What is Arrhythmia?
An arrhythmia is an abnormal heart rate beating pattern of the heart. A normal heart beats between 60-90 times a minute. The number of heart beats per minute is called as heart rate. A heart rate below and above the normal heart rate in rest is called an arrhythmia.
The rhythmic contraction of the heart is essential in ensuring proper blood supply to the body. Any abnormality in the rhythm can prevent the heart from discharging its duty in an effective manner. A heart rate over 100 is termed as tachycardia and less than 60 is called bradycardia.
A majority of arrhythmia are not serious and life threatening. But certain types of arrhythmias can cause stroke or cardiac arrest in certain situations. It is normal for everybody to experience some kind of abnormality in their heart rate at certain times. Mental and physical stress can induce arrhythmia at times. This usually resolves by itself without causing any problems. But arrhythmias occurring in a regular manner with associated symptoms indicate a problem with the electrical circuit in the heart.
Heart arrhythmia causes:
The heart consists of four chambers, two atria and two ventricles. The atria and ventricles contract to pump blood from the heart to the rest of the body. This relaxation and contraction of heart chambers are due to the electrical signals it receives. Any change in the electrical conduction system of the heart can cause a change in the normal heart rhythm.
A heart beat originates when the sino-atrial node (SA node) located in the right atrium produces an electrical impulse. The impulse is then transmitted along a specific pathway to complete the process. The SA node is also referred to as the natural pacemaker of the heart. From the SA node the impulse travels to the atrioventricular or the AV node. From the AV node a nerve fibre system called the His-Purkinje system transmits the impulses through the ventricular walls. Any change in this conduction system can cause atrial or ventricular arrhythmia.
Some of the most common causes of arrhythmias are:
• The onset of a heart attack
• Scarring of heart tissue due to a previous heart attack
• Diseases like cardiomyopathy that results in a change of the structure of the heart
• Coronary artery disease
• Smoking, alcohol, caffeine and recreational drugs
• Certain medications
• Sleep apnoea
Cardiac Arrhythmia Classification:
Arrhythmias are classified according to the speed at which the heart beats. They may also be classified according to their point of origin.
Tachycardias occur when the heart starts beating at a rate above hundred beats per minute. Bradycardias occur when the heart beats number less than sixty times per minute.
All tachycardias and bradycardias need not cause a problem. They may occur in normal individuals also at certain times. Exercise, mental stress or strenuous physical activity can cause tachycardias in otherwise normal individuals. Relaxation exercises and deep sleep may lower the heart rate as well. Athletes and other endurance sportspersons also have lower heart rates than normal.
Types of arrhythmia:
There are several types of arrhythmias according to their area of origin. The common types are listed below:
Tachycardias of the atrium-
• Atrial fibrillation-The heart beats at a rate above three hundred and fifty beats per minute. The atrium instead of contracting with strength tends to quiver or fibrillate. At times the atrium fibrillates at a speed of more than six hundred beats per minute.
• Atrial flutter- the heart rate may be between two fifty to three fifty beats per minute.
Atrial flutter and fibrillation are classified as supraventricular tachycardias since it occurs above the ventricles.
Tachycardia of the ventricles:
• Ventricular tachycardia- the heart beats at a speed of more than two hundred beats per minute.
• Ventricular fibrillation- The heart rate is more than three hundred beats per minute.
• Long QT syndrome- a condition where there is very rapid and uncoordinated heart beats.
Bradycardias occur when the heart rate falls below sixty beats per minute. A low heart rate need not be a cause of concern if the heart pumps adequate volume of blood to maintain proper circulation. Certain drugs, high blood pressure etc may cause phases of bradycardia. The major cardiac causes of bradycardia are Sick- sinus syndrome and conduction blocks also called as heart blocks.
Cardiac/ Heart Arrhythmia Symptoms
Some of the patients with life threatening arrhythmias may not exhibit any symptoms at all. Some people with symptoms may not have a major problem as well.
Symptoms of tachycardia
• thumping in the chest
• chest pain
Symptoms of bradycardia
• chest pain
• cold sweats
Diagnosis of arrhythmia:
Apart from patient's medical history, family history, diet and lifestyle other diagnostic tests include:
• Blood and urine tests
• Holter monitor tests
• Chest x-ray
Cardiac Arrhythmia Treatment in India:
Arrhythmia needs to be treated only if the symptoms are very severe or the condition is putting the patient at risk of a more serious arrhythmia or a complication.
Treatments for bradycardia
Bradycardia needs treatment if the symptoms are severe in nature. The first line of treatment is the correction of the underlying condition that caused bradycardia. A pacemaker is an electronic device implanted in the chest wall. The device helps to regulate the heart rate within limits.
There are several different treatments for tachycardia:
• Vagal manoeuvres - certain movements like coughing etc can help to restore heart rhythm
• Medications - helps to check the frequency of incidence
• Cardioversion - an electric shock or medication to restore normal heart rhythm
• Heart Ablation procedure - uses catheters to destroy abnormal heart tissues that trigger tachycardia
• ICD (Implantable cardioverter-defibrillator) - a device implanted near the left collarbone that stimulates the heart to return to a normal rhythm.
• Maze procedure - a series of surgical incisions are made in the heart muscles to create scar tissue. The scar tissue prevents the improper conduction of electrical signals.
• Ventricular aneurysm surgery and coronary bypass surgeries may be done to improve the flow of blood to the heart or to the heart muscles.
Prevention of arrhythmias:
• Having a heart-healthy diet
• Proper physical activity
• Quitting smoking
• Weight control
• Limiting or avoiding caffeine and alcohol
• Reducing mental stress
Cost of Arrythmia treatment in India:
Arrythmia treatment in India costs around 5400 USD and includes the doctors charges, hospital charges for 2-4 days in hospital and medicines for the duration.