Cardiac rhythm disorders, also known as cardiac arrhythmias, are due to the improper functioning of the cardiac electrical system that can appear de novo or in the course of the evolution of pre-existing cardiac (ischemic cardiopathy, valvulopathies, myocardial infarction) and non-cardiac (thyroid disorders, lung disorders) diseases.
What are heart rhythm disorders?
What are the symptoms of arrhythmia?
How to establish the diagnosis for heart rhythm disorders
What is the treatment of arrhythmia?
What are heart rhythm disorders?
Cardiac rhythm disorders, also known as cardiac arrhythmias, are due to the improper functioning of the cardiac electrical system that can appear de novo or in the course of the evolution of pre-existing cardiac (ischemic cardiopathy, valvulopathies, myocardial infarction) and non-cardiac (thyroid disorders, lung disorders) diseases.
Why do arrhythmias occur?
Affecting the excitoconductive tissue of the heart due to genetic causes has the effect of altering the function of generating and conducting electrical impulses and is one of the causes of cardiac rhythm disorders along with cardiac pathologies developed later in life.
Other causes that lead to the appearance of rhythm disorders are represented by:
- Atherosclerotic coronary disease
- Valvular lesions
- Heart failure
- Infections (myocarditis, pericarditis, septic shock)
- Cardiac surgery post-interventions
- Thyroid disorders: hyperthyroidism, hypothyroidism
- Respiratory failure, sleep apnea syndrome
- Hydroelectric imbalances: severe dehydration, affecting the concentration of serum potassium, magnesium and calcium
- Excessive consumption of alcohol, tobacco, coffee, drug use
- Electrocution
- Hypothermia
Rhythm disorders can be classified according to the way of affect the cardiac electrical impulses as follows:
- Bradyarrhythmias are due to a deficit in the generation of electrical impulses of the excitoconductive system (sinus node disease) or a conduction disorder (atrioventricular block of various degrees), being defined as a decrease in heartbeats below 60/minute
- Tachyarrhythmias are manifested in the form of an increase in the number of cardiac electrical impulses that generate >100 beats per minute and can be of ventricular origin (ventricular tachycardia, ventricular flutter, ventricular fibrillation) and supraventricular (atrial fibrillation, atrial flutter, atrial tachycardia and supraventricular paroxysmal tachycardia)
- Ventricular extrasystoles represent premature heartbeats that occur physiologically during periods of intense physical effort, stress or consumption of exciting substances (coffee, energy drinks) and are not pathological
What are the symptoms of arrhythmia?
Heart rhythm disorders are frequently described by patients in the form of:
- Palpitations
- Lack of air
- Angina pectoralis (chest stabbing)
- Increased fatigue
- Balance disorders accompanied by the feeling of dizziness
- Syncope (loss of consciousness)
How to establish the diagnosis for heart rhythm disorders
The diagnosis of arrhythmias is established within a cardiological clinical examination that includes the anamnesis and objective examination of the patient and requires a 12-lead EKG electrocardiogram.
Additionally, the specialist doctor can request other more detailed investigations represented by:
- Installation of a Holter EKG device with its maintenance for a period between 24 hours and 7 days; the device monitors and records cardiac contractility during the patient’s daily activities but also during the night
- The standardized stress test
- The tilt table test (tilt test)
- Electrophysiological study
What is the treatment of arrhythmia?
The non-pharmacological treatment of heart rhythm disorders requires the adoption of a healthy lifestyle that is based on a proper diet and regular physical exercises. The drug therapy of heart rhythm disorders is done according to the type of nerve impulse dysregulation, most of the time addressing the basic pathologies that lead to the secondary occurrence of arrhythmias.
In the case of benign arrhythmias, heart rhythm control can be obtained with antiarrhythmic medication represented by beta blockers with an antiarrhythmic role, while life-threatening malignant rhythm disorders benefit from external electrical cardioversion.
In situations where a satisfactory result is not obtained after the administration of drug therapy, radiofrequency ablation can be successfully used to treat tachycardias or cardiac pacemakers (cardiac pacemakers) in the case of patients with bradycardia or severe arrhythmias with an unfavorable prognosis.
If you have symptoms associated with cardiovascular diseases, contact your doctor for a specialist consultation!
References:
- Role of diabetes in heart rhythm disorders – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733448/
- Neuromodulation for the Treatment of Heart Rhythm Disorders – https://www.jacc.org/doi/full/10.1016/j.jacbts.2019.02.009
- Electrocardiographic Imaging of Heart Rhythm Disorders – https://www.cardiacep.theclinics.com/article/S1877-9182(14)00151-8/abstract
