardia: Irregular heartbeats originating above the ventricles.
Ventricular fibrillation: Chaos in the electrical signals of the ventricles.
Ventricular tachycardia: Rapid and irregular frequency in the ventricles.
Slow heartbeat (bradycardia)
Sick sinus syndrome: The sinus node is not working properly.
Driving lock: Heart signals are slow or stop.
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