Have you ever felt like your heart was beating too fast or skipped a beat? Many people have experienced this. But sometimes this is not normal and can be a sign of a serious problem with your heart rhythm. For example, we call ventricular arrhythmias the rhythm changes that occur in the lower chambers of the heart. While some of these are harmless, some types can be life-threatening.
How does this affect heart function?
Simply put, your heart is like a powerful pump with four chambers. The two small chambers on top are called the atria, and the two large, powerful chambers on the bottom are called the ventricles.
The right ventricle pumps blood to the lungs to get oxygen. Then the oxygenated blood returns to the heart, where it is pumped to the rest of the body through the left ventricle. So you can see that the two lower ventricles are responsible for pumping blood throughout the body .
So if there is any disruption to the normal rhythm of these cells, it can have serious consequences.
- Cardiogenic shock: This is a condition in which the heart is unable to pump enough blood, causing the body's organs to lack the oxygen they need.
- Sudden cardiac arrest: This is when the heart suddenly stops beating without any warning .
In both of these situations, death can occur within minutes if immediate first aid (such as CPR) or medical attention is not received.
What are the main types of Ventricular Arrhythmia?
There are three main types of this condition. Let's talk about them one by one.
1. Extra heartbeats (Preventricular Contractions - PVCs)
These are what feel like an "extra beat" in the heart. They are usually harmless . Most people experience something like this at some point in their lives. However, if you already have a condition that changes the shape of your heart, or if you have these extra beats (PVCs) frequently or for a long time, it is a cause for concern.
2. Ventricular Tachycardia (VT)
This is when the lower chambers of the heart, or atria, start beating at an unimaginable rate. This is caused by a defect in the heart's electrical system. In some cases, this `Ventricular Tachycardia` (VT) condition can become more severe and turn into the dangerous condition `Ventricular Fibrillation`, which we will discuss next.
Doctors divide this type of VT into several other types:
- Short-term or long-term? (Sustained vs. non-sustained): If this rapid heartbeat lasts for more than 30 seconds, it is called `Sustained VT`. If it lasts less than 30 seconds and then stops, but causes a condition like `Cardiogenic shock`, it also falls into this category.
- ECG pattern: Doctors can look at the electrical activity of your heart with a test called an `Electrocardiography (ECG or EKG).` In this test, several sensors are attached to your chest and a pattern of electrical waves from your heart is recorded. In a healthy heart, this pattern of waves is called `Sinus rhythm.` In a condition like VT, this pattern changes. Doctors can study this changed pattern to figure out exactly what the problem is.
3. Ventricular Fibrillation (V-fib)
This is the most dangerous of these and requires emergency treatment . What happens here is that instead of pumping properly, the lower chambers of the heart just quiver and flutter. Because they do not contract properly and pump blood, the blood flow to the body almost completely stops. This is called `Sudden cardiac arrest`, where the heart suddenly stops. Because blood does not flow to the brain, you lose consciousness within a few seconds and collapse. If blood flow is not restored within a few minutes, this is fatal.
What could be the symptoms of this condition?
Symptoms vary depending on the type. Some, like PVCs, may not have any symptoms at all. Let's take a closer look at the common symptoms of the two main types.
| Type of arrhythmia | Commonly seen symptoms |
|---|---|
| Ventricular Tachycardia (VT) |
|
| Ventricular Fibrillation (V-fib) |
|
What could be causing this?
There can be various reasons for these situations to occur.
Causes of Ventricular Tachycardia (VT)
- Weakening or thickening of the heart muscle (Cardiomyopathy)
- Heart disease (especially diseases that change the shape of the heart)
- Congenital heart conditions
- Electrolyte imbalances in the body
- Heart attack
- Heart failure
- Inflammatory conditions of the heart
- After heart surgery
- Heart valve diseases
- Lack of oxygen to the body
- Some medications
Causes of Ventricular Fibrillation (V-fib)
- A strong blow to the chest (e.g., being hit by a speeding ball)
- Weakening or thickening of the heart muscle (Cardiomyopathy)
- Congenital heart disease
- Electrocution
- Heart attack
- After heart surgery
- Some medications
- Uncontrolled Ventricular Tachycardia
Who is most likely to develop this condition?
Ventricular Arrhythmia is most common in people with pre-existing heart disease. Therefore, the risk naturally increases with age. This risk is especially high in people with diseases that change the structure or shape of the heart.
Some harmless types can occur in people of any age. But the more dangerous types, such as `Sustained VT`, are more common in people with underlying heart disease. But sometimes, it can occur in people who have no symptoms and don't know they have heart disease.
How does a doctor find this?
When you go to see a doctor, he will first ask you questions, ask about your symptoms, and take a medical history. Then he will examine you. That means listening to your heart and taking your blood pressure.
