Heart Disease: Abnormal Heart Rhythm

(Arrhythmia)
Heart Disease: Abnormal Heart Rhythm (Arrhythmia)
An irregular heartbeat is an arrhythmia (also called
dysrhythmia). Heart rates can also be irregular. A normal
heart rate is 50 to 100 beats per minute. Arrhythmias
and abnormal heart rates don't necessarily occur
together. Arrhythmias can occur with a normal heart
rate, or with heart rates that are slow (called brad
arrhythmias -- less than 60 beats per minute).
Arrhythmias can also occur with rapid heart rates (called
tachyarrhythmia’s -- faster than 100 beats per minute).
In the United States more than 850,000 people are
hospitalized for an arrhythmia each year.
What Causes an Arrhythmia?

Arrhythmias may be caused by many different factors,

including:

* Coronary artery disease.

* Electrolyte imbalances in your blood (such as sodium or
potassium).
* Changes in your heart muscle.
* Injury from a heart attack.
* Healing process after heart surgery.

Irregular heart rhythms can also occur in "normal,

healthy" hearts.
What Are the Types of Arrhythmias?

The types of arrhythmias include:

* Premature atria contractions. These are early extra

beats that originate in the atria (upper chambers of the
heart). They are harmless and do not require treatment.
* Premature ventricular contractions (PVCs). These are
among the most common arrhythmias and occur in
people with and without heart disease. This is the
skipped heartbeat we all occasionally experience. In
some people, it can be related to stress, too much
caffeine or nicotine, or too much exercise. But
sometimes, PVCs can be caused by heart disease or
electrolyte imbalance. People, who have a lot of PVCs,
and/or symptoms associated with them, should be
evaluated by a heart doctor. However, in most people,
PVCs are usually harmless and rarely need treatment.
* Atrial fibrillation. AF is a very common irregular heart
rhythm that causes the atria, the upper chambers of the
heart to contract abnormally.
* Atrial flutter. This is an arrhythmia caused by one or
more rapid circuits in the atrium. Atria flutter is usually
more organized and regular than atrial fibrillation. This
arrhythmia occurs most often in people with heart
disease, and in the first week after heart surgery. It often
converts to atrial fibrillation.
* Paroxysmal supraventricular tachycardia (PSVT). A
rapid heart rate, usually with a regular rhythm,
originating from above the ventricles. PSVT begins and
ends suddenly. There are two main types: accessory path
tachycardias and AV nodal reentrant tachycardias (see
below).
* Accessory pathway tachycardias. A rapid heart rate due
to an extra abnormal pathway or connection between the
atria and the ventricles. The impulses travel through the
extra pathways as well as through the usual route. This
allows the impulses to travel around the heart very
quickly, causing the heart to beat unusually fast.
* AV nodal reentrant tachycardia. A rapid heart rate due
to more than one pathway through the AV node. It can
cause heart palpitations, fainting or heart failure. In
many cases, it can be terminated using a simple
maneuver performed by a trained medical professional,
medications or a pacemaker.
* Ventricular tachycardia (V-tach). A rapid heart rhythm
originating from the lower chambers (or ventricles) of the
heart. The rapid rate prevents the heart from filling
adequately with blood; therefore, less blood is able to
pump through the body. This can be a serious
arrhythmia, especially in people with heart disease, and
may be associated with more symptoms. A heart doctor
should evaluate this arrhythmia.
* Ventricular fibrillation. An erratic, disorganized firing of
impulses from the ventricles. The ventricles quiver and
are unable to contract or pump blood to the body. This is
a medical emergency that must be treated with
cardiopulmonary resuscitation (CPR) and defibrillation as
soon as possible.
* Long QT syndrome. The QT interval is the area on the
electrocardiogram (ECG) that represents the time it takes
for the heart muscle to contract and then recover, or for
the electrical impulse to fire impulses and then recharge.
When the QT interval is longer than normal, it increases
the risk for "torsade de pointes," a life-threatening form
of ventricular tachycardia. Long QT syndrome is an
inherited condition that can cause sudden death in young
people. It can be treated with antiarrhythmic drugs,
pacemaker, electrical cardioversion, defibrillation,
implanted cardioverter/defibrillator or ablation therapy.
* Bradyarrhythmias. These are slow heart rhythms,
which may arise from disease in the heart's electrical
conduction system. Examples include sinus node
dysfunction and heart block.
* Sinus node dysfunction. A slow heart rhythm due to an
abnormal SA (sinus) node. Sinus node dysfunction is
treated with a pacemaker.
* Heart block. A delay or complete block of the electrical
impulse as it travels from the sinus node to the
ventricles. The level of the block or delay may occur in
the AV node or HIS-Purkinje system. The heart may beat
irregularly and, often, more slowly. If serious, heart block
is treated with a pacemaker.
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