Overview – What is it?
Arrhythmia is an abnormal heart condition which causes rapid electrical signals which cause the upper chamber of the heart to beat too fast, too slow or irregularly. It can be harmless but in some cases heart arrhythmia can be life-threatening.
It can be caused by a heart attack, changes to the structure of the heart and hypertension, among several other causes. A racing or slow heartbeat, shortness of breath and chest pains are some of the symptoms one can experience when they have arrhythmia.
To diagnose this condition, electrocardiogram, echocardiogram and implantable loop recorders can be used.
The treatment for heart arrhythmia can range from use of medication to implantable devices like the pacemaker, to surgical treatments such as coronary bypass surgery.
Some of the ways to prevent heart arrhythmia is by not smoking, by limiting alcohol intake and reducing stress.
Causes – What causes it?
Heart arrhythmia can be caused by a number of factors, including:
- Certain health conditions like diabetes, congenital heart disease, coronary artery disease and hypertension increase the risk of having arrhythmia because they can damage and weaken the heart. Thyroid problems can increase arrhythmia risk as well.
- Smoking, excessive alcohol intake and drug abuse also increase the risk of arrhythmia.
- Excessive intake of coffee can also increase arrhythmia risk due to the caffeine contained in the coffee.
- Certain medications and supplements such as cold and allergy, and nutritional supplements can also increase arrhythmia risk.
- Changes in the heart structure due to diseases like cardiomyopathy which causes enlargement of the heart muscles can increase arrhythmia risk.
- Mental Stress when not managed properly, increases the risk of arrhythmia.
- Old age is another factor that can increase the risk of arrhythmia.
- Family history and gene inheritance, where a close relative has had arrhythmia, or you have inherited the gene defects can lead to arrhythmia.
- Being overweight or obese can also increase the chance of a person having heart arrhythmia.
Symptoms – What do you feel?
Arrhythmia does not cause noticeable symptoms in most cases, however, when it does, some of the symptoms one can look out for are:
- Fluttering in the chest
- Chest pain
- Rapid heartbeat (tachycardia)
- Slow heartbeat (bradycardia)
- Shortness of breath
- Fatigue and weakness
- Dizziness or feeling lightheaded
- Fainting or nearly fainting
Diagnosis – How do you diagnose it?
After the initial consultation where the doctor finds out your medical history and does a physical exam, the following tests can be done to confirm whether you have arrhythmia:
- Electrocardiogram: This test is done to check the heart’s electrical activity by measuring the time and duration of each electrical phase in the heartbeat.
- Echocardiogram: The doctor uses a hand-held device which is placed on the chest to produce images of the heart’s structure, size and motion.
- Holter monitor: This is a device worn for a day or more to record the heart’s activity as one goes on with your normal routine.
- Event monitor: This device is also placed on the body. However, you have to press a button when you have symptoms to allow the doctor to check your heart rhythm at the point of your symptoms.
- Implantable loop recorder: This device is implanted under the skin in the chest area and used to detect abnormal heart rhythms.
If arrhythmia is not diagnosed using these tests, other tests that trigger your arrhythmia are carried out. They include:
- Tilt table test: This test is done when a person has a fainting spell. The heart rate and blood pressure of the person are monitored while the person lies flat on a table which is then tilted so that the person appears like they are standing. The doctor observes how the heart and the nervous system respond to the change in angle.
- Stress test: During a stress test, a person is asked to exercise on a treadmill or stationery bicycle while the heart’s activity is monitored. If the person has trouble exercising, a drug is administered to stimulate the heart in a way similar to exercising.
- Electrophysiological testing and mapping: This test uses electrodes to map the spread of electrical impulses through the heart.
Treatment – How do you treat it?
The treatment of heart arrhythmia depends on whether the person has slow heartbeats or fast heartbeats. Slow heartbeats (bradycardias) can only be corrected using a pacemaker because there are no medications that can reliably speed up the heart. The pacemaker is implanted near the collarbone, with one or more electrodes running from the pacemaker through the blood vessels to the inner heart. It works by stimulating the heartbeat to beat at a steady rate when the heart rate is too slow or if the heart stops.
Treatments for fast heartbeats (tachycardias), include:
- Medications: Used to control the heart rate or restore the normal heart rhythm. Blood thinners may also be prescribed to prevent formation of blood clots.
- Cardioversion: This is a procedure used to deliver shock to the heart through paddles or patches placed on the chest. By doing this, it affects the electrical impulses in the heart restoring the normal heart rhythm.
- Catheter ablation: Through this procedure, radiofrequency energy is used to create damage to a small spot of heart tissue, thereby, correcting the pathway that is responsible for causing arrhythmia.
- Implantable devices.
- Pacemaker: This device in implanted near the collarbone, under the skin, to control abnormal heartbeat by emitting electrical impulses that stimulate the heart to beat at a normal rate.
- Implantable cardioverter-defibrillator (ICD): This is a battery powered unit which is implanted under the skin near the collarbone, just like the pacemaker. However, this device has electrodes running through the veins from the ICD to the heart and it monitors heart rhythm continuously. When it detects an abnormal heartbeat, it sends low or high-energy shocks to bring the heart rate back to normal.
- Surgical treatments
- Coronary artery surgery: This procedure is done to improve blood flow in people who have severe coronary artery disease.
- Maze procedure: In this procedure, small incisions are made in the heart tissue, in the atria, creating a pattern of scar tissue which does not conduct electricity and therefore interferes with stray electrical impulses that cause arrhythmia.
Prevention – How do you prevent it?
Prevention of heart arrhythmia mainly focuses on living a heart-healthy lifestyle to reduce the risk of heart disease. This lifestyle involves:
- Not smoking,
- Avoiding excessive alcohol intake,
- Limiting intake of caffeine,
- Eating healthy; more vegetables and fruits and less fatty foods,
- Increasing physical activity,
- Avoiding regular use of over-the-counter medications,
- Maintaining a healthy body weight, and
- Reducing stress and managing your anger as that can cause heart rhythm problems.