Arrhythmia

We’ve all felt our heart pound from intense emotion. However, arrhythmia happens to people who have an irregular heart beat or whose heart rate is too fast or too slow. Learn more about how this heart problem can be treated.

What is arrhythmia?

The heart is a pump that circulates blood throughout the body. It has 4 chambers that include 2 atria and 2 ventricles. The atria receive blood into the heart, and the ventricles push blood out to circulate through the entire body. For this system to work properly, the heart needs to beat at the right rate (speed) and rhythm (regularity).

Heart beats are controlled by a nerve impulse that is like an electric current. A specific point in the heart called the sinus node acts as a conductor to orchestrate each small part of the heart so that they contract at precisely the right time to send blood to the lungs and the rest of the body.

When this system doesn’t work properly or doesn’t let the heart beat normally, this is called cardiac arrhythmia or heart arrhythmia. The normal heart rate for an adult without any health problem is between 60 and 100 beats per minute.

What are the types of arrhythmia?

There are many types of arrhythmia. These include an accelerated heart rate (tachycardia, or more than 100 beats per minute), a slowed heart rate (bradycardia, less than 60 beats per minute), or an irregular heart rate.

Arrhythmias are also named for the part of the heart that is causing the problem (atria, ventricle) and for the nature of the problem: atrial or ventricular fibrillation, atrial or ventricular extrasystoles, atrial flutter, etc.

No matter what type of arrhythmia you have, the result is often the same: the heart doesn’t work as well and can’t provide enough oxygen to the body’s organs. The organs therefore tire out  and don't function as effectively. While some arrhythmias cause few or no symptoms, some are dangerous (e.g., ventricular fibrillation) and can cause a heart attack, stroke, and even death.

What can cause arrhythmia?

Heart disease can be a cause of arrhythmia and can include:

• a history of myocardial infarction (heart attack)
• valvular heart disease
• cardiomyopathy (disease of the heart muscle)
• hypertension

 

Other factors can also be responsible for arrhythmia or contribute to its onset:

• Diabetes.
• Thyroid disorders.
• Abuse of stimulants, such as drugs or coffee.
• Alcohol abuse.
• Smoking.
• Stress.
• Certain medications. Oral decongestants to relieve cold and flu symptoms are an example of drugs that stimulate the heart and should therefore be avoided if you have heart problems. If you have arrhythmia, you need to talk to your pharmacist before using over-the-counter medication.

Arrhythmia symptoms

Arrhythmia symptoms may vary depending on your heart condition, the type of arrhythmia you have, how serious it is, and the frequency and duration of your episodes. Some people feel no symptoms.

If you have tachycardia, an accelerated heart rate might cause palpitations and cause chest discomfort, general weakness, shortness of breath, sweating and sometimes fainting. People with atrial fibrillation (a different type of arrhythmia) may also get heart palpitations, which can be occasional or frequent.

If you suffer from bradycardia, your slow heart rate may cause fatigue, shortness of breath, dizziness and even fainting.

If you experience one of these symptoms, you should see a doctor.

How is arrhythmia detected?

The type of arrhythmia you have can be diagnosed  with different tests:

• Resting electrocardiogram (ECG): For this test, a device called an “electrocardiograph” records the electrical activity of your heart on a piece of paper.
• Exercise ECG (or stress test): This test records the electrical activity of your heart during a period of sustained physical activity (for example, while you walk on a treadmill).
• Holter monitoring : A Holter monitor is a device that you wear non-stop for 24 to 48 hours and that records your heart data for this period.

Your doctor will consider different treatments based on your test results, the cause of your arrhythmia, and the urgency of your situation.

How is arrhythmia treated?

Although most arrhythmias can't be cured, they can be controlled with the right treatment. The chosen treatment will depend on multiple factors, including the type of arrhythmia and associated symptoms.

Medication

Since there are multiple types of arrhythmias, it is quite normal for two individuals with arrhythmia to receive completely different medications. Depending on your arrhythmia, your doctor may prescribe medication that slows down or, on the contrary, accelerates your heart rate. Other drugs called “antiarrhythmics” help protect the ventricles when the atria don't work well, as they help keep the heart beating at a regular rhythm. You may also need to take blood thinners to prevent blood clots from forming due to the heart’s reduced effectiveness at pumping blood.

You need to regularly take any prescribed medication, and don’t stop taking this medication without your doctor’s consent. Stopping your medication could make your symptoms return, which could lead to complications (such as stroke and heart attack) and even death.

Pacemakers

A pacemaker is a device mainly used to treat patients whose hearts beat too slowly (bradycardia). It is surgically implanted and programmed to electrically stimulate the heart at a precise rhythm. This means that if your heart beats too slowly or “forgets” to beat, the pacemaker will beat in its place.

Implantable cardioverter defibrillator (ICD)

Some arrhythmias can be life threatening, and these types include ventricular tachycardia and ventricular fibrillation. An ICD is surgically implanted to monitor your heart rhythm  and correct it when it becomes irregular. When the device detects a dangerous arrhythmia, it shocks your heart to restore its normal rhythm.

Cardioversion

Cardioversion re-establishes the heart’s electrical system. This technique is often used for atrial fibrillation, meaning when the heart beats quickly and irregularly. A doctor administers a shock or electrical current to the heart. This shock temporarily neutralizes the heart's electrical activity and allows the sinus node  to start over with a regular and continuous heart rhythm. Cardioversion is used to treat arrhythmias that are both life threatening and not life threatening. However, the arrhythmia can reappear even if the procedure is a success.

Catheter ablation

In some cases, your doctor may perform a catheter ablation to destroy the heart tissue responsible for your arrhythmia. This non-surgical procedure involves pushing flexible tubes called catheters to the heart to destroy the defective tissue with an electric current. This procedure is very effective. In most cases, the arrhythmia does not return.

Surgical ablation

While this procedure is performed less often than others, it can be done during another surgery (e.g., coronary bypass). During the surgery, the doctor may use different techniques to destroy the heart tissue responsible for the arrhythmia.

Adopt a healthy lifestyle

Changes in your lifestyle can help reduce your symptoms and control your arrhythmia.

• Quit smoking. Ask your pharmacist about smoking cessation programs.
• Try to avoid things that may unnecessarily stimulate your heart, such as caffeine, drugs and intense exercise (e.g., sprinting or weightlifting).
• Stay active. Check with your doctor about the best activities for your situation.
• Eat a healthy diet.
• Reach or maintain a healthy weight.
• Learn to manage stress.

Although these changes are often not enough to control arrhythmia, they are healthy habits to adopt for life.

Arrhythmia is a problem with serious consequences that can  put your life in danger. You need to follow the advice of health care professionals and adhere to your drug regimen.

Don’t hesitate to consult your pharmacist or doctor, who are here to help!

Resource:
The Heart and Stroke Foundation