Do you sometimes feel short of breath, tired all the time, or have swollen legs? These can sometimes be signs of a problem with your heart. Today we're going to talk about a condition that affects the functioning of the heart, but we probably haven't heard much about it. That's ventricular dyssynchrony , or as doctors call it, ``(Ventricular Dyssynchrony)``. Although the name may sound a bit complicated, let's explain it simply.
What is Ventricular Dyssynchrony?
Simply put, ventricular arrhythmia is when one or more of the lower chambers of your heart, called the ventricles , beat unevenly and without coordination. Imagine that there is a slight delay of about 40 milliseconds between the different parts of your heart's cells starting to contract, or between one cell starting to contract relative to the other. That can be considered arrhythmia.
Our heart only works efficiently when the muscles in its chambers contract at the same time and in the same way. Normally, electrical signals travel through the heart in a very orderly manner. When the two main chambers of the heart receive a signal to contract, the muscles in those chambers must contract to the same extent and at the same time. In particular, your left ventricle, the main pumping chamber of the heart, must contract in a very coordinated manner. It's like pushing from both sides toward the center.
However, if this signal doesn't reach both heart cells at the same time, the muscles can't contract at the same time. That's what we call this dyssynchrony .
Cellular dyssynchrony can affect your body in the following ways:
- It reduces the efficiency of your heart.
- Valves that normally help blood flow in only one direction can cause blood to flow backwards (in the wrong direction).
- The amount of blood your heart can pump (Cardiac Output) decreases.
What are the types of cardiac arrhythmias?
There are several main types of cell asynchrony:
- Atrioventricular Dyssynchrony: This is when the upper chambers (atria) and lower chambers (ventricles) of your heart contract without coordination.
- Interventricular Dyssynchrony: In this, your left and right ventricles (lower chambers) contract at different times.
- Intraventricular Dyssynchrony: In this, muscles in different parts of the same cell contract at different times. Think of it as the walls of a room contracting at different times, rather than being pushed inward at the same time.
Who is most affected by cell asynchrony?
This condition is commonly seen in people with the following medical conditions:
- People with heart failure.
- Left Bundle Branch Block (LBBB).
- Right Bundle Branch Block (RBBB).
- Heart muscle disease `(Cardiomyopathy)`.
- High blood pressure.
- Other heart diseases.
Think about Uncle Somapala from our village. He had been suffering from `(Heart Failure)` for some time. Lately, he has been having difficulty breathing and getting more and more tired. When the doctor examined him, he said that he also has this condition called `(Ventricular Dyssynchrony)` in his heart, which is why his symptoms have become worse.
How common is this condition?
About one-third of people with some form of heart failure may experience this type of cell asynchrony. About 2% of adults in developed countries suffer from heart failure. Also, between 6% and 10% of people over the age of 65 have heart failure. So, this condition is also something that is seen in connection with that.
What are the symptoms?
Cellular dyssynchrony can worsen the symptoms of heart failure, or even cause symptoms that are unique to it. These are the main ones:
- Difficulty breathing (especially when you are tired).
- Feeling very tired (even if just for a moment).
- Cough (possibly persistent).
- Swelling (edema) in the body (especially in areas like the legs and ankles).
What are the causes of cell asynchrony?
Several different heart problems can cause this. Some of them are:
- Ventricular Dysfunction.
- Scar tissue caused by a heart attack.
- Electrical Conduction Delay, which includes conditions such as Left Bundle Branch Block and Right Bundle Branch Block.
- Diseased heart muscle.
- Insufficient blood flow to the heart muscle (Ischemia).
What tests are done to diagnose this condition?
Your doctor will first ask you about your symptoms and perform a physical exam to assess your heart function. Sometimes , listening to your heart with a stethoscope can also give you an idea of this asynchrony.
The main test used to diagnose problems with the heart's electrical conduction system is an electrocardiogram (ECG) . It can detect conditions such as Right Bundle Branch Block and Left Bundle Branch Block, which cause the heart to beat out of sync. If these conditions are found on the ECG, the doctor will refer you for further tests.
Doctors often use an echocardiogram to detect cardiac arrhythmias. This allows them to see how the heart's chambers, valves, and muscles are contracting.
Other tests can also be done:
- Positron Emission Tomography (PET) scan.
- Multigated Acquisition (MUGA) scan.
- Heart Magnetic Resonance Imaging (MRI).
- Computerized Tomography (CT) scan.
- Single Photon Emission Computed Tomography (SPECT) scan.
How is cell asynchrony treated?
Healthcare providers may treat the underlying medical condition that is causing your cell asynchrony.
In many cases, cardiac resynchronization therapy (CRT) (also called CRT or biventricular pacemaker) can help the heart pump better by controlling the rhythm of both sides of the heart. However, this treatment only improves symptoms in 50% to 70% of people who receive this treatment. People with severe asynchrony are more likely to be successful.
