Beware of palpitations, the most common symptom of arrhythmias

An arrhythmia represents any alteration of the normal heart rhythm, whether it is a slower, faster, or simply out of rhythm of the heart. Arrhythmias may not cause any symptoms or may cause very varied symptoms. The most common symptom is palpitations, but arrhythmias can manifest with a variety of symptoms that can range from simple discomfort to chest pain, shortness of breath or even loss of consciousness or lead to sudden death.

“The presence or absence of symptoms is not always related to the severity of the arrhythmias. It should be noted that although there are some arrhythmias that may have a hereditary component, the most frequent do not have a family pattern,” explains Dr. Ángel Moya, director of the Arrhythmia Unit at the Quirónsalud Dexeus Heart Institute (Barcelona), belonging to the group Quirónsalud.

Of course, this expert highlights that the presence of an arrhythmia in the context of heart disease can “complicate or worsen the prognosis” if it is not identified and treated correctly, which is why it is important that patients with heart disease be followed up regularly. periodically and evaluated by a specialist, in cases where it is considered appropriate and, on the other hand, patients with arrhythmias undergo a series of cardiological examinations to rule out the presence of underlying heart disease.

On the other hand, this cardiologist warns that any habit that worsens the person’s state of health, and that can lead to the evolution of cardiovascular disease, can favor the appearance of certain arrhythmias. For this reason, Dr. Moya advises that a balanced diet should be followed to avoid overweight and obesity, as well as restrict excessive consumption of salt, sugar, fat and meat, especially sausages and processed meats. “It is always recommended to consume fruits, vegetables, legumes, more fish, and avoid processed foods. And regarding sports practice, it is advisable to consult with an expert beforehand,” adds the director of the Arrhythmia Unit of the Quirónsalud Dexeus Heart Institute.

In this context, he emphasizes that there are patients who may have, for example, atrial fibrillation (common arrhythmia and one of the most frequent tachycardias among the older population), or even ventricular tachycardia (arrhythmia in the ventricles of the heart), but not notice any symptoms. “In any case, one of the most frequent symptoms of arrhythmias is palpitations. It is about the perception of the heartbeat, which can range from a sensation of isolated, out-of-sync beats to the heart beating faster than usual,” he details.

Most frequent symptoms

In addition to palpitations, the arrhythmia may be accompanied by fatigue and a feeling of shortness of breath at rest.

Whether or not added to the sensation of palpitations, Dr. Moya maintains that other symptoms may occur in some patients, such as an increased feeling of fatigue when exercising; feeling of suffocation at rest; instability or even temporary loss of consciousness (syncope); chest pain; stroke, which in some patients may be the first manifestation of an arrhythmia; or even sudden death.

For this reason, this expert from the Quirónsalud Dexeus Heart Institute maintains that arrhythmias can be dangerous, for example, in the case of atrial fibrillation, because if not recognized and treated appropriately it can cause stroke, or even contribute to deterioration. of ventricular function and lead to heart failure. “On the other hand, the presence of atrial fibrillation in patients with certain heart diseases, such as a previous heart attack or hypertrophic cardiomyopathy, can aggravate their symptoms,” he adds.

On the other hand, this cardiologist maintains that the presence of ventricular tachycardia in patients with underlying heart disease can lead to syncope, which, if not treated immediately with cardiopulmonary resuscitation maneuvers and immediate defibrillation, can lead to cardiac arrest.

In turn, Dr. Moya defends that in addition to treating arrhythmias when they do give symptoms, treatment should also be considered in those cases in which, regardless of the presence of symptoms, the arrhythmias ‘per se’ may be causing deterioration. of cardiac function; or, in the event that the arrhythmia represents an immediate or highly probable risk of compromising the patient’s life.

Get ahead of the problems

In patients at high risk of presenting arrhythmias, despite not having had any, preventive treatment must be performed

“There are patients who have never had an arrhythmia, but who, due to their underlying pathology, may be at high risk of presenting arrhythmias, and preventive treatment should be performed in these patients,” warns the director of the Arrhythmia Unit of the Quirónsalud Dexeus Heart Institute (Barcelona).

Regarding treatment options, this expert maintains that there are several alternatives depending on the arrhythmia, from pharmacological treatments (oral, venous) to non-pharmacological ones. “Most pharmacological treatments have limitations, which is why more and more non-pharmacological treatments have been developed for the treatment of arrhythmias,” says this doctor, among which he highlights:

Pacemaker. Device that is implanted under the patient’s skin, under the collarbone, and that is connected inside the heart cavity by means of a cable. Currently, there are some models that can be implanted directly into the heart itself; They serve to increase your heart rate in cases where the heart beats slower than usual.

Implantable defibrillators. Similar to pacemakers, but larger in size, they are devices that, in the event of a serious ventricular arrhythmia that could endanger the patient’s life, can automatically and immediately carry out an electric shock (defibrillation) that allows the heart to return to its rhythm. usual.

Catheter ablation. This is one of the greatest advances in the treatment of patients with arrhythmias. It consists of the introduction of one or more catheters that are advanced to the cardiac cavities, usually through the femoral vein, with which one or more areas that may be responsible for the origin or maintenance of arrhythmias are located. There, some type of energy is applied, usually radiofrequency, but it can also be cold or another type, to cauterize the tissue responsible for the arrhythmia and prevent it from occurring again. Today, ablation can be performed for most arrhythmias.