Arrythmia - Irregular Heart Beat
General Information
Arrhythmias are abnormalities in the rate or rhythm, or both, of the heartbeat. These abnormalities occur with increasing frequency as one ages. Under normal circumstances, the heartbeat is regular in its timing, and the heart rate falls into somewhat narrow limits of numbers of heartbeats per minute. The heart rate increases with exercise.
The development of abnormal rates or rhythms has many causes. Some of these causes are primary, and others are secondary. Primary causes are those that occur within the heart. Secondary causes are those that result from external forces that act on the heart indirectly to cause a change in its rate or rhythm. It is important for your physician to separate primary from secondary causes to be able to select the most appropriate form of therapy. If the arrhythmia is secondary, it is better to treat the underlying cause than simply to try to normalize the heart rhythm with drugs and ignore what has caused the change in the first place.
Some arrhythmias pose no threat to your health. Others have great implications for the development of more serious problems. Careful evaluation to figure out the cause of the arrhythmia also permits your physician to learn the significance of the arrhythmia. The identi- fication of the occurrence of an arrhythmia is not a dire finding, but it is an indication for further investigation.
Ordinarily, we have no perception of our own heartbeat. Irregular heart rates can come to our awareness. Single extra heartbeats may feel like ‘‘the heart turning over.’’ Many people also notice a ‘‘racing heart’’ when the rate is inappropriately fast. Nonetheless, many arrhythmias occur without symptoms specific enough to alert the patient that there is abnormal heart action.
Important Points in Treatment
Treatments for arrhythmias are almost as varied as the causes of the problem itself. Arrhythmias such as an occasional extra heartbeat may require no therapy at all. Arrhythmias that are more persistent or lead to the development of serious life-threatening rhythm changes or may cause heart failure do require treatment. Treatment may be with drugs, with the use of electronic pacemakers (devices that can be used to regulate the heart rate and rhythm), or with other devices that can alter the heart rate and rhythm.
Notify Our Office If ...
- You have a frequent or persistent change in your heart rate or heartbeat rhythm. The identification of an arrhythmia is not a dire finding, but it is an indication for further investigation.
AFIB
General Information
Rapid heartbeat, called tachycardia, may have many causes. When the heart rate and rhythm are irregular without any recognizable pattern, the problem is usually atrial fibrillation.
The heart rate and rhythm are set within the heart itself. The natural pacemaker is found within the heart. When there is a partial or complete block to the conduction of the heartbeat from this pacemaker, abnormal heart rhythms can occur. One of these abnormal heart rhythms is atrial fibrillation. In this rhythm, the normal pacemaker does not drive the heartbeat. Because the pathways are not normal, the rhythm is irregular.
This change in heart rhythm is a chronic, rather than an acute, problem. It is not the sort of rate or rhythm that changes back and forth from normal to abnormal, as occurs with many other causes of abnormal heartbeat.
Some noncardiac problems, particularly an overactive thyroid, also can cause atrial fibrillation.
Important Points in Treatment
Treatment includes the care of any underlying conditions. Medication can be used to control the heart rate by slowing the heartbeat, although the heart rhythm does not return to normal. By slowing the heartbeat, one can avoