Irregular Heartbeat (Heart Arrhythmia)

Heart arrhythmia, also known as an irregular heartbeat, occurs when the electrical impulses that coordinate your heartbeats don't function properly, causing your heart to beat too fast (tachycardia), too slow (bradycardia), or irregularly. While some arrhythmias are harmless, others can be serious or even life-threatening.

Heart arrhythmias can be caused by a variety of factors, including:

• Heart Conditions:
  • Coronary Artery Disease (CAD) can lead to reduced blood flow to the heart, triggering arrhythmias.
  • Heart Attacks could damage heart tissues, disrupting the heart's electrical signals, leading to arrhythmias.
  • Heart Failure may result in changes in heart structure, and pressure can create a conducive environment for arrhythmias.
• Medication Side Effects: Certain medications used to treat high blood pressure, depression, and other conditions can affect the heart's rhythm. For instance, beta-blockers, while often used to treat arrhythmias, can sometimes cause bradycardia (slow heart rate).
• Lifestyle Factors:
  • Excessive Alcohol Consumption
  • Smoking
  • High doses of caffeine
  • Stress
• Other Health Conditions:
  • High Blood Pressure: can lead to changes in the heart muscle and its electrical system, increasing the risk of arrhythmias.
  • Thyroid: Hyperthyroidism, in particular, can cause rapid heart rates and arrhythmias like atrial fibrillation.
  • Electrolyte imbalance or disorder: A lack of electrolytes such as potassium, sodium, calcium, and magnesium can disrupt the heart's electrical activity, leading to irregular heartbeats and arrhythmias.
  • Diabetes: increases the risk of heart disease and can lead to changes in heart structure and function, contributing to arrhythmias.
  • Sleep Apnea: where breathing repeatedly stops and starts during sleep, can lead to irregular heart rhythms due to intermittent lack of oxygen and increased strain on the heart.

1. Tachyarrhythmias (Fast Heart Rate)

• At Atrial:
  • Atrial Fibrillation (AFib)
  • Atrial Flutter
  • Supraventricular Tachycardia (SVT)
• Ventricular:
  • Ventricular Tachycardia (VT)
  • Ventricular Fibrillation (VFib)

2. Bradyarrhythmias (Slow Heart Rate)

• Bradycardia: includes heart block and sick sinus syndrome.

3. Premature Beats (Extra Heartbeats)

• Premature Atrial Contractions (PACs)
• Premature Ventricular Contractions (PVCs)
• Paroxysmal Supraventricular Tachycardia (PSVT)

To accurately diagnose arrhythmias, it is necessary to carry out several tests:

• Electrocardiogram (ECG or EKG): Measures the electrical activity of your heart. Electrodes are attached to your skin to record your heart’s activity over a short period, usually a few minutes.
• Holter Monitor: A portable wearable device that provides continuous ECG monitoring over 24-48 hours and records your heart’s activity as you go about your daily activities.
• Event Monitor: A portable wearable device that captures irregular heartbeats that occur sporadically up to 30 days, and you may activate it when you feel symptoms.
• Echocardiogram: A transducer placed on your chest sends sound waves to create a moving picture of your heart and captures detailed images of your heart’s structure and function.
• Stress Test: Your heart activity is monitored while exercising on a treadmill. It assesses how your heart performs under physical stress.
• Electrophysiological Study (EPS): Thin, flexible tubes (catheters) are inserted through blood vessels into your heart, and electrical impulses are recorded. It maps the electrical activity of your heart to pinpoint the source of arrhythmias.

• Medications:
  Your healthcare provider may prescribe antiarrhythmic medications to regulate heart rhythm and prevent arrhythmia episodes.
• Cardioversion:
  In certain cases, cardioversion may be performed using electrical shocks or medications to restore normal heart rhythm.
• Catheter Ablation:
  This procedure involves using radiofrequency energy or extreme cold to destroy abnormal heart tissue responsible for causing arrhythmias.
• Implantable Devices:
  Devices like pacemakers and implantable cardioverter-defibrillators (ICDs) can help regulate heart rhythm and deliver electrical shocks if needed.
• Lifestyle Modifications:
  Making lifestyle changes such as reducing stress, avoiding excessive alcohol and caffeine intake, and quitting smoking can help manage arrhythmias.
• Surgical Intervention:
  In severe cases or when other treatments fail, surgical procedures like maze surgery may be considered to create scar tissue that interrupts abnormal electrical pathways in the heart.