Does your heart beat strangely? Let's talk about heart rhythm irregularities (Arrhythmia)!

Don't worry, have you ever felt like your heart rate suddenly increased, or it was beating very fast, sometimes like it was pounding in a strange way? This is something that happens to many people. Today we are going to talk about this irregular heartbeat, which is called arrhythmia . This is sometimes called dysrhythmia .

Simply put, what is arrhythmia?

An arrhythmia is a change in the rhythm, or pattern, of your heart. Think of it this way: our heart is like a skilled musician, it should beat in a regular, regular rhythm. But sometimes this rhythm goes out of whack. That's when we call it an arrhythmia. It can start in different parts of the heart. Sometimes the heart beats very fast, other times very slowly, or without any regularity.

Normally, our heart works in a very organized and coordinated way. Because, this heart is the one that supplies our entire body with blood, providing nourishment and oxygen. So, if there is any problem in different parts of the heart, or in the blood that the heart pumps, this normal rhythm can be disrupted. That is why having a normal heartbeat rhythm is very important .

How serious is this heart rhythm disorder (arrhythmia)?

In fact, not all arrhythmias are dangerous. There are some types that do not cause any harm and do not require treatment. However, there are others that can cause a heart attack or cardiac arrest . Most arrhythmias fall somewhere in between these two extremes. Only a doctor can tell you exactly what type of arrhythmia you have and whether it needs treatment. Therefore, if you have any doubts, it is best to seek medical advice.

What are the main types of arrhythmia?

Doctors classify arrhythmias based on where in the heart they start.

• Supraventricular Arrhythmias: These start in the upper chambers of your heart, called the atria . "Supraventricular" means above the lower chambers of the heart, called the ventricles .
• Ventricular Arrhythmias: These start in the lower chambers of the heart, that is, the atria.
• Bradyarrhythmias and junctional rhythms: These can occur due to problems in the heart's electrical signal-conducting system, such as the sinoatrial (SA) node , atrioventricular (AV) node , or His-Purkinje network .

Simply put, there are two types of heart defects: those that start in the upper parts of the heart and those that start in the lower parts. In addition, there are also defects that involve the heart beating too slowly.

How common is this condition?

Worldwide, it is estimated that between 1.5% and 5% of people have arrhythmia. However, it is difficult to say exactly how many people actually have it, as some people do not show any symptoms. In countries like the United States, a type of arrhythmia called atrial fibrillation is the most common.

What symptoms do we feel?

A person with arrhythmia may experience symptoms such as:

• Heart Palpitations: It may feel like a drum is beating inside the chest, or like the heart is suddenly stopping, or it may feel like it is beating very fast.
• Dizziness or lightheadedness.
• Fainting Episodes.
• Shortness of Breath: It seems like you have difficulty breathing even with a little exertion.
• Chest discomfort or pain.
• Weakness or fatigue.

Sometimes, a heart rhythm disorder can be "silent," meaning it doesn't cause any symptoms. That's why regular medical checkups are important.

Why does this happen? What are the causes of arrhythmia?

There are various causes of arrhythmia. Some of them are:

• Coronary Artery Disease: This means blockage of the arteries that supply blood to the heart.
• Irritable tissue in your heart: This can be due to genetic causes or factors that develop later in life.
• High blood pressure.
• Changes in the heart muscle (Cardiomyopathy).
• Heart valve disorders.
• Electrolyte imbalances in your blood: These are changes in the amount of salts like sodium and potassium.
• Injury from a Heart Attack.
• The healing process after heart surgery.
• Other medical conditions.

Most often, arrhythmias are caused by a problem with the arteries, valves, or muscles of the heart.

What are the risk factors for arrhythmia?

These things can increase the risk of arrhythmia:

• Using tobacco products.
• Drinking alcohol.
• Consuming drinks and foods that have caffeine: Things like tea, coffee, and some soft drinks.
• Taking stimulants: Things like some cold medicines and herbal supplements.
• Having high blood pressure.
• Body Mass Index (BMI) greater than 30.
• Having high blood sugar: Like diabetes.
• Sleep apnea.

What complications can occur if left untreated?

If arrhythmias are not treated properly, complications such as:

• Heart muscle weakness (Cardiomyopathy).
• Cardiac arrest.
• Stroke: Interruption of blood flow to the brain.

How is this arrhythmia diagnosed?

A doctor can check your pulse and listen to your heart to detect an irregular heartbeat.

