Category Archives: Disorders Of Heart Rhythm

Arrhythmia Treatment

When awareness of heart beats (palpitations) can be felt, it may be quite unsettling. If they are found to be harmless, the patient may be reassured and advised to avoid the circumstances that bring about the condition. Arrhythmia can be due to certain drugs a person is taking. In such cases, changing the medication or its dosage may bring relief. Those with arrhythmia are often advised to avoid stimulants like alcohol, caffeine and tobacco. Also, if palpitations are felt only during exercise, such exertions may be avoided.

Arrhythmia Treatment With Drugs

A group of drugs that help suppress arrhythmia are called antiarrhythmic drugs. They are usually given for tachyarrythmia or fast heart rate that causes severe discomfort. Since, arrhythmias can be of various types, and neither a particular drug can treat all types of arrhythmia nor a particular type of arrhythmia can be treated with a specific drug, doctors have to try several drugs and combinations to arrive at suitable medication. In addition to having side effects, paradoxically, antiarrhythmic drugs can have a proarrythmic effect in some cases, where, they can actually cause arrhythmias or worsen them.

Arrhythmia Treatment With Pacemakers

When the natural pacemaker of the heart is not working properly, artificial pacemakers can take over, to preempt any potentially fatal situations. An artificial pacemaker is so small that it can be comfortably embedded in the chest, with tiny wires connecting it to the heart. With the advancement in technology; better electrical circuitry and longer lasting batteries have ensured ten to fifteen years of life for these implants. Techniques have been devised to work around the problem of interference from other commonly encountered electronic devices such as mobile phones and microwave ovens, though it is not entirely fool-proof. High energy fields of MRI machine and diathermy machine (used in physiotherapy to apply heat to the muscles) often interfere with artificial pacemakers.

Pacemakers are mainly used to treat bradyarrhythmias or slow heart rate and they can be life savers. Whenever the heartbeat slows down to a dangerously low rate, they can deliver pulses of electric current directly into the heart, reviving it. Occasionally, pacemakers are also used to suppress tachyarrhythmia

Restoring Normal Rhythm with Electrical DC Shock

An electrical shock delivered into the heart, can stop tachyarrhythmia and normalize the heart rhythm. This is called cardioversion and it is often used to reverse arrhythmias originating in the atria or in the ventricles. The defibrillator machine has to be operated by specially trained professionals such as doctors or emergency care providers. A compact device called implantable cardioverter-defibrillator (ICD) can be used for continuous monitoring of the heart rhythm.

Implantable cardioverter defibrillator (ICD)

is a compact electronic device that can be implanted under the skin by a minimally invasive surgery and be connected to the heart via veins. These life-saving devices are for people at risk of death from arrhythmia. When ICDs that monitor the heart all the time; encounter a fast heart rhythm, they automatically apply a shock to reverse it and restore normal rhythm. The shock applied may be experienced as a kick in the chest. ICDs do the work of pacemakers too, reviving a sluggish heart. Interference by high energy fields of an MRI machine or a diathermy machine is still a problem with these devices; but they are safe from interference with most of the commonly used electronic devices such as cell phones. Since these devices only help correct an abnormal heart rhythm but not prevent the occurrence of arrhythmias, drugs are often prescribed to treat the condition.

Automated external defibrillator (AED) is a new, easy to use device that can be operated by those trained in providing first aid. It can detect arrhythmia and automatically deliver an electric shock if necessary. If placed accessibly in public places like shopping malls, it has the potential to be a life saver on a large scale.

Destroying Abnormal Tissue

Surgical removal of a small area of the heart’s electrical system that is faulty can help control arrhythmia in certain cases. Radiofrequency ablation is a minimally invasive procedure for selective destruction of the faulty tissue. A catheter fitted with electrodes (ablator) is inserted into the heart and high frequency electric current is applied to destroy the ear marked area. This highly successful procedure, which takes only two to four hours to complete and just one or two days of hospitalization, is preferred over an open-heart surgery with its inherent risks.

