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Arrhythmias

Overview

Any disorder of heart rate or rhythm.

Arrhythmias include tachycardias (heartbeat too fast), bradycardias (heartbeat too slow) and "true" arrhythmias (disturbedrhythm). Arrhythmias are classified as lethal if they cause a severe decrease in the pumping function of the heart. When thepumping function is severely decreased for more than a few seconds, blood circulation is essentially stopped, and organ damage(such as brain damage) may occur within a few minutes. Lethal arrhythmias include ventricular fibrillation, also ventriculartachycardia that is rapid and sustained, or pulseless, and may include sustained episodes of other arrhythmias.Some other arrhythmias include atrial fibrillation/flutter, multifocal atrial tachycardia, paroxysmal supraventricular tachycardia,Wolff-Parkinson-White syndrome, sinus tachycardia, sinus bradycardia, bradycardia associated with heart block, sick sinussyndrome, and ectopic heartbeat.


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Causes

Arrhythmias are caused by a disruption of the normal functioning of the electrical conduction system of the heart. Normally, thechambers of the heart (atria and ventricles) contract in a coordinated manner. The signal to contract is an electrical impulsethat begins in the sinoatrial node (sinus node, SA node). It is conducted through the atria and stimulates them to contract. Theimpulse passes through the atrioventricular node (AV node), then travels through the ventricles and stimulates them tocontract. Problems can occur anywhere along the conduction system, causing various arrhythmias. Problems can also occur inthe heart muscle itself, causing it to respond differently to the signal to contract, also causing arrhythmias, or causing theventricles to contract independently of the normal conduction system.People who have a history of coronary artery disease, heart valve disorders, or other cardiac disorders, and people withimbalances of blood chemistries, are at higher risk for arrhythmias and complications from arrhythmias.Arrhythmias are also caused by some drugs. These include antiarrhythmics, Beta blockers, caffeine, cocaine, psychotropics, andsympathomimetics.


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Signs & Symptoms

symptomatic arrhythmias:- changes in the rate, rhythm, or pattern of the pulse- sensation of feeling the heart beat (palpitations)- chest pain- shortness of breath- fainting- light headedness, dizziness

Note: The person may be without symptoms. The first symptom may be sudden cardiac death (loss of heart beat) associated withlethal arrhythmias.Additional symptoms that may be associated with this disease:- clammy skin- weak or absent pulse- paleness- temporarily absent breathing- low blood pressure

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Prevention

Interventions that are aimed at prevention of other heart diseases (e.g. coronary artery disease) may decrease the likelihood ofdevelopment of an arrhythmia.


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Treatments
Implanting Devices Modern Medicine

Implantable Device (Pacemaker):

These are small devices that are surgically implanted below the collarbone beneath the skin and are connected inside the heart through a vein. This delivers a small electrical stimulation to the heart to beat faster when it is going too slow. These machines are specifically used to treat slow heart rhythms.

Catheter Ablation

This method involves attaching a small metal-tipped wire catheter through a vein, from the leg to the heart. Catheter provides cardiologist with a road map to know which area is causing problem, the short circuits. It is maneuvered to see the problematic parts and gently burn away the troubling and unwanted parts of tissue. It is a faster method than the bypass surgery.

Implantable Cardioverter Defibrillator

It is a device for people who are prone to a severe case of arrhythmia where the rapid heart rhythms can become life-threatening. In comparison to the pacemaker it is slightly bigger. These too are surgically implanted and connected to the vein in the heart. It has the capability of delivering an electric shock to stimulate the heart when it determines the heart rate is too fast or deems it to be too slow.

CRT

This devices work by pacing both the left and right ventricles at the same time, which results in re synchronizing the muscle contractions and this results in the increased efficiency of the weakened heart.

Oral Medication Modern Medicine

Treatment completely depends on the severity of Arrhythmia and the results of the various check ups and reports. Electrophysiology study will show the condition of Arrhythmia and then with the advice and recommendation of the doctor the patient would be treated with the various options available. The options available are:

Oral Medication:

There are few anti-arrhythmic drugs that change the electrical signals in the heart. This helps prevent abnormal sites from beginning irregular or rapid heart rhythms.

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