Arrhythmias

An irregular heartbeat, which follows a pattern outside the heart’s normal rhythm, is called arrhythmia. Arrhythmia can mean that your heart beats too slowly, fast, or irregularly. 

Arrhythmia can feel like a fluttering or racing heart and may be harmless or cause minor discomfort. However, for some people, arrhythmias can cause potentially life-threatening symptoms.

The heart has four chambers: two upper chambers (atria) and two lower chambers (ventricles). Every heartbeat is a two-part pumping action that pushes blood from the atria to the ventricles and the rest of the body. 

As blood collects in the atria (upper chamber), the electrical signals in the heart cause both the right and left atria to contract. This action pushes the blood to the ventricles. 

Once the ventricles are full of blood, the heart's electrical signals cause the lower chambers to contract. This causes the pulmonary and aortic valves to open, and the blood is pushed from the right ventricle into the lungs to pick up oxygen. The oxygen-rich blood then flows from the left ventricle to the heart and other parts of the body.

Once the blood has moved into the aorta and the pulmonary artery, the cycle begins again. This process occurs with every single beat of the heart. 

The standard resting heart rate ranges between 60 to 100 beats a minute. If you have an arrhythmia, your heart rate is likely below 60 beats or more than 100 beats per minute. 

Not every person who has arrhythmia will have clear symptoms for it. Many people go through life without realizing they have arrhythmia till it is discovered during a physical exam by their doctor. 

People who do have symptoms may experience one or more of the following:

• Heart Palpitations
• Shortness of Breath
• Dizziness or Fainting
• Chest Pain or Tightness in the Chest
• Fatigue
• Blurry Vision
• Sweating

In extreme cases, you could become unconscious or go into cardiac arrest.

Arrhythmia can be caused by a variety of factors, such as:

• Heart disease
• Imbalance of electrolytes (such as potassium, sodium, calcium, and magnesium) in your blood
• Heart injury or changes such as reduced blood flow or stiff heart tissue
• Post-heart-surgery healing
• Infection or fever
• Certain medications (such as those for a cold)
• Problems with the electrical signals in your heart
• Intense emotions, stress, or surprise
• Lifestyle choices, such as alcohol, tobacco, caffeine, or exercise

Arrhythmias can be classified by your heart rate. A rate of fewer than 60 beats per minute is called Bradycardia, and a rate of more than 100 beats per minute is called Tachycardia. 

Bradycardia means that your heart isn’t pumping enough blood. This is usually caused by a problem with the heart’s electrical system or as a side-effect of certain medication.

Types of bradycardias include:

Sinus node dysfunction - The sinus node is the natural pacemaker for the heart and is responsible for setting the heart's pace. If the sinus node does not work correctly, the heart rate may be too slow (bradycardia) or too fast (tachycardia). Sinus node dysfunction is most commonly seen among older adults.

Heart block - This condition occurs due to a delay or a block of the electrical impulse as it travels from the sinus node to the heart’s lower chambers.

Types of tachycardias include:

Supraventricular Arrhythmia - This occurs if a problem with the electrical signals in the heart’s upper chambers (atria) causes the heart rate to speed up. The heart rate is so fast that there is not enough time to fill the chambers with blood before they contract, thus reducing the blood flow to the rest of your body.

Ventricular Arrhythmia - This occurs if a problem with the electrical signals in the heart’s lower chambers (ventricles) cause the heart rate to increase. The heart beats so fast that it can’t fill with blood or pump it through the rest of your body.

Factors that can increase the risk for arrhythmia include:

• Heart disease or heart surgery
• High blood pressure
• Congenital heart disease
• Thyroid problems
• Obstructive sleep apnea
• Imbalance of electrolytes (such as potassium, sodium, calcium, and magnesium) in your blood
• Excessive alcohol consumption
• Consumption of caffeine, nicotine, and other stimulants

If your doctor suspects that you may have an arrhythmia, you may be asked to undergo an electrocardiogram (EKG), wear a cardiac event monitor, or take a transthoracic echocardiogram (TTE). These tests help determine the cause of your heart rhythm problem and identify the best treatment for you. 

If you are diagnosed with arrhythmia, your doctor may recommend regular checkups to monitor your condition.

The type of arrhythmia you have determines the treatment you will need. Any underlying causes for the arrhythmia will also need a treatment plan. 

Treatment for arrhythmia may include:

Your doctor may prescribe medicines to control the heart rate and restore a normal heart rhythm for people with tachycardia. Alternatively, your doctor may prescribe blood thinners to prevent blood clots from forming. 

Medication must always be taken per the guidelines from your doctor to avoid further complications.

During the cardioversion procedure, electrical impulses are delivered to your heart through paddles or patches on your chest. The current passed through your body can affect the electrical impulses in your heart to restore it to a normal rhythm.

Vagal maneuvers target the vagus nerves in your nervous system. These nerves control your heartbeat. 

Vagal maneuvers usually help slow your heart rate and therefore do not work for all types of arrhythmias. Examples of vagal maneuvers that may be recommended include dunking your face in ice water or holding your breath and straining.

Types of surgery used for arrhythmias include:

• Pacemakers can be useful to correct slow heart rates. A pacemaker is a small device implanted near your collarbone. If the device senses that your heart rate is very slow or is likely to stop, it sends electrical signals to your heart through the blood vessels.
• Catheter ablation is performed by inserting one or more catheters into your blood vessels. These catheters create tiny scars in your heart to block abnormal electrical signals and restore a normal heartbeat.
• Implantable cardioverter defibrillator (ICD) can be useful if your heart rate is very fast. If the ICD detects an abnormal heart rhythm, it sends out low- or high-energy shocks to reset the heart to a normal rhythm. 
• Coronary bypass may be needed to increase the blood flow to your heart if you have a severe heart condition underlying the arrhythmia. 

If you feel like your heart is beating too fast, too slowly, or skipping a beat, please schedule an appointment with Dr. Lilian Ahiable as soon as possible. 

At Sydnor Cardiovascular Center, we provide expert care for people with all types of arrhythmias. Entrust your heart health with Dr. Ahiable and the team at Sydnor Cardiovascular Center. 

To schedule an appointment, call us on 727-300-2282 or request an appointment online.