Complications of CRT treatment
The following complications may occur when implanting a `CRT` (a bi-polar pacemaker) (these are rare, but good to be aware of):
- Pneumothorax.
- Accumulation of blood between the chest wall and the lung (Hemothorax).
- Heart puncture.
- Stimulation of muscles other than the heart.
- Pacemaker leads moving out of place.
How quickly will I feel better after treatment?
CRT therapy reduces cell asynchrony almost immediately. Some people start to feel better within a few weeks of having the device implanted. There are also long-term benefits:
- Improving the amount of blood pumped by your heart (Cardiac Output).
- Reduced backward leakage of blood from the mitral valve.
- Improving the quality of your life.
- The distance you can walk in six minutes increases.
What medicine is used?
For conditions that cause atrial fibrillation, such as heart failure, cardiomyopathy, or high blood pressure, a doctor may prescribe medications such as:
- Angiotensin-Converting Enzyme (ACE) Inhibitors.
- Angiotensin II Receptor Blockers (ARBs).
- Beta-Blockers.
- Diuretics (diuretics).
Although these medications may improve your heart's function to some extent, they cannot completely reverse the asynchrony caused by electrical conduction abnormalities. That's why treatments like CRT are needed.
How can you reduce the risk of cell asynchrony?
The best thing you can do is take good care of your heart. If you do, you will be able to prevent some of the conditions that cause cell asynchrony.
Some ways to protect your heart:
- Eat a diet low in saturated fat (reduce oil and fried foods).
- Exercise for at least 30 minutes most days (even walking is good).
- Maintaining a healthy weight for you.
- Taking the medicine exactly as prescribed by the doctor.
What happens if I have cell asynchrony?
Left Ventricular Dyssynchrony (LVD) is not treated, and the outcome is not as good. People with LVD are at higher risk of cardiac events than those without the condition. You can have dyssynchrony in either (or both) of your ventricles, but your left ventricle is the main part that pumps oxygen-rich blood throughout your body. This is a very important function.
A treatment called `CRT` (dual-cell pacemaker) can help people with heart failure reduce hospital stays and live longer.
Remember, the underlying cause of the asynchrony also affects the outcome. Some people's condition may be worse than others.
How do I take care of myself?
- If your doctor has prescribed medication for you, be sure to take it exactly as directed . Take the medication as directed until your doctor tells you to stop.
- If you have a biventricular pacemaker, remember to go to the clinics on the scheduled dates . These are where your doctor can check whether your pacemaker is working properly. Some hospitals have special clinics called CRT clinics. There, cardiologists and heart specialists work together to make sure you are getting the most out of your pacemaker.
When should I see my doctor?
- If you are not feeling better with the prescribed medication.
- If there is a problem with your biventricular pacemaker.
In such cases, see a doctor immediately.
When should I go to the Emergency Treatment Unit (ETU) ?
If you experience any of these symptoms , seek medical advice immediately:
- Chest pain or discomfort.
- Vertigo (feeling like you're spinning).
- Severe difficulty breathing.
- Stomach ache, nausea.
- Back, neck, or jaw pain.
What questions should I ask my doctor?
Don't forget to ask these questions when you see your doctor:
- Why did I develop cell asynchrony?
- Am I suitable for `CRT` treatment?
- Are there support groups that help people with heart disease?
It's normal to feel a little anxious when you find out that your heart isn't working properly. But don't worry. Your doctor can find the cause of your arrhythmia and choose the best treatment for you. Follow the instructions on the medicine bottle exactly. Taking your medicine at the same time every day will help you remember to take it. Mark your appointment dates on a calendar or set a reminder on your phone. This will help you avoid missing them.
Summary and Take-Home Message
Okay, so I hope you now have a better understanding of the ``Ventricular Dyssynchrony'' that we talked about today.
Simply put, this is a condition in which the lower chambers (cells) of the heart beat unevenly, out of sync with each other. This can reduce the efficiency of the heart, and can also cause symptoms such as shortness of breath and fatigue.
- Tests like `(ECG)` and `(Echocardiogram)` help to diagnose this condition.
- As a treatment, in addition to treating the underlying disease, pacemaker therapy called ``Cardiac Resynchronization Therapy (CRT)`` is also very important.
- Taking care of your heart and following a healthy lifestyle go a long way in preventing such conditions.
- If you have these symptoms, don't hesitate to seek medical advice. The sooner the disease is diagnosed and treated, the better the outcome.
Remember, your heart is your most precious possession. It is your responsibility to protect it.
` Heart disease, ventricular dyssynchrony, ventricular tachycardia, heart attack, CRT, pacemaker
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