An irregular heartbeat, also known as arrhythmia, occurs when the heart beats too fast, too slow, or unevenly. It results from disruptions in the heart’s electrical signals
While some irregular heartbeats are harmless, others can signal serious heart conditions.
Causes of arrhythmia
Arrythmias can result from diseases involving various structures of heart
Blood vessels supplying the heart -coronary artery diseaseNervous circuits regulating the heart- conduction system diseaseDiseases affecting the four valves of the heart – valvular heart diseaseDiseases affecting the cardiac muscles and its metabolism– cardiomyopathiesDevelopmental abnormality- congenital heart diseasesRare diseases affecting cellular ion channels- channelopathies
Symptoms of arrhythmia
Giddiness, light-headedness, palpitations, chest pain or discomfort, fatigue, breathing difficulty, in severe cases can complicate into stroke, loss of consciousness, sudden cardiac death
High risk individuals who require early and frequent screening-
Strong family history of heart disease or unexplained sudden cardiac deathHistory of Diabetes, hypertensionPregnancy -all pregnant women need basic cardiac screeningObesity, alcohol and smoking abuseHistory of Congenital heart diseaseHistory of vascular diseases like recurrent stroke, peripheral vascular diseases
It is essential to be aware of frequently encountered noncardiac conditions having effect on heart beats -
panic attacks, anemia, thyroid imbalance, dehydration, electrolyte imbalance, gastrointestinal issues like dyspepsia and constipation, diabetics on insulin having frequent fluctuations of sugar levels have irregular spikes of their heartbeat.
Arrythmias can be classified based on heart rate into: Bradyarrhythmia (rate<60) and Tachyarrhythmia (rate >100)
There are various types of rhythms among these two categories with varying clinical presentations keynote arrythmias to be aware of are -
Tachyarrhythmias- Atrial fibrillation, ventricular tachycardia, supraventricular tachycardiaBradyarrhythmias- complete heart block, sinus node dysfunction
Diagnostic investigations include-
ElectrocardiogramEchocardiogram24hrs to 72 hours Holter monitoring (continuous ecg monitoring)Coronary angiogram if indicatedElectrophysiological study if indicated
Blood investigations: complete Hemogram, thyroid profile, renal function test, Diabetic and lipid profile
Treatment varies with each rhythm, underlying cause and the presenting symptoms.
Medical management -
Interventional treatment options - angioplasty ,pacemaker, device therapy, ablative procedures.
Early diagnosis by consulting a cardiologist will help in enjoying good quality of life by avoiding irreversible complications
Healthy habits that have long term effects on the outcomes of these abnormal rhythms include:
Healthy sleepMindful eating - including adequate fruits, vegetables and fibres in dietRegular health checkup and compliance to medicationsRegular physical activityAvoiding high salt and high fat dietAvoiding alcohol, smoking, substance abuse
(Author: Dr Deeyaneswar.D, Consultant Preventive And Interventional Cardiologist, Prashanth Superspecialtiy Hospital, Kolathur, Chennai)
