Introduction

A proper functioning heart is important for complete well-being. What if there are some irregularities that are unknown to us? So today, let’s gain knowledge on irregularities of heartbeat also called Arrhythmias.

Arrhythmias is a condition where the heart beats abnormally, either beats too fast or too slow. Within the heart are a sophisticated system of valves, nodes, and chambers that regard, it can change the pattern with which your heart beats. Arrhythmias can cause no symptoms, or you may feel discomfort, fluttering, pain, or pounding in your chest. Not all arrhythmias are life-threatening or cause health complications. But to be on the safe side, you should report any abnormal heart rhythm to your doctor.

How does the heart work?

The responsibility of the heart is to circulate blood throughout the body. It is a two-stage electric pump. The first electrical impulse that starts the process of heartbeat is caused by a group of cells located in the upper chamber of the heart, the atrium. These cells act as an automatic pacemaker, starting the electric signal that spreads along with the “wiring” within the heart muscle, allowing a coordinated squeeze so that the pump can function. There are special cells in the right atrium called the sinoatrial node (SA node) that generate the first electrical impulse, allowing the heart to beat in a coordinated way. The SA node is considered the “natural pacemaker” of the heart.

This pacemaker function begins the electrical impulse, which follows pathways in the atrial walls, almost like wiring, to a junction box between the atrium and ventricle called the atrioventricular node (AV node). At the AV node, the electric signal waits for a short time, usually one- to two-tenths of a second, to allow blood pumped from the atria to fill up the ventricles. The signal then passes through electric bundles in the ventricle walls to allow these chambers to contract, again in a coordinated way, and pump blood to the lungs and body.

Working of SA node

The SA node generates an electric beat about 60 to 80 times a minute, and each should result in a heartbeat and feel like an external pulse. After the heartbeat, muscle cells of the heart need few seconds to get ready to beat again, and the electrical system allows a pause for this to happen. Each cell in the heart can act as a pacemaker. A healthy SA node has an inherent heartbeat generation rate of 60 to 80.

If the atrium fails to generate a heartbeat, then a healthy AV node can do so at a rate of about 40, and if needed, the ventricles themselves can generate heartbeats at a rate of about 20 per minute. This may happen if the cells of the upper chamber fail to generate an electrical impulse or if the electrical signals to the ventricle are blocked. However, these lower rates may be associated with the inability of the heart to pump blood to the body to meet its needs and may result in shortness of breath, chest pain, weakness, or passing out.

Arrhythmias and their types

The most common types of abnormal heart rhythms are:

Tachycardia

Tachycardia is a condition where the heart beats too fast. For example, a normal heart beats 60 to 100 times per minute in adults. In Tachycardia the resting heart rate is over 100 beats per minute (BPM) which is quite abnormal.

  • Supraventricular tachycardia occurs in the atria the upper chambers of the heart.
  • Ventricular tachycardia occurs in the ventricles the lower chambers of the heart.
  • Sinus tachycardia occurs when you are sick or excited, it’s the normal increase in the heart rate in the case of sinus tachycardia, a heartbeat returns to normal once you get better or become calm.

Atrial fibrillation

The most common Arrhythmia is Atrial fibrillation. It is a condition where the incoherent heart rhythm occurs in the upper chambers of the heart. Atrial fibrillation also occurs when many uncertain electrical impulses miscarry and that might result in the atria quivering which gets out of control. Atrial fibrillation causes the heart rate to increase and become unstable. It can increase the heart rate up to 100 to 200 BPM, which is a lot faster than the normal heart rate that is 60 to 100 BPM.

Atrial flutter

An atrial flutter (AFL) typically happens in the right atrium, which is one of the two upper chambers of the heart. However, it may occur in the left atrium as well. This condition is inflicted by a single electrical impulse that travels rapidly in the affected atrium. Due to which it often results in a fast heart rate, but it has a more normal rhythm.

Bradycardia

Bradycardia commonly occurs when the electrical signals traveling from the atria to the ventricles become disruptive, if you have a slow heart rate that means you’re a bradycardiac that is having less than 60 BPM. Slower heart rates for few athletes are a sign of good physical condition, and this isn’t usually the result of a heart problem or bradycardia.

