When your heart is healthy it beats at a steady, regular rhythm, coordinated by your ‘natural pacemaker’, the sinoatrial node.
Arrhythmia describes the group of disorders where your heartbeat falls out of steady rhythm, and beats too quickly, too slowly, erratically, or a combination of all three.
In some cases Arrhythmia is not severe – you might be aware of a slight flutter or ‘skip’ in your heartbeat, but otherwise feel fine. At other times symptoms may be mild, causing chest pain, dizziness and light-headedness.
But some types of Arrhythmia are serious, and can develop into life-threatening conditions, possibly leading to Stroke, Heart Failure or Cardiac Arrest.
Broadly speaking, Arrhythmia falls into three categories: fast, slow and irregular.
The condition where, at rest, the heart beats too quickly – generally described as over 100 beats per minute.
Atrial fibrillation (AF) is one of the most common forms of tachycardia, and is caused by confused electrical signals in the atria (the upper chamber of the heart). These cause the heart to ‘fibrillate’ or quiver, rather than keep up a solid beat.
Atrial fibrillation can be further categorised as either ‘Slow AF’ which often causes no symptoms at all and may be present for weeks or months before detection ‘Rapid AF’ on the other hand does cause symptoms and needs prompt treatment.
The unusually slow beating of the heart, which means blood can’t circulate properly through your body, is called bradycardia and is generally defined as a heart rate of less than 60 beats per minute. In extreme cases, it can lead to Cardiac Arrest.
PVC is the skipped heartbeat that we all experience from time to time. These are among the most common Arrhythmias and are usually harmless and rarely need treatment. They can occur in people with and without heart disease and can be related to stress, too much exercise, too much caffeine or nicotine. Sometimes, PVCs can be caused by heart disease or electrolyte imbalance. People who experience PVCs, regularly or symptoms associated with them, should see their doctor.
Arrhythmia is often caused by Coronary Heart Disease, although other medical conditions can be triggers, and in some cases, the cause remains a mystery.
Key Risk factors include:
Heart Arrhythmia can be silent and not exhibit any obvious symptoms. A doctor can detect an irregular heartbeat by taking your pulse or through an electrocardiogram (ECG). Portable ECG's are commonly worn for extended periods to capture intermittent cardiac events such as Arrhythmias.
Symptoms at the mild range of Arrhythmia may include a slight and occasional flutter or ‘skip’ in your heartbeat, or chest pain, dizziness and light-headedness.
Symptoms of Arrhythmias may include:
Treatment is based on the severity and the cause of the Arrhythmia. In cases where Arrhythmia is not severe, it can be controlled with life style changes to manage the symptoms. And as with many cardiovascular conditions, knowing the Risk factors and tackling them head on is a major part of treatment and management.
Tachycardia is often treated with beta-blockers, calcium channel blockers and digitalis/digoxin. Overactive thyroids are also treated with medication if this is identified as an underlying cause. Blood thinners such as aspirin and warfarin may be used to lower blood pressure and prevent dangerous clots forming in the heart.
Electrical shock is delivered under anaesthesia to the chest wall to reset and synchronize the heart rate of longstanding or severe cases of atrial fibrillation.
How you treat yourself is directly related to your heart health. Making changes to mitigate your Risk of Cardiovascular Disease and avoiding heart-stimulants such as caffeine, stressful situations, and over the counter decongestants all help to reduce your Risk of Arrhythmia. Regular activity, moderate alcohol consumption, not smoking and monitoring your key heart health indicators can all help to improve your cardiovascular health and reduce your Risk of experiencing Arrhythmia.
While not common, some surgical procedures can be effective for Arrhythmias: deactivating the section of the heart that is malfunctioning, in a process called catheter ablation, or surgically removing the faulty section altogether.
Other forms of Arrhythmia are more serious and have to be treated with defibrillation to re-set the heartbeat. In some cases people receive implantable cardiac defibrillators (ICDs). These units can either pace your heart or deliver electric shocks to try to set a normal heart rhythm.
In some cases of bradycardia, artificial pacemakers are implanted to contract the heart with electrical impulses.
Not all risks for Arrhythmia are controllable, but you can tackle the underlying triggers and suspected causes, which are closely associated with Cardiovascular Disease.
Know your Risk factors, manage them, and follow this quick guide to improved cardiovascular health. Importantly, if you have any concerns about your heart, particularly if you have a family history of heart disease, don’t delay – talk to your doctor.
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Get a minimum of 30 minutes of moderate physical activity every day, or at least 2 hours in total per week. Even better, if you can get 4 hours of sweaty activity per week, you'll help lower your Risk of cancer too.
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Happiness is good for the heart. Just as negative emotions such as depression, anger, and hostility are risk factors for heart attack and stroke, studies show that happiness seems to protect the heart.