Identifying and Treating Arrhythmias
Your body is an amazing machine, capable of maintaining and regulating all of the complex systems necessary for life without any conscious direction from you. Occasionally, however, those systems may malfunction, threatening oneâ€™s health and well-being. An all-too-common malfunction that strikes one of the bodyâ€™s most vital organs is called arrhythmia, or an irregular heartbeat. There are several types of arrhythmias, ranging from mild irregularities that are relatively minor in nature to those that are immediately life threatening. If you have an arrhythmia, knowing what type it is may just save your life.
Your heartbeat is controlled by an electrical signal that regulates its rate and rhythm. This signal originates in a group of cells called the sinoatrial (or SA) node, which is located in the upper right chamber of the heart, called the right atrium. This signal travels down the heart, causing the upper chambers (or atria) to contract, which pumps blood to the heartâ€™s lower chambers, or ventricles. The signal then passes though the ventricles, causing them to contract and pump blood to the body. In a healthy individual, this process repeats like clockwork 60 to 100 times a minute. If at any time this system is interrupted or suffers a malfunction, it can result in an arrhythmia. The type of arrhythmia produced depends upon the nature and location of the malfunction.
The most common – and typically least concerning â€“ arrhythmia consists of extra heartbeats, also called premature beats. They often appear as a flutter in the chest or the sensation of the heart having skipped a beat. Premature beats can occur in either the atria or the ventricles, and are often triggered by over exercising, stress, or consumption of excessive amounts of stimulants such as caffeine or nicotine. In most instances premature beats are harmless and require no medical intervention or treatment. In rarer cases, however, they can indicate the presence of heart disease.
What Is Paroxysmal Supraventricular Tachycardia?
A similar type of arrhythmia is called paroxysmal supraventricular tachycardia, or PSVT. This is a type of tachycardia (rapid heartbeat) that starts suddenly and ends just as quickly. It is typically caused when the electrical signal passes to the ventricles and then reenters the atria, triggering additional heartbeats. PSVT often occurs in younger individuals. Like premature beats, PSVT is rarely life threatening.
A different type of arrhythmia, known as a bradyarrhythmia, occurs when oneâ€™s heart rate is slower than normal (about 60 beats/minute). As with the other minor arrhythmias discussed above, bradyarrhythmia usually is not a serious condition. In fact, many people have naturally slower heart rates, especially individuals who are in extremely good physical shape. However, bradyarrhythmia can result in such a slow heartbeat that insufficient blood reaches the brain, which can cause lightheadedness and ultimately loss of consciousness. A number of factors can cause bradyarrhythmia, including heart attacks, chemical imbalances, thyroid problems, and the normal aging process.
Some arrhythmias constitute a much greater health concern than the minor ones listed above. These more serious disorders can have serious consequences that may include sudden death. As a result, any sign of such problems should be a signal to see an electrophsyiologist immediately.
The most common type of major arrhythmia is called atria fibrillation, or a-fib. In a-fib, the electrical signal that starts the heartbeat does not originate in the SA node, but in nearby atrial structures or blood vessels. Instead of producing a strong, steady beat, a heart suffering from a-fib sends weak and disorganized signals that cause the heart to quiver â€“ or fibrillate â€“ rather than beat. This prevents the heart from pumping blood normally. While a-fib itself is rarely life threatening, it can lead to serious health consequences.
The condition may prevent the ventricles from filling with blood, forcing the heart to work harder to pump blood to the body. Over time, this can lead to heart failure. Another danger from a-fib is the possibility of stroke. A-fib can cause blood to pool in the atria, producing conditions under which blood clots may form. If one of these clots breaks off and is carried to the brain, it could result in a stroke.
A similar type of arrhythmia that strikes the ventricles rather than the atria is called ventricular fibrillation, or VF. In VF, chaotic electrical signals cause a quivering of the ventricles that prevents them from pumping normally. Unlike a-fib, this presents an immediate threat to survival. If the ventricles canâ€™t pump blood to the body, major systems will shut down and sudden cardiac arrest can occur within minutes. The only way to prevent death is through immediate defibrillation – the use of electrical shock to stop the quivering and return the heart to its normal rhythm.
Treating Major Arrhythmias
Several methods are used to treat a-fib and VF. In milder cases of a-fib, medicines called antiarrhythmics are used to slow down the heartbeat and help it maintain a normal rhythm. In more serious cases, when medicines or other treatments are ineffective or inappropriate for a patient, an electrophysiologist may undertake a procedure called catheter ablation. In this procedure, the electrophysiologist locates and destroys selected areas of heart tissue where arrhythmias may start.
VF can be treated with a device called an implantable cardioverter defibrillator ICD. This is a device similar to a pacemaker that monitors the heartbeat and sends a shock to the heart if it detects the signs of VF.
If you suffer from arrhythmia, even if you think itâ€™s nothing to worry about, you should consult an electrophysiologist to diagnose your condition. Most likely, it will be a minor condition such as premature beats that requires no medical intervention. However, if there is a more serious underlying problem, having a specialist identify it early is the best way to make sure you manage the condition to prevent serious complications in the future.
This article was sponsored by Heart Rhythm Specialists of South Florida, a Florida practice specializing in interventional cardiac electrophysiology. Staff physicians Dr. Hakop Hrachian and Dr. Giancarlo Speziani are two of Floridaâ€™s top electrophysiologists. Dr. Hrachian is a board certified physician in the fields of Internal Medicine, Cardiovascular Disease, Echocardiography, Nuclear Cardiology, and Clinical Cardiac Electrophysiology. Dr. Spezianai is Board Certified in Internal Medicine, Cardiovascular Medicine, and Cardiac Electrophysiology. Heart Rhythm Specialists welcomes a diverse clientele and offers staff fluency in five languages – English, Spanish, Armenian, Farsi and Turkish.