by Carson-DeWitt R

Arrhythmias

Definition

Arrhythmias are abnormal beats of the heart. Types of arrhythmias include:
  • Heartbeats that are too slow— bradycardia
  • Heartbeats that are too fast— tachycardia
  • Extra beats
  • Skipped beats
  • Beats coming from abnormal areas of the heart

Causes

Arrhythmias can be caused by:
  • The heart's natural pacemaker (sinoatrial node [SA node]) developing an abnormal rate or rhythm
  • The normal conduction path being interrupted
  • Another part of the heart taking over as pacemaker
Conduction Pathways of the Heart
IMAGE
Copyright © Nucleus Medical Media, Inc.

Risk Factors

Factors that may increase your risk of arrhythmias include:

Symptoms

Some arrhythmias may occur without any symptoms. Others may cause noticeable symptoms, such as:
  • Fainting
  • Lightheadedness
  • Sensation of your heart fluttering (palpitations)
  • Sensation of a missed or extra heart beat
  • Weakness
  • Fatigue
  • Shortness of breath
  • Chest pain

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will listen to your heart with an instrument called a stethoscope.
Tests may include:

Treatment

Not all arrhythmias need to be treated. Many are harmless and do not cause problems. When arrhythmias affect heart function, and cause symptoms serious enough to affect your daily life, treatment may be needed. The goal of arrhythmia treatment is to restore the normal rhythm to your heart to avoid potential complications

Medications

Medications can be used to slow down or speed up your heart rate, or return your heart rhythm to normal.

Cardioversion

Various causes of a rapid heartbeat can be shocked back to a normal rhythm. These treatments involve placing paddles on the chest or back. An electrical current is passed through the chest wall to the heart. The current resets the heart's electrical circuits. It also tries to return the heart rhythm to normal.

Surgery

Surgery can be used to remove tissue to disrupt factors that cause arrhythmias. It may also involve implanting devices that trigger and maintain regular rhythm.
  • Ablation —An area of the heart that is responsible for an abnormal rhythm may be surgically removed or altered (ablated) with different techniques.
  • Maze procedure and mini-maze procedure —The Maze procedure creates a pattern of scar tissue in the upper chambers of the heart. This makes a pathway for electrical impulses to travel through the heart. It also blocks the pathway for fast or irregular impulses. The Maze procedure may also be done as minimally invasive surgery (called mini-Maze).
  • Automatic implantable defibrillator —A tiny defibrillator can be surgically implanted in your chest to monitor your heart rhythm. The device will automatically shock the heart if a dangerous arrhythmia happens. This may help return the heart rhythm to normal.
  • Artificial pacemaker —The pacemaker is surgically implanted in your chest. It takes over the job of providing the electrical impulses needed to have a good heart rhythm.

Prevention

To help reduce your chance of heart arrhythmias:
  • Treat underlying conditions that might lead to arrhythmias.
  • Avoid substances that trigger arrhythmia or make it worse, such as caffeine, alcohol, tobacco, and certain medications.
  • Follow general advice to prevent heart disease:
    • Maintain a healthy weight.
    • Talk to your doctor about a safe exercise program .
    • Do not smoke. If you smoke, find out ways you can quit .
    • Eat a healthful diet that is low in saturated fat and rich in whole grains, fruits, and vegetables.

RESOURCES

American Heart Association
http://www.heart.org
Heart Rhythm Society
http://www.hrsonline.org

CANADIAN RESOURCES

Canadian Cardiovascular Society
http://www.ccs.ca
Heart and Stroke Foundation
http://www.heartandstroke.com

References

Arrhythmias. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/Arrhythmia/Arrhythmia%5FUCM%5F002013%5FSubHomePage.jsp. Accessed November 8, 2012.
Arrhythmia. Texas Heart Institute website. Available at: http://www.texasheartinstitute.org/HIC/Topics/Cond/Arrhythmia.cfm. Updated October 2012. Accessed November 8, 2012.
Explore arrhythmia. National Heart Lung and Blood website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/arr. Updated July 1, 2011. Accessed November 8, 2012.

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