What kind of tests are done?
The main test used to diagnose this condition is the ECG (Electrocardiography) . We've talked about this before. In this, the electrical activity of the heart is recorded as a wave pattern, and the doctor analyzes it to see what abnormalities there are.
But sometimes this abnormal rhythm is not always present. In such cases, it may not be detected by a regular ECG. In such cases, your doctor may give you a device that you can wear for one or more days.
- Holter monitors: This is a small device, usually about the size of a cell phone. It has wires attached to sensors that you wear on your chest. It continuously records your heart rhythm for 24 or 48 hours.
- Ambulatory monitors: These are similar to a Holter monitor, but can be worn for longer periods of time, sometimes up to 30 days. Some types come with a button that you press when you feel a symptom. Others are automatic, recording an abnormal rhythm as soon as it is detected.
What are the treatments for this?
Whether this condition can be completely cured depends on the cause. Sometimes the cause can be treated and cured. However, if it is caused by a chronic disease, such as a congenital condition, it is usually difficult to cure. In that case, the goal of treatment is to manage the disease and minimize its impact on your life.
Emergency treatment
- CPR (Cardiopulmonary Resuscitation): If someone's heart has stopped and there is no pulse, CPR should be started immediately. This means artificially maintaining blood circulation by compressing the chest. It is not a good idea to stop CPR until an ambulance arrives or an `AED` machine is brought in and used.
- Automated External Defibrillator (AED): This is a device that analyzes a person's heart rhythm and, if necessary, delivers an electric shock (`shock`) to restore the heart's rhythm. Both `VT` and `V-fib` rhythms can be corrected with an electric shock in this way.
- Medications: There are special medications that are given to control the heart rhythm.
Non-emergency treatment
- Ablation: This involves inserting a thin tube, such as a cannula, into the heart and using extreme heat or extreme cold to inactivate a very small part of the heart that is causing the abnormal electrical signals. This stops the abnormal rhythm from occurring.
- Implantable Cardioverter Defibrillator (ICD): This is a small device that is implanted under the skin of the chest. It can automatically deliver an electric shock to restore normal heart rhythm when it detects a dangerous irregular heartbeat.
- Medications: There are medications that can be given to control the rhythm over the long term. However, these are not equally effective for everyone, and some side effects may occur. Therefore, you should talk to your doctor to choose the treatment that is most suitable for you.
What happens after treatment? What can you do?
The most important thing you need to do is follow your doctor's instructions exactly . It is very important to take your medications as prescribed and attend clinics on the scheduled dates.
If you notice any changes in your symptoms, especially if they suddenly get worse, let your doctor know right away.
The recovery time after treatment varies depending on the treatment. If you have an ablation or an ICD, you will start to feel better within a few days. With medication, you will see a difference in a few weeks. The future course of this condition varies greatly depending on your condition. The doctor who is treating you can best explain this to you.
Can this situation be prevented?
Because these types of arrhythmias often occur unexpectedly, they are not easy to prevent, especially if you have congenital heart disease.
However, we can indirectly reduce our risk of developing this condition by reducing the risk of other diseases (such as heart disease, high blood pressure) that can lead to this condition. To do this:
- Quit smoking (including cigarettes, vaping) completely.
- Eat a balanced diet recommended by your doctor.
- Stay as physically active as possible.
- Maintain a healthy weight .
- Control your alcohol consumption .
When should I see a doctor? When should I go to the ETU?
If you notice a change in your symptoms, or if they start to interfere with your daily life, see your doctor. Also, even if you don't have any symptoms, it's important to see a doctor at least once a year for a full physical examination to detect diseases early.
If you experience any of the following serious symptoms, go to a hospital's Emergency Department (ETU) immediately without delay.
- Severe chest pain (Angina)
- Difficulty breathing
- Unexplained loss of consciousness or frequent feeling of fainting (dizziness)
Ventricular Arrhythmia can vary greatly from person to person, so the best way to understand and manage your health is to seek medical advice if you suspect you have these symptoms.
Take-Home Message
- Ventricular Arrhythmia is an irregular heartbeat that occurs in the lower, stronger chambers (cells) of the heart.
- While some types (such as PVCs) are harmless, types such as Ventricular Fibrillation (V-fib) can be immediately life-threatening.
- If you have symptoms such as chest pain, difficulty breathing, dizziness, or loss of consciousness, it is an emergency. Go to a hospital's Emergency Department (ETU) immediately.
- An ECG test is very important to diagnose this condition.
- This condition can be successfully managed with medications, ablation, and implantation of devices such as ICDs.
- It is very important to follow your doctor's instructions exactly and to pay attention to your symptoms.
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