Arrhythmia

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The Heart's Electrical System & Rhythm

The typical heart beats 100,000 times a day. The rhythm of a healthy heart is known as a sinus heart rhythm. A sinus node is a group of cells in the right atrium of the heart. A sinus heart rhythm implies that the electrical impulses from your sinus node are being transmitted properly. Problems with your heart’s electrical system can cause rhythm problems.

You may have felt your heart flutter or pound during intense exercise, moments of stress, or after having too much caffeine or alcohol. Pregnancy can also cause heart palpitations. In medical language, the racing, pounding, or fluttering of the heart is termed arrhythmia. Most of the time, irregular, or abnormal heartbeats are harmless. In rare cases, they may indicate severe heart damage.

Types of Arrhythmia

Bradycardia – A slow heart rhythm, less than 60 beats per minute

Bradycardia is the result of a disease of the sinus node. Some medical conditions may be contributing factors. In the absence of symptoms, you may not need any treatment for bradycardia.  

Tachycardia – A rapid heart rhythm, more than 150 beats per minute

Tachycardia may be caused by abnormal heart cells or electrical connections, certain medicines, hormones, an existing heart disease, or a family history of arrhythmia.  

Abnormal heart rhythms in the upper chambers can be categorized into supraventricular tachycardia (SVT), more specifically atrial flutter or atrial fibrillation. In most cases, SVTs are not life-threatening, although they can weaken the heart muscle over time. 

When rapid heart rhythm originates in the lower heart chambers, as opposed to the upper chambers, the condition is known as ventricular fibrillation. It’s typically life-threatening, causing cardiac arrest and death if not treated immediately. 

Risk Factors of Arrhythmia

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Smoking
  • Stress
  • Excessive alcohol or caffeine

Symptoms of Arrhythmia

  • Palpitations or flutters
  • Dizziness
  • Fatigue
  • Blackouts
  • Light-headedness

Diagnosis

Your doctor will diagnose arrhythmia based on your medical history, family history, a physical examination, and the results of certain tests such as a 12-lead electrocardiogram, stress testing, or an ambulatory monitor.

You may need to wear an ambulatory monitor for a few days. There are various kinds of ambulatory monitors that capture your heart’s performance and are worn for different periods of time. Such are the Holter monitor (24-48 hours), the loop recorder (30 days), and the implantable loop recorder (14 months).

Summary of Treatments

Bradycardia:

Reduce or stop certain medications, if any are being taken

Wear a pacemaker to monitor slow electrical activity 

Tachycardia:

Blood-thinning medications

An electrophysiology study (EPS) and ablation (surgical removal of body tissue) to destroy the tissues sending incorrect electrical signals

“Bearing down,” a maneuver where you are directed to breathe out with your stomach muscles but don’t exhale out of your nose or mouth

FAQs

If I’m experiencing heart palpitations, do I need to get checked out immediately?

If you experience frequent or persistent palpitations, make sure you see your doctor at the earliest. If you have additional symptoms, such as dizziness, shortness of breath, or fainting, seek medical help immediately.

Do heart palpitations indicate underlying heart disease?

They might, but not always. Some forms of atrial fibrillation in young people may occur without any heart disease present. The symptoms may show for a short period of time, go away, and then return. That said, it is best to get recurring palpitations checked out.

Can I drive if I have heart arrhythmia?

As long as your condition doesn’t cause symptoms, it may be safe for you to drive. However, one should always consult their medical doctor directly when deciding such matters.

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