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Any abnormal heart rhythm or heartbeat is known as an ‘arrhythmia’. The heart is an amazing creation, pumping on it is own through the efforts of a small cluster of specialized cells that create a natural pacemaker. The electrical signals created by this pacemaker normally travel from the atrium (the upper chamber of the heart) to the ventricle (the lower chamber of the heart). This causes the heart to contract, creating heartbeats that can be felt as a pulse. Normally the heart beats at around 60 to 80 beats per minute. Abnormal heartbeats include those that are too slow (bradyarrhythmia), too fast (tachyarrhythmia) or skipped beats.

Arrhythmias have many causes which include:

• Heart muscle damage caused by heart attack
Imbalance of electrolytes (e.g. sodium or potassium), which are used to help
• transmit the electrical impulses
Changes in the heart muscle which make it more difficult to carry the electrical signal (e.g. an enlarged heart caused by a condition called cardiomyopathy)
• Another part of the heart taking over as the pacemaker

WHAT ARE THE SYMPTOMS OF A RRHYTHMIA

During bradycardia (slow heartbeat), the body doesn’t get enough oxygen-rich blood to areas that need it. This can make you feel tired, lightheaded or dizzy. During tachycardia (fast heart rate), the heart beats so fast that it can’t fill up with enough blood in between beats to be able to pump it to the rest of the body. This may result in fainting spells, blackouts, temporary blind spots or dizziness, or in serious cases, unconsciousness (sudden cardiac arrest). In serious cases, sudden cardiac death may occur.

Common types of bradycardia include:

• Sick sinus syndrome – A malfunction in the pacemaker, which makes it fire too slowly. This can be caused by age or disease. Some drugs can also slow down the heart rate (e.g. beta-blockers).
• Heart block – Caused by slowing down of heart signals from the upper chambers (atria) to the lower chambers (ventricles) of the heart. Seriousness of heart block ranges from 1st degree (all the impulses reach the ventricle but the heart is slowed down) to 2nd degree (some of the impulses get stopped, resulting in missed beats), or 3rd degree (no impulses reach the ventricles and the pacemaker function is taken over by cells in the ventricle). Third degree heart block results in the uncoordinated heartbeat which makes it slow and irregular.

Common types of tachycardia include:

• Atrial fibrillation – This is one of the most common types of abnormal heart rhythm. It occurs when the electrical pulse in the atria is totally disorganized and very rapid. This prevents the atria from pumping blood effectively into the ventricles. If atrial fibrillation is present for a long time, blood trapped in the atrial chamber can start to clot. If a clot released from the heart, it can find its way to the brain causing a stroke. That is why people with atrial fibrillation need to take blood thinners.
• Atrial flutter – occurs when an extra impulse travels around the artria in a circle, causing the heart to contract at a higher rate than normal.
• Wolf-Parkinson-White Syndrome is an inherited condition caused by an abnormal development of the heart’s electrical system. Most people with this condition can lead normal lives. In some, episodes of rapid heartbeat can cause symptoms that include heart palpitations, shortness of breath, fainting and chest pain.

What to do




Options for the management of abnormal heart rhythms of arrhythmias include pacemakers, medications and additional strategies aimed at stabilizing the rhythm of the heart.

Pacemakers are most commonly used to treat heartbeats that are too slow or irregular. The pacemaker takes over from the heart’s natural pacemaker when needed and sends out a normal strong signal. A pacemaker may consist of a battery-powered generator and one or two leads (wires) that connect the generator to the heart. A permanent pacemaker is inserted beneath the skin, usually under the collarbone. The leads are placed in direct contact with the walls of the heart in a minor operation that usually takes about one hour. These pacemakers are very efficient and batteries last from 7 to 12 years (and are placed with a minor operation). Most people with a pacemaker forget that it’s even there!

Implantable defibrillators deliver electrical signals to the heart to slow it down and restore it to a more normal rhythm. This allows the heart’s normal pacemaker to take over again. The surgical procedure to implant defibrillators is similar to that for pacemakers.

Cardio version involves a strong electric shock or current delivered through the chest wall to the heart. This procedure temporarily wipes out all electrical activity in the heart and allows the heart’s natural pacemaker to take control once again. The procedure is done in a hospital where the patient is sedated or put under anesthetic. It temporary measure, so medications or other strategies may be needed after the procedure is finished.

Medications include anti-arrhythmic drugs designed specifically to control abnormal heart rhythms (e.g. amiodarone, propafenone, quinidine, disopyramide) and beta-blockers to help slow the heart rate down (e.g. sotalol, propranol, nadolol) Each medication has its own benefits for certain types of arrhythmias and its own profile of side effects.

IT’S IMPORTANT

HOW CAN THE DOCTOR TELL IF I HAVE AN ABNORMAL HEART RHYTHM?

Before an abnormal heart rhythm is treated, a doctor needs to detect the probeln and investigate the cause of the arrhythmia. The most common way to detect abnormal heart rhythms is through the use of an electrocardiogram (ECG).

ECG – An electrocardiogram or ECG can record the electrical impulses on a computer or on paper as they make their way around the heart. The impulses are detected with the aid of electrodes (small metal conductors) place on the chest, arms and legs.

• If an ECG is done in the doctor’s office, it is called a . This type of test may miss the abnormality in the heart rhythm if it only occurs once in a while.
• A Holter monitor is a small portable ECG machine that can record heart electrical impulse activity for up to 48 hours. It can clip to a belt or hang on a cord around the neck. To help doctors understand what is happening when abnormal heart rhythms occur, you will be asked to record what you were doing and note the exact time whenever you feel unusual heart activity.
• A pocket event recorder is similar to a Holter monitor except that the recorder is only turned on when the heart is felt to be skipping or beating unusually. Once the event has been recorded, the pocket event recorder can send the record to a medical technician using a touch-tone phone.
• A ‘stress test’ is usually done in a medical clinic or hospital to determine if exercise promotes abnormal heart activity. It involves the use of an ECG test while walking on a treadmill at increasingly faster rates and inclines.
• The Tilt Test is usually performed only if EC tests don’t pinpoint the cause of abnormal heart rhythm. In this test a blood pressure recorder is put on the arm and an ECG recorder is put in place. Certain diagnostic drugs are injected via an intravenous line to the test the heart’s reaction. Temporary feelings of stomachache, nausea, lightheadedness or a fast heart rate may occur.

Article By:- eHealthhut Webmaster
www.ehealthhut.com
2008-04-10