Ventricular fibrillation

This occurs in the ventricles, due to irregular heartbeat the ventricles are unable to pump the blood out of the heart, the body, and the brain, and can stop the heart from beating and causes instant cardiac arrest. It is a severe condition that may result in death if it’s not instantly treated.

Premature contractions

If the pulse is taken from the wrist or chest the heart appears to skip a beat mostly due to premature contractions. The skipped beat is so faint or weak that it’s not heard or felt. Premature contractions occur in the upper or lower heart chambers. Types of premature contractions include extra beats and early beats. All these three types may occur in the upper or lower heart chambers.

Arrhythmias, their symptoms, and what should we know about abnormal heart rhythms?

If you have an unusual heart rhythm, you may encounter some or all of these symptoms:

  • unconsciousness, dizziness, or light-headed
  • shortness of breath
  • uneven pulse or heart palpitations
  • chest pain
  • pale skin
  • sweating

What causes heart rhythm disorders?

The abnormalities in the body environment can affect the heart’s ability to conduct electricity, the problem within the heart itself causes heart rhythm disturbances. Cardiac or heart muscle cells become irritated when they are deprived of oxygen. This can happen during a heart attack, in which the coronary arteries, the blood vessels that supply the heart with blood, are blocked. Scarcity of oxygen can arise when the lungs are unable to pull sufficient oxygen from the air.

The proper oxygen delivery is prevented by the low oxygen-carrying capacity of the blood which is due to significant anemia or low red blood cell count. The “ wiring problems with the electrical pathway in the heart causes rapid heart rates, This can lead to “short circuits” making the heart speed up and beat vigorously up to 150 beats per minute or more. This anomaly can be due to a physical extra electrical pathway which is seen in Wolff-Parkinson.

Diagnosing abnormal heart rhythms

The doctor will enact a physical examination, which will involve the use of a stethoscope to hear your heart. They may also use an electrocardiogram (EKG or ECG) machine to analyze the electrical impulses of your heart. This will help them discern whether your heart rhythm is abnormal and recognize the cause for it.

To diagnose an arrhythmia the tools required are

Echocardiogram: This test utilizes sound waves to take images of your heart and is also called a cardiac echo Holter monitor. You have to wear the monitor for at least 24 hours while you go about doing your normal activities. It enables your doctor to trace changes in your heart’s rhythm throughout the entire day.

Stress Test: You will be supposed to walk or jog on a treadmill by your doctor to see how exercise affects your heart.

Holter Monitor: Wear this monitor for at least 24 hours while you go about your normal activities, it allows your doctor to track changes in your heart’s rhythm throughout the day.

Treating abnormal heart rhythms

Arrhythmia treatment depends on its cause. You may need changes in your lifestyle, like boosting your activity level or changing your diet (for example, restricting your caffeine intake). If you smoke, your doctor will tell you to quit smoking. Medication is also required for you to regulate your abnormal heartbeat, as well as any secondary symptoms. For severe anomalies that don’t go away with behavioral changes or medication, the doctor can recommend:

  • Cardiac catheterization is used to diagnose heart abnormality
  • Catheter ablation to demolish tissue that induces abnormal rhythms
  • Cardioversion used for treatment or an electrical shock to the heart
  • Cardioverter defibrillator or implantation of a pacemaker
  • Correcting an abnormality by surgery

Prevention

If your arrhythmia comes under control, the physician will supervise your ways to keep it from coming back.

In general, healthy lifestyle choices can go a long way toward helping you control your condition. Your doctor will recommend you in improving your diet, exercising more, and trying to stop unhealthy behaviors like smoking. 

Conclusion

Arrhythmias are a result of abnormalities in the body’s environment that affects the heart’s ability to conduct several functions. This can occur during a heart attack, significant anemia, or low blood cell counts and also can be due to Wolff Parkinson White syndrome. To prevent Arrhythmias there are several medical treatments but also  Arrhythmias can be prevented if we lead a healthy lifestyle. It can be brought under control by stopping certain unhealthy behaviors.

 

Subin Joshua
Author: Hi there, my name is Subin Joshua, and I am a Medical student. I grew up in a family of teachers and know that being a social worker is my calling. My passion for helping others has been evident in my involvement in helping the poor and needy for the last three years. Through those experiences, I have learned to interact with a diverse group of people, which has increased my ability to relate to others.