After listening to your symptoms and performing a physical exam, your doctor may order additional tests to confirm the presence of an arrhythmia and to find the cause. Sometimes you may be referred to an electrophysiologist , a cardiologist who has special training in heart rhythm disorders.

What kind of tests are done?

The following tests can be performed to diagnose an irregular heartbeat and related conditions:

• Electrocardiogram (ECG or EKG): This records the electrical activity of the heart.
• Blood tests: Check your electrolyte levels, or check for a genetic problem.
• Ambulatory Monitors: These are small devices that you wear for a few days. They record your heart rhythm while you go about your normal activities. An example is the Holter Monitor .
• Stress Test: This tests the heart's function while exercising.
• Echocardiogram: A sound wave test of the heart. It can look at the shape, size, and function of the heart.
• Cardiac Catheterization: A test to look for blockages in the arteries of the heart.
• Electrophysiology Study (EPS): A test that looks in depth at the heart's electrical system.
• Tilt Table Test: A test performed on people who experience dizziness while standing.
• CT scan (Computed Tomography - CT scan).
• Heart MRI (Heart MRI - Magnetic Resonance Imaging).

How is arrhythmia treated?

Treatment depends on the type of arrhythmia you have and its severity. In some cases, no treatment is needed. Treatment options for heart rhythm disorders include:

• Medications.
• Lifestyle changes.
• Therapies.
• Devices.
• Surgery.

1. Medications

There are many types of medications to treat arrhythmias. Because not everyone is the same, you may need to try several types and doses of medication to find the right medication and dose for you. Some of these include:

• Antiarrhythmic drugs: These help to return the arrhythmia to normal rhythm (Sinus Rhythm) or prevent the occurrence of an arrhythmia.
• Medicines that control your heart rate.
• Anticoagulant or Antiplatelet therapy drugs: For example , Warfarin or Aspirin . These reduce the risk of blood clots.
• Medications that treat related conditions that can cause abnormal heart rhythms.

It is very important to know these things:

• The names of the medications you take.
• Why are you taking that medicine?
• How often and at what time to take the medicine.
• What are the side effects of your medication?

2. Lifestyle Changes

Simple changes to your lifestyle can help with arrhythmias. Some of these include:

• Controlling blood pressure and blood sugar levels.
• Avoiding the use of tobacco products.
• Limiting alcohol consumption.
• Avoiding caffeine and stimulants.
• Maintaining a healthy weight.

3. Therapies

In addition to medication, some people may need other treatments to treat or stop irregular heart rhythms. Your doctor will decide which treatment is best for you and will discuss the pros and cons of these treatments with you.

• Cardioversion: An electrical shock is administered to synchronize the heart and restore normal rhythm.
• Catheter Ablation: A catheter sends high-frequency electrical energy to a small area of ​​tissue in the heart, "disconnecting" the abnormal rhythm pathway. This procedure can treat many types of SVT (Supraventricular Tachycardia) , Atrial Flutter , Atrial Fibrillation, and some Atrial and Ventricular Tachycardias .
• Pulmonary Vein Isolation: This is also a type of ablation. Scar tissue rings are created to isolate areas that may be causing atrial fibrillation . This can be helpful for people with frequent, paroxysmal, or persistent atrial fibrillation.

4. Devices

During a procedure performed by a cardiologist in an electrophysiology lab, certain devices may be implanted. The devices used to treat a heart rhythm disorder are:

• Permanent Pacemaker: This device sends small electrical impulses to the heart muscle, helping to maintain a normal heart rate and prevent the heart from beating too slowly.
• Implantable Cardioverter Defibrillator (ICD): This device constantly monitors your heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers a shock to the heart muscle to help restore it to a normal rhythm. This device treats two life-threatening heart rhythms called Ventricular Tachycardia and Ventricular Fibrillation .
• Biventricular (BV) Pacemakers and Defibrillators: Also called Cardiac Resynchronization Therapy (CRT) , these devices help synchronize the contractions of your left ventricle. In addition to the leads (small wires) that go to the right side of the heart, there is also a lead that goes to the left ventricle. This may be needed for people with heart failure and uncoordinated contractions of the left ventricle.

5. Surgery

People with arrhythmia may need heart surgery for these reasons:

• Treat a heart condition that may be causing the arrhythmia. For example, valve surgery or coronary artery bypass surgery .
• Maze Procedure: This can be used to treat atrial fibrillation that cannot be controlled with medication or non-surgical treatments.
• In some cases, a doctor may implant biventricular pacemaker leads (small wires) in your heart using minimally invasive or surgical techniques.

Are there any side effects and complications of the treatment?

