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Heart Arrhythmias

  • What is Heart Arrhythmia?

    A heart arrhythmia refers to an irregular heartbeat. Some arrhythmias have no serious consequences while other types can be life threatening. The severity of the consequences depends on how long the arrhythmia lasts, how irregular it is and how it affects blood flow and blood pressure.

    Arrhythmias can cause the heart to beat too slowly (below 50 beats per minute), too quickly (more than 100 beats per minute), or irregularly.

    There are different types of heart arrhythmias including:

    • Premature (extra) beats – feels like a skipped beat
    • Supraventricular arrhythmias – arrhythmias that start above the ventricles (bottom heart chambers), in the atria (top chambers) or the atrioventricular (AV) node
    • Ventricular arrhythmias –abnormal heartbeats that start in the heart's bottom chambers
    • Ventricular tachycardia – fast heartbeat due to abnormal electrical signals. The ventricles do not fill and pump blood efficiently and it can develop into ventricular fibrillation if left untreated
    • Ventricular fibrillation – fast and chaotic electrical signals cause the ventricles to shiver instead of beat. Can be fatal if left untreated
  • The risk of developing heart arrhythmias increases with age, and the condition can occur in someone with a healthy heart. In some cases the cause may remain unknown. However, the condition is known to be strongly linked with cardiovascular (heart and blood vessels) conditions including:

    • Coronary artery disease
    • Heart failure
    • Heart valve diseases
    • High blood pressure

    There are also non-heart-related causes that lead to heart arrhythmias. These include:

    • Overactive thyroid gland
    • Stress
    • Drinking too much alcohol
    • Smoking habit
    • High caffeine intake
    • Some diet pills, decongestants (medication for a blocked nose) and cough medicines
  • The symptoms of heart arrhythmia can include any of the following:

    • Chest pain
    • Dizziness
    • Fainting
    • Palpitations (fast, irregular or strong heartbeats)
    • Shortness of breath
  • Many arrhythmias do not need treatment. Your doctor will evaluate your condition and discuss with you the range of treatment options suitable for you. These may include a combination of:

    • Lifestyle changes:
      1. Quit smoking
      2. Avoid activities that trigger irregular heart beat
      3. Limit consumption of caffeine
      4. Avoid stimulants used in cough and cold medications
    • Medications:
      1. Anti-arrhythmic drugs to control heart rate
      2. Anticoagulant therapy (blood thinners) to reduce blood clot formation
    • Surgery to control arrhythmias and restore a regular heart rate:
      1. Pacemakers, defibrillators, and cardiac implants. These small electrical devises are implanted in the chest and send electrical energy to fill in the missing beats, thus restoring heart function close to normal. These can be temporary or permanent implants.
      2. Electrophysical (EP) studies. Done under a local anaesthetic, this procedure allows doctors to stimulate the heart with controlled electrical pulses, which shows the source of the block or irregular beat.
    • Catheter ablation usually cures arrhythmia and is usually done after EP studies and when medication is not effective or convenient. The procedure works as follows:
      1. Several thin tubes (catheters) with electrodes are inserted into the blood vessels and directed into the heart
      2. A burst of radiofrequency energy (similar to microwave heat) ablates (destroys) the area of the heart muscle that is causing the irregular beats
  • Most heart arrhythmias can be managed and do not lead to severe complications. However, in cases where they are not treated correctly, they can lead to fainting, stroke and heart failure.

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