Share and Enjoy

  • Facebook
  • Twitter
  • Delicious
  • LinkedIn
  • StumbleUpon
  • Add to favorites
  • Email
  • RSS

Diagnosis And Prognosis Of Abnormal Heart Rhythms (Heart arrhythmia)

Arrhythmia can often be diagnosed from the symptoms described by the patients. Doctors try to determine the type of arrhythmia from these observations:

  • whether palpitations are felt by the patient,
  • whether the rhythm is slow, fast, or irregular,
  • whether they last for a long time or resolve in a short period,
  • whether they precipitate symptoms or worsen the symptoms of heart failure,
  • whether they are felt only during exertion or even at rest,
  • whether they appear and disappear suddenly or over a period of time

In spite of the fairly good picture doctors can obtain from these facts, certain tests are required to identify the exact causes and effects.

Since, faulty electrical activity is the main cause of arrhythmias; Electrocardiography (ECG) is an ideal diagnostic test for this condition. The electrical current involved in each heartbeat is graphically recorded during this procedure so that cardiologists can easily observe abnormal patterns in the heartbeats and correlate them to the abnormalities they indicate.

Since the duration of an electrocardiography test is limited, it may not be possible to assess arrhythmias that appear and disappear intermittently and the result of a single ECG may be misleading. To overcome this possibility, a compact, portable, ECG machine called Holter monitor can be used to monitor and record the electrical activity over an extended period of time. Usually, for a 24-hour observation period the device would be worn, as the patients go about performing their day to day activities keeping a record of the time of each activity as well as the symptoms they felt while doing it. The incidence of arrhythmia can be compared with the activity performed at that time, to arrive at conclusions.

To observe arrhythmias that are infrequent, a small device, to record the electrical activity over a longer period of time, is implanted in the chest. This device can keep transmitting the recorded data across the skin, which doctors can use to make the correct diagnosis.

Hospitalization for continuous monitoring and recording of the heart rhythm is often the only option for critically ill people with potentially fatal arrhythmias, as prompt identification of any sudden development of a serious nature can be immediately recognized and attended to.

Exercise stress testing (ECG) and measuring blood pressure while doing the exercise is also a diagnostic procedure often employed. Another useful diagnostic method is electrophysiologic testing with a minimally invasive catheterization procedure which can determine the type of arrhythmia and its treatment options. In this test, electrodes are attached to the tip of the catheters introduced into the heart, to deliver electric impulses to stimulate the heart so that the response of the heart to such stimuli can be studied.

Prognosis

Arrhythmias are often a cause of great anxiety when awareness of heart beats or palpitations are felt. Unless arrhythmia interferes with and impairs the pumping action of the heart; reducing blood flow, it is often considered harmless. However, in some cases, harmless arrhythmias may lead to serious arrhythmias. The origin of the irregularity is an important factor in determining the seriousness of the condition. Arrhythmias starting in the natural pacemaker of the heart (sinoatrial node) are less serious than those having their origin at a lower point in the electrical pathway. Arrhythmias that start in the ventricles of the heart are the most critical.

Share and Enjoy

  • Facebook
  • Twitter
  • Delicious
  • LinkedIn
  • StumbleUpon
  • Add to favorites
  • Email
  • RSS

What Is A Heart Arrhythmia

What Is A Heart Arrhythmia? Heart arrhythmia is defined as an abnormally patterned series of heart beats which tend to be either very slow (bradyarrhythmia) or too fast (tachyarrhythmia) and produced by electrical impulses travelling in the heart through a faulty electrical circuitry.

  • Heart Arrhythmia is usually caused by underlying heart disorders.
  • Palpitations associated with arrhythmias are occasionally felt by some people, but often, weakness and fainting are the only symptoms felt.
  • Electrocardiography (ECG) can diagnose arrhythmia
  • Treatment focuses on restoring the normal rhythm of the heart and preventing recurrence.

Heart is a strong, muscular pump that works round the clock and non-stop throughout the entire lifespan of a person. This four- chambered organ pumps out blood to the entire body, by a series of contractions with a definite pattern and a regular rhythm.

