Atrial Fibrillation

An arrhythmia is an irregular or abnormal heartbeat. A heart arrhythmia may occur when the electrical impulses that control the beating of the heart don't work properly, causing the heart to beat too slow, too rapidly, or irregularly. While most arrhythmias are harmless, they may be an indication of a serious underlying condition, such as heart disease or a lack of blood flow to the heart. Heart arrhythmias are not uncommon and may be congenital or caused by various factors.

Types of Heart Arrhythmia

There are different types of arrhythmias, which are classified by the speed of heart rate and the area of the heart that they originate. Types of arrhythmia include:

  • Bradycardia, a slow heart rhythm
  • Tachycardia, a fast heart rhythm
  • Supraventricular, occurring in the atria
  • Ventricular, occurring in the ventricles

Atrial fibrillation is another common type of arrhythmia and one of the most serious forms. It is classified by a very fast heartbeat that is caused by chaotic electrical impulses in the atria of the heart. Atrial fibrillation may lead to stroke or heart failure as a result of blood clots that block the blood flow to the brain or heart.

Causes of Heart Arrhythmia

There are many factors that may cause a heart arrhythmia, and in some cases they may be cause by underlying medical conditions. An injury to the heart from chest trauma or heart surgery may lead to an arrhythmia. Additional causes of heart arrhythmia include:

  • High blood pressure
  • Coronary artery disease
  • Heart failure
  • Hyperthyroidism
  • Hypothyroidism
  • Current or prior heart attack
  • Obesity
  • Diabetes
  • Stress
  • Congenital heart disease

Behaviors such as smoking, excessive alcohol or caffeine consumption, use or certain prescription drugs, and drug abuse may lead to a heart arrhythmia.

Symptoms of Arrhythmia

Some arrhythmias are so brief that the overall heart rate is not greatly affected. When arrhythmias last longer, they may cause the heart to beat too slow or too fast, resulting in a heart that pumps blood less effectively. Symptoms of a heart arrhythmia may include:

  • Fluttering in the chest, or palpitations
  • Dizziness
  • Fainting
  • Racing heart beat
  • Shortness of breath
  • Chest pain

Symptoms may vary depending on the type of arrhythmia, and some patients may not experience any symptoms.

Diagnosis of Heart Arrhythmia

A heart arrhythmia may diagnosed through a physical examination and a review of symptoms. Diagnostic tests may include an electrocardiogram to measure the electrical activity of the heart and a chest X-ray to detect any abnormalities within the heart. Additional tests may include:

  • Stress test
  • Echocardiogram
  • Electrophysiological tests

The doctor may recommend that the patient wear a holter monitor for a few days to get an accurate reading of the heart's activity. A holter monitor is a small, portable device that continuously records the heart's rhythms and records the electrical activity of the heart.

Treatment of a Heart Arrhythmia

Treatment for a heart arrhythmia varies depending on the severity and underlying cause of the arrhythmia. Mild heart arrhythmias may require no treatment at all. A bradycardia, or slow heart beat, may be treated with a pacemaker to stimulate the heart to beat at a steady rate. A pacemaker is a small device, implanted under the skin near the collarbone, that sends out electrical impulses through the blood vessels to the heart. Other treatments for heart arrhythmia include:

  • Medication
  • Catheter ablation
  • Cardioversion
  • Implantable cardioverter defibrillator

In some cases, surgery may be performed to treat arrhythmia, often for cases caused by heart disease. Coronary artery bypass surgery may be performed to improve blood supply to the heart, while valve repair surgery may correct an arrhythmia as well.

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Chima Nwizu, MD

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