Arrhythmia

Overview

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Arrhythmia is a condition in which the heart beats irregularly, either too fast (tachycardia), too slow (bradycardia), or with an erratic rhythm. This can affect how well the heart pumps blood to the body, potentially leading to serious health issues.

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Symptoms
  • Palpitations – A feeling of skipped heartbeats or fluttering in the chest.
  • Shortness of Breath – Difficulty breathing, especially with exertion.
  • Chest Pain – Discomfort or tightness in the chest.
  • Dizziness or Lightheadedness – Sensation of spinning or imbalance.
  • Fainting (syncope) – Sudden, brief loss of consciousness.
  • Fatigue – Feeling unusually tired or weak.
  • Sweating – Excessive perspiration without exertion.
Complications
  • Stroke – Irregular heartbeats, especially atrial fibrillation, can lead to blood clots that travel to the brain, causing a stroke.
  • Heart Failure – Chronic arrhythmia can weaken the heart’s ability to pump efficiently, leading to heart failure.
  • Cardiac Arrest – Sudden arrhythmias can cause the heart to stop beating, leading to sudden cardiac death.
  • Organ Damage – Poor blood flow can affect organs such as the kidneys or liver.
  • Blood Clots – Irregular heart rhythms may promote clot formation, increasing the risk of a blockage in vital organs.
Causes

Heart-related Causes

  • Coronary artery disease
  • Heart attack
  • Heart failure
  • Congenital heart defects
  • Cardiomyopathy (heart muscle disease)
  • Valve disease

Non-heart-related Causes

  • Electrolyte Imbalances: Changes in potassium, calcium, magnesium, etc.
  • High blood pressure (hypertension)
  • Excessive alcohol or caffeine consumption
  • Drug use (e.g., cocaine, amphetamines)
  • Thyroid Dysfunction: Hyperthyroidism or hypothyroidism
  • Stress and anxiety
  • Certain Medications: Some heart or asthma drugs can trigger arrhythmias.
  • Sleep apnea
Prevention

Lifestyle Modifications

  • Maintain a healthy diet (e.g., heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins).
  • Regular exercise.
  • Limiting alcohol and caffeine intake.
  • Avoiding smoking and drug use.
  • Managing stress and anxiety through relaxation techniques.
  • Controlling conditions like high blood pressure, diabetes, and cholesterol.
  • Routine medical care: Regular check-ups to monitor heart health, especially if you have known risk factors."
Risk Factors
  • Age: Older adults are at higher risk.
  • Family history of arrhythmia or heart disease.
  • Previous heart attack or other heart diseases.
  • High blood pressure.
  • Diabetes.
  • Sleep apnea.
  • Obesity.
  • Excessive alcohol, caffeine, or drug use.
  • Electrolyte imbalances.
  • Use of certain medications (e.g., stimulants, certain antidepressants).
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How is it Treated?

The Treatment depends on the type of arrhythmia, its severity, and its underlying cause.

Lifestyle Changes

  • Modifying diet, quitting smoking, reducing stress, etc.

Medications

  • Anti-arrhythmic drugs.
  • Blood thinners (e.g., anticoagulants) to prevent stroke in atrial fibrillation.
  • Beta-blockers or calcium channel blockers to control heart rate.
  • Cardioversion: An electric shock or medication used to reset the heart's rhythm.
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How is it Diagnosed?

Arrhythmia refers to any irregularity in the heart's rhythm, rate, or conduction. Diagnosis begins with a detailed clinical history focusing on symptoms such as palpitations, dizziness, syncope, chest pain, or breathlessness. Family history of sudden cardiac death or arrhythmic disorders is also significant.

Physical examination may reveal an irregular pulse, variable heart rate, or signs of heart failure. Auscultation can detect irregular rhythms, and pulse deficit may be noted. The primary diagnostic tool is the electrocardiogram (ECG), which records electrical activity of the heart. It can help identify arrhythmia types such as atrial fibrillation, supraventricular tachycardia, ventricular tachycardia, or bradyarrhythmias. However, intermittent arrhythmias may not be captured during a routine ECG.

    For intermittent or suspected arrhythmias, ambulatory monitoring is employed:

  • Holter monitor (24–48 hours)
  • Event recorder or loop recorder (for infrequent symptoms)

    Echocardiography helps assess underlying structural heart diseases. Additional tests may include:

  • Electrophysiological study (EPS) – invasive testing to pinpoint arrhythmia origin
  • Tilt-table test – for unexplained syncope
  • Thyroid function tests and electrolyte levels – to rule out metabolic causes
  • Advanced imaging like cardiac MRI may be warranted if structural or infiltrative diseases (e.g., sarcoidosis, myocarditis) are suspected.
  • Early and accurate diagnosis of arrhythmia is crucial to guide treatment, which may include medications, ablation therapy, pacemaker, or implantable cardioverter defibrillator (ICD) depending on severity and type.

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FAQs

Atrial fibrillation (AFib) is the most common type, characterized by a fast and irregular heart rhythm.

Some arrhythmias can be cured with ablation or treated with lifestyle changes and medications, but others may require lifelong management.

Some arrhythmias, like ventricular fibrillation, can be life-threatening and require immediate treatment. Others, like AFib, are less dangerous but can lead to complications if not managed.

Yes, stress can trigger arrhythmias, particularly in individuals who are predisposed.

Bradycardia refers to a slow heart rate (below 60 beats per minute), while tachycardia refers to a fast heart rate (above 100 beats per minute).

Many arrhythmias can be prevented by maintaining a heart-healthy lifestyle, managing chronic conditions, and avoiding known triggers like caffeine and alcohol.

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