Cardiac arrhythmia

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 22, 2016
StartDiseasesCardiac arrhythmia

Cardiac arrhythmia (also known as abnormal heart rhythms, irregular heartbeat or simply arrhythmia) is a medical condition that describes irregular heart rhythms. This condition occurs when electrical impulses that control the heartbeat work erratically causing the heart to beat too quickly, the heart to beat too slowly or irregularly. This medical condition can be bothersome and life threatening in some cases.

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Definition & Facts

The electrical system of the heart controls its rhythm and rate. Each heartbeat is initiated by an electrical signal that spreads from the top of the heart to the bottom. The movements of the signals cause the heart to contract and pump blood. A delay or blockage of the electrical signals in any part of this process causes cardiac arrhythmia.

Cardiac arrhythmia may increase the risk for clotting if the heart is beating too fast, or less blood being delivered to the heart if the heart is beating too slowly. Because arrhythmia affects the normal pumping of the blood, it can result in less oxygen being delivered to different parts of the body, causing organ damage.

Symptoms & Complaints

Arrhythmia can produce a wide range of symptoms from mild to severe. They can also be silent meaning that they do not cause any symptoms. One of the most common symptoms of arrhythmia is heart palpitations that make the patient feel as if the heart is throbbing or pounding in the chest. In addition, the pulse may pound visibly in the patient’s neck or wrist.

The patient may also feel dizzy and lightheaded as if he or she is about to faint. Arrhythmia may also cause clamminess and sweating as well as chest pains, shortness of breath, and unconsciousness. In severe cases, arrhythmia may cause sudden cardiac arrest or stroke.

Causes

The main cause of an arrhythmia is a delay or blockage of the heart’s electrical signals. This may happen if the nerves that produce the electrical signals do not work properly or if the electrical signals do not travel normally through the heart. Cardiac arrhythmia can also occur if electrical signals from other parts of the body interfere with the signals produced by the heart. Using substances such as caffeine, nicotine, cocaine, amphetamines and alcohol may lead to arrhythmia.

Emotional stress and anger may cause the heart to work harder, raise blood pressure, and cause abnormal reactions that may lead to the development of arrhythmia. Heart conditions such as high blood pressure, coronary heart disease, heart failure, thyroid problems, rheumatic heart disease, and heart attack may cause arrhythmia. However, sometimes the specific cause of arrhythmia is unknown.

Diagnosis & Tests

Diagnosing arrhythmia can be quite difficult because the medical condition may sometimes produce few symptoms. Many physicians diagnose an arrhythmia by examining the patient’s medical and family history and by performing physical examinations.

To diagnose an arrhythmia, physicians usually ask patients to describe their symptoms. A physician may ask the patient if he or she feels thumping in his or her chest and whether the patient feels dizzy or lightheaded. A physician may also diagnose an arrhythmia by asking a patient if his or her family has a history of arrhythmia or other heart diseases. The doctor may ask the patient if he or she is under medications including over the counter medicines and supplements.

A physical exam can also serve as an important diagnostic procedure for arrhythmia. During the physical exam, the doctor will examine the patient’s heart rate and rhythm, and the pulse to see if they are regular. He or she will also check for swelling in the legs or swelling in the feet, which could be a sign of a heart problem, and look for signs of other diseases that may be causing the heart problem. An arrhythmia test may also involve performing an electrocardiogram (EKG) test. This test measures the heartbeat rate and rhythm. It also records the strength and timing of the heart’s electrical signals.

Treatment & Therapy

There are various treatment options for arrhythmia including medicines, medical procedures, and surgery in some cases. Physicians often recommend certain medications for fast palpitations. These medications are known as antiarrhythmic agents, which work by modifying the patient’s heart rhythm to make it more normal and steady. Doctors may also prescribe beta-blockers to help slow down a fast heart.

However, there are no known medicines that can reliably speed up a slow heart and pacemakers are often used to treat slow heart rates. Pacemakers are small devices that are typically placed under the skin of patients with slow heart rates to help speed up their hearts and control abnormal heart rhythms. A pacemaker is fitted with sensors that can detect abnormal heart rhythms and send out electrical signals to prompt the heart to beat normally.

Some arrhythmias are treated with surgery, especially if the arrhythmia is caused by heart valve disfunction. Other treatment options for arrhythmia include performing vagal maneuvers such as gagging and coughing.

Prevention & Prophylaxis

Arrhythmia can be prevented by avoiding substances that may contribute to having an irregular heartbeat including tobacco, caffeine, appetite suppressants, alcohol, and psychotropic drugs. Patients can also prevent arrhythmia by managing the risk factors.

Having certain heart conditions such as stroke, high blood pressure, and heart attack increases the risk for arrhythmia. Patients should work with their healthcare teams to reduce high blood pressure, include healthy foods in their diets, avoid smoking tobacco, work out on a regular basis, maintain a healthy weight, and reduce cholesterol levels.