Heart Arrhythmia

Heart arrhythmia refers to irregular heartbeat caused by abnormalities in the electrical impulses that coordinate heart rhythm. Irregularities in heartbeat may be:

• Tachycardia – heartbeat is faster than normal
• Premature contraction – heartbeat is earlier than normal
• Fibrillation – heartbeat is irregularly

Most of the abnormalities in heartbeat are normal. But, occasionally the rhythm is too deviated from normal, and this may be an indication of a damage in the heart.

It may also result in potentially fatal symptoms. Heart-healthy lifestyle is the best way to treat and prevent heart problems. Treatment depends on the type of arrhythmias.

Many patients may remain asymptomatic and heart arrhythmia is often recorded during a routine examination. Tachycardia is characterized by:

• Breathlessness
• Dizziness
• Fainting
• Racing or fluttering in chest
• Lightheaded feeling
• Weakness, which develops suddenly

Bradycardia also may not have any symptoms initially. When present common symptoms include:

• Pain in chest
• Difficulty in concentrating
• Confusion
• Difficulties during physical exercise
• Dizziness
• Fatigue
• Lightheadedness
• Fainting
• Difficulty in breathing

Symptoms of atrial fibrillation include:

• Chest pain
• Dizziness
• Shortness of breath
• Fainting
• Weakness
• Palpitations

Heart arrhythmia is caused by a change in the electrical impulses that control normal heart rhythm. It may be caused by several factors including changes in the structure of heart, blockage in arteries, and hypertension.

Some other common causes of arrhythmia include:

• Thyroid issues like hyperthyroidism or hypothyroidism
• Smoking
• Heart attack
• Alcohol abuse
• Too much of caffeine
• Drug abuse
• Stress
• Scarring of heart tissue
• Certain medications
• Certain conditions like diabetes
• Sleep apnea
• Genetics

The major risk factors for arrhythmia include hypertension, congenital heart disease, certain drugs, sleep apnea, thyroid problems, coronary heart disease, and diabetes.

Review of symptoms and medical history, and physical examination are the first steps in the diagnosis of heart arrhythmia. Tests are recommended to check out for conditions that may trigger a change in the heart rhythm. This includes ECG to detect the electrical activity in the heart.

Holter monitor is used to record and evaluate the electrical activity in the heart, particularly during every day routine. Event monitor is a special device that checks heart rhythm when the symptoms appear.

Size, structure, and functioning of the heart is visualized using echocardiogram. Abnormal heart rhythm can be recorded using a loop recorder that can be implanted under the skin.

Arrhythmia can be triggered by stress test, tilt table test, or electrophysiological testing. These tests are recommended when irregular heartbeats are not recorded in any of the conventional methods.

In a stress test, the patient is asked to exercise on a treadmill or a stationary bicycle during which his/her heart rhythm is monitored. This is usually suggested to see whether coronary heart disease can be implied as the cause of heartbeat irregularities.

Tilt table test is used for patients who had episodes of fainting. In this test, the table in which the patient is lying is tilted. The functioning of nervous system and heart is monitored during this time. Electrophysiological testing tracks the electrical impulses across the heart.

Treatment depends on the type of arrhythmia. Mild symptoms do not require any specific treatment. Bradycardia is treated with pacemaker, a device that stimulate and regulate the heartbeat.

Tachycardia is treated with vagal maneuvers, a process that triggers the nervous system to slow down the heart rate. It can also be treated with anti-arrhythmic medications.

Atrial fibrillation is controlled by cardioversion, a procedure in which a shock is delivered to the heart to restore the normal rhythm of the heart. In catheter ablation, energy is provided in the form of heat, cold, or radio waves to ablate tissues of the heart to create an obstruction for impulses that cause arrhythmia.

Implantable cardioverter-defibrillator (ICD) is an implantable device with a battery-powered unit and sends energy shocks to normalize the heart rhythm. Energy delivered may be low or high depending on the type of arrhythmia.

A number of surgical procedures are also recommended for controlling arrhythmia. Maze procedure is a surgical method suggested for people who do not respond to other methods. In this procedure, a series of incisions are made in the upper atria. This creates a maze or pattern of scar tissue that does not conduct stray electrical impulses.

These random impulses are often the cause of arrhythmia. Coronary bypass surgery is recommended for people with coronary artery disease, a risk factor for irregular heartbeat.

Arrhythmia can be prevented by making the right lifestyle changes.

Know about the symptoms of arrhythmia, and have regular checkups. Avoid or control the major risk factors of arrhythmia.

Stop smoking, maintain a healthy body weight, limit caffeine, and control stress.

Exercise regularly to improve health.

Many alternative remedies are being studied for controlling heart arrhythmia. Some of the complementary therapies like yoga, meditation, and relaxation techniques help to reduce stress.

Acupuncture is also considered to be good in alleviating symptoms of arrhythmia, but it lacks solid scientific evidence. Staphysagria, Ignatia, nux vomica, iberis, digitalis, and spigelia are suggested to control palpitations and arrhythmia.

You must follow the treatment plan for heart arrhythmia and educate others around you to cope with the condition.

Medications should be taken as per the prescription.

Monitoring pulse is important, particularly if you on pacemaker.

Manage the risk factors through a healthy lifestyle.

Heart arrhythmia may increase the risk of stroke and heart failure.