Side effects and complications vary depending on the treatment. Some of them include:

• Arrhythmia drugs:
• Allergic reactions
• Dizziness
• Headaches
• Bleeding
• Upset stomach
• Cardioversion:
• Embolization of blood clots
• Skin bruises
• Skin rash
• Catheter Ablation:
• Bleeding
• Blood clots
• Stroke
• Infection
• Injury to a vein or heart tissue
• Pulmonary Vein Isolation:
• Allergy to a dye (if used)
• Infection
• Injury to your heart, esophagus or vein
• Stroke
• Devices:
• Device malfunction
• Infection
• Bleeding
• Collapsed lung
• Surgery:
• Bleeding
• Infection
• Stroke
• Heart attack
• Need for a pacemaker

How long does it take to feel better after treatment?

It may take some time to find the right medication and dosage for your arrhythmia. Depending on the procedure or surgery, recovery may take weeks or months. If you have a procedure such as Catheter Ablation or Pulmonary Vein Isolation , you may still have arrhythmias for several weeks while you recover. Your doctor will tell you what to expect based on your specific situation.

How to reduce the risk of arrhythmia?

You can do these things to reduce your risk of arrhythmia:

• Stop using tobacco products.
• Limit alcohol consumption.
• Limit or stop caffeine consumption. Some people are sensitive to caffeine. They may experience more symptoms when they consume products containing caffeine (tea, coffee, cola, some over-the-counter medications).
• Don't take stimulants. Be careful of stimulants in cough and cold medicines and herbal or nutritional supplements. Some of these medicines may contain ingredients that can cause irregular heart rhythms. Read the label and ask your doctor which medicine is best for you.
• Control high blood pressure.
• Try to maintain a healthy weight.
• Control your blood sugar levels.
• Get treatment for sleep apnea.
• Avoid activities that seem to trigger an arrhythmia.

What should I expect if I have an arrhythmia?

Depending on the type of heart rhythm disorder you have, you may have mild or severe symptoms, or you may have no symptoms at all. You may not need treatment, but some people may need medication or a procedure. With treatment for heart rhythm disorders, most people can live a full life. Some people with more serious arrhythmias can go into cardiac arrest , and they may or may not survive.

How long the arrhythmia lasts is also important. Harmless arrhythmias come and go depending on the cause. However, people with other types of arrhythmias – especially those at risk of cardiac arrest – may need lifelong treatment.

How do I take care of myself?

If you have a heart rhythm disorder, it can be helpful to know how to take your pulse . Your pulse is your heart rate, which is the number of times your heart beats per minute. Pulse rates vary from person to person. Your heart rate is slow when you are at rest and increases when you exercise. A normal heart rate (when you are at rest) is between 60 and 100 beats per minute. If you have a fitness tracker or smartwatch , you can use it to monitor your heart rate.

It's also important to make sure your family and friends know how to recognize the symptoms of your arrhythmia. You'll feel better if they learn how to perform CPR (Cardiopulmonary Resuscitation) .

What are the things you can't eat or drink with this condition?

If you have arrhythmia, you should limit your intake of alcohol and caffeine, both of which can trigger arrhythmias.

When should I see my doctor?

He or she will tell you how often you should see your doctor. If your symptoms are getting worse or getting worse between appointments, talk to your doctor .

You should always see a doctor for these things:

• See if your arrhythmia treatment is working.
• Prepare your medicine properly.
• See how well the implanted devices work.
• Make sure you are healthy and have no other medical problems.

When should I go to an Emergency Treatment Unit (ETU) ?

Seek immediate medical attention if you have any of these:

• Trouble breathing.
• Chest pain.
• Dizziness.
• Fainting episodes.

What questions should I ask my doctor?

Some questions you may want to ask your doctor:

• What type of arrhythmia do I have?
• Do I need treatment?
• What is the best treatment for me?
• What should I do to maintain my device?

There are many ways your heart can beat irregularly. Some of these irregular heartbeats, called arrhythmias, don't cause any symptoms. It's important to see your doctor if you have symptoms like extreme fatigue or chest pain. Your doctor can help you decide on the best treatment options for you, but you can also help yourself by making appropriate lifestyle changes.

Finally, things to remember

An irregular heartbeat, or arrhythmia, may not be serious for some people, but it can be life-threatening for others. Therefore, if you have a chest tightness, difficulty breathing, or frequent dizziness, be sure to seek medical advice. If detected early and treated properly, most people can live a normal life. Don't panic, the most important thing is to be aware.

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