Arrhythmia

An irregular heartbeat caused by problems with the heart’s electrical system is called arrhythmia.

Patients experiencing arrhythmia may feel that their heart is beating too rapidly (tachycardia), too slowly (bradycardia), or is fluttering (fibrillation). They may also feel like their heart either added a beat or skipped one.

Arrhythmia can be completely harmless, or it can be indicative of a serious medical emergency. Either way, it is always advisable to check in with an electrophysiologist to be safe.

Individuals may not always know they have arrhythmia because it is often asymptomatic, meaning it doesn’t have any signs or symptoms.

However, in some cases, arrhythmia can cause symptoms like chest pain, shortness of breath, and dizziness. These arrhythmia symptoms require immediate medical attention.

There are other signs and symptoms patients may experience, including:

• Palpitations (“flip-flops”, fluttering, feeling of skipped heartbeats).
• Pounding in the chest
• Feeling lightheaded or dizzy
• Fainting
• Shortness of breath
• Chest pain, discomfort, or tightness
• Weakness or fatigue
• Blurry vision
• Sweating
• Anxiety

Arrhythmia is a general term for any problem with the rate or rhythm of the heartbeat. There are many different types of arrhythmia, and each one can cause different symptoms.

Here’s a look at some of the most common arrhythmia types:

• Bradycardia: In this form of arrhythmia, the heart beats slower than normal (less than 60 beats per minute). While bradycardia can be benign, it can also signify a more serious condition like heart block or sick sinus syndrome. The latter is an umbrella term given to a range of disorders concerned with the sinus node. Bradycardia can also be a result of sleep apnea.
• Tachycardia: When the heart beats abnormally fast (greater than 100 beats per minute), it is called tachycardia. Because of this, ventricles may not receive enough blood to supply to the rest of the body. Tachycardia that lasts more than 30 minutes requires urgent medical attention.
• Ventricular tachycardia (VT): When arrhythmia originates in the heart’s lower chambers or ventricles, it is known as ventricular tachycardia. VT occurs when ventricles beat at more than 100 bpm. It most commonly affects people who have a history of heart attacks, heart disease, or structurally abnormal hearts. However, people who don’t belong to any of these categories may also experience ventricular tachycardia.
• Ventricular fibrillation: This is a more dangerous form of ventricular arrhythmia. Ventricular fibrillation is a condition in which the heart’s ventricles begin to beat erratically. It can lead to several serious health complications, including sudden cardiac arrest.
• Atrial arrhythmia or supraventricular arrhythmias: As the name indicates, this type of arrhythmia heart disease originates in the upper chambers or atria. It is an umbrella term given to various arrhythmias affecting the upper chambers. These include atrial tachycardia, atrial flutter, atrial fibrillation, paroxysmal supraventricular tachycardia (PSVT), supraventricular tachycardia, atrioventricular reentrant tachycardia, and atrioventricular nodal reentrant tachycardia (AVNRT).

The following conditions can trigger an arrhythmia:

• Blocked arteries (coronary artery disease)
• Scar tissue left from a previous heart attack
• COVID-19 infection
• Hyperthyroidism (overactive thyroid gland)
• Sleep apnea
• Hypothyroidism (underactive thyroid gland)
• Certain medications
• Alcohol and drug abuse
• Smoking
• Stress or anxiety
• High blood pressure
• Diabetes
• Cardiomyopathy (heart muscle disease)

Our doctors employ the following diagnostic methods for arrhythmia:

• Electrophysiology study (EP): This test is used to assess the heart’s electrical activity and is performed by inserting wire electrodes through blood vessels and connecting them to the heart.
• Echocardiogram: Also known as “ultrasound of the heart”, an echocardiogram shows how well the heart valves and muscles are working.
• Tilt table test: A tilt table test is a diagnostic tool used to evaluate patients with syncope (fainting) and dizziness. The test determines if these symptoms are caused by a drop in blood pressure or heart rate.
• Magnetic resonance imaging (MRI): This test is used to obtain detailed images of the heart.
• Exercise stress test: An exercise stress test, also known as a treadmill test, is used to evaluate how well the heart handles physical activity. In this test, our doctors record an ECG (electrocardiogram) while the patient performs strenuous exercises.
• Devices: To continuously monitor heart rhythm, our doctors may recommend wearable devices such as Holter monitors or implantable devices like loop recorders.

Arrhythmia treatment may involve:

• Medications
• Cardioversion: It is a medical procedure used to reset the heart’s rhythm back to its normal pattern. Cardioversion can be done either by a controlled electrical shock or by medications.
• Vagal manoeuvres: They are a great way to help relieve symptoms of certain conditions like supraventricular tachycardia. Vagal manoeuvres are a set of techniques such as dunking the face in cold water, holding the breath, and straining and coughing that can be used to slow down a fast heart rate. They are named after the vagus nerve, which controls the heart rate.
• Pacemaker implantation: A pacemaker is a small, battery-operated device that’s placed under the skin on the chest. It sends electrical pulses to control abnormal heartbeats. This helps the heart beat at a steady, normal pace.
• Catheter ablation: This involves using a catheter, which is a thin, flexible tube, to reach the heart. Once the catheter is in place, radiofrequency energy is used to destroy the abnormal tissue causing the arrhythmia.
• Implantable cardioverter-defibrillator (ICD): The ICD monitors the heart, and if it detects a life-threatening arrhythmia, it will deliver a shock to the heart to restore a normal rhythm.
• Maze procedure: This procedure involves creating a series of incisions in the heart to create a “maze” of scar tissue that will help restore normal electrical function.

Living a heart-healthy lifestyle may help prevent arrhythmia. This includes:

• Not smoking
• Maintaining a healthy weight
• Staying physically active
• Eating a balanced diet
• Limiting alcohol and caffeine intake
• Reducing stress
• Using medications for current medical conditions.

While arrhythmia can be harmless, in some cases, it can be a sign of a more serious problem. Patients must keep no room for doubt and seek medical help as and when they experience symptoms.

Visit the CK Birla Hospital or book an appointment with Dr Sanjeeva Kumar Gupta to get the proper diagnosis and the best treatment for arrhythmia. We have a team of experienced electrophysiologists, cardiologists, and support staff to deliver top-notch treatment and care.