Arrhythmia Overview

Arrhythmia, also called dysrhythmia, is a condition in which the rhythm of the heartbeat is disturbed or becomes irregular due to abnormal electrical activity in the cardiac muscles. Arrhythmia may be classified according to the rate at which the heart is beating, the point of origin or the nature of the disturbance. If the beat of the heart is fast (more than 100 beats/minute), it is known as tachycardia; and bradycardia, if it is slow (less than 60 beats/min). It may be classified as Atrial, Ventricular or Junctional, depending on which part of the heart it begins in. Or it may be classified as automaticity (muscles firing off electrical impulses on their own), re-entry (repeated cycling of the same impulse) or fibrillation (uncontrolled impulses resulting in an entire chamber of the heart vibrating).

Arrhythmia is found to be much more common among older people; especially people over 60 years of age. Older people are at a higher risk of heart disease, which can lead to arrhythmia. Atrial fibrillation, which affects millions of people in the US each year, is found to be amongst the most common type.

Some other types of arrhythmia, though, are seen to be more common in children and young adults. For example, paroxysmal supraventricular tachycardia (PSVT), or Wolff-Parkinson (White syndrome), is more common in young people. The risk of arrhythmia is increased if the person is already suffering from some previous heart condition, like congenital defects, cardiomyopathy, or leaking in the valves of the heart. Other conditions like diabetes, sleep apnea or high blood pressure can also indirectly lead to arrhythmia. Certain medications, particularly medication meant for heart conditions, have been seen to raise the risk as well. Smoking, alcohol and illicit drug use (cocaine or methamphetamine) also increase risk of arrhythmia.

Arrhythmia mostly occurs when the normal electrical activity of the heart is disturbed, i.e. if the nerve endings in the heart produce signals that are disjointed with the normal operation of the heart. For example, in a re-entry type arrhythmia, the same signal cycles around the heart multiple times instead of just going from one end to the other. Symptoms of arrhythmia include palpitations, anxiety, weakness, dizziness, fainting or nearly fainting, sweating, shortness of breath and chest pain.

Diagnosis of arrhythmia usually requires extensive heart testing and examination of medical history to identify the risk factors. A battery of tests may be performed, including an ECG (electrocardiogram); a holter monitor which measures heart function through out the day and extensive blood tests, physical exams and echocardiography. The doctors may also check for symptoms of other diseases that may be leading to arrhythmia.

Arrhythmia may be treated using medicines, medical procedures, or surgery, depending on the seriousness of the problem and the doctor’s discretion. Medication such as amiodarone, sotalol, flecainide, propafenone, may be used to restore the heart rate to normal. Other medication like blood thinners may also be used. Some of these medications are known to have noticeable side effects, even to the extent of causing another kind of arrhythmia. A slow heart rate may be treated using a pacemaker. Arrhythmias may also be controlled using Vagal maneuvers. These self-performed exercises can restore heart rate by affecting the Vagus nerve, which controls the heart rate. However, these should only be performed on the recommendation of your doctor.