Contraction of the heart is an electrically controlled process with a series of well orchestrated events, starting with an electric pulse originating in the upper right chamber of the heart, at a point called the sinoatrial node. Heart rate is determined by the frequency at which this electric pulse is discharged, which in turn is controlled by specific hormones and the impulses from nerves.

Autonomic nervous system, consisting of a sympathetic division and a parasympathetic division, automatically regulates the heart rate. While the sympathetic system acts through a group of nerves called sympathetic plexus to increase the heart rate, the parasympathetic division acting through the vagus nerve has the opposite action; that of decreasing heart rate.

The rate at which the heart beats can be affected by hormones delivered into the bloodstream by the sympathetic nervous system. These hormones include the Thyroid hormone produced by the thyroid gland, epinephrine (adrenaline) produced by the adrenal gland, and norepinephrine (noradrenaline). All these hormones cause the heart to beat faster.

The usual heart rate for an adult when idle varies between 60 bpm to 100 bpm (beats per minute).The heart rate is sometimes lower in healthy, younger adults.

Exercise and other strenuous physical activity cause the number of beats per minute to increase. Emotions which activate the sympathetic nervous system, such as anger, love or pain also increase the heart rate by secreting sympathetic hormones like adrenaline.

When the heart rate is considerably low it is called bradycardia and when it is high, it is called tachycardia. Both are abnormal heart rhythms or arrhythmias. When the beat is irregular or when the electric impulse follows a faulty circuit across the heart; then again, they are arrhythmias.

Normal Electrical Pathway

The sinoatrial node in the right atrium, which can be called the pacemaker of the heart, is the starting point of the electrical activity. The electrical impulse that starts in the sinoatrial node travels across the right atrium and then the left atrium, making them contract, pushing the blood into the ventricles. When the electrical impulse is picked up by the atrioventricular node, it is delayed there, to allow time for the complete contraction of the atria and the maximum filling up of the ventricles.

From the atrioventricular node, after a brief delay, the current passes into the Bundle of His. This bundle of fibers branches out into left and right bundles and pass into respective ventricles and spread out, causing the ventricles to contract, and pump blood out of the heart.

Causes of heart arrhythmia

Disorders of the heart such as coronary artery disease, valve defects and heart failure are the major causes of heart arrhythmias, especially coronary artery disease that affects the blood supply to the muscular walls of the heart. Sometimes arrhythmia has its roots in certain congenital abnormality in the anatomy of the heart. Certain medications, including several of those used in the treatment of heart disorders, are also known to cause arrhythmias. Excessive levels of thyroid hormone may increase heart rate resulting in tachyarrhythmia while low levels of the same hormone may result in bradyarrhythmia. An ageing heart is also more prone to arrhythmias due to possible deterioration in the electrical transmission system of the heart.

Symptoms of heart arrhythmia

Awareness of heartbeats or the feeling of the heart thumbing inside the chest is called palpitations. Irregular heart rhythm (arrhythmias), especially an abnormally fast heart beat (tachyarrhythmia) is the usual reason for this feeling of awareness; but it can vary from person to person. Everybody feels a racing heart in very stressful situations, but a few people feel their normal heartbeats too, as do most people when they are lying on the left side (or right side, if they have situs inversus or reversed body symmetry).

Arrhythmia can often be quite harmless even when their symptoms are severe. On the other hand, extremely dangerous arrhythmias can be asymptomatic too. Seriousness of an arrhythmia cannot be gauged by the symptoms exhibited. In other words, the heart disorders that cause the arrhythmia are of greater importance than the symptoms arrhythmia precipitates, however severe they are.

Arrhythmias interfering with the pumping action of the heart produce various symptoms such as shortness of breath, fatigue, a dizzy and light-headed feeling or even fainting. Fainting (syncope) is due to lowering of blood pressure resulting from the inability of the heart to pump out adequate quantity of blood. Such arrhythmia, if prolonged, can be fatal. Arrhythmias can worsen the symptoms of the heart disorder that is causing it, such as shortness of breath and chest pain and such situations call for immediate attention.

Share and Enjoy

  • Facebook
  • Twitter
  • Delicious
  • LinkedIn
  • StumbleUpon
  • Add to favorites
  • Email
  • RSS
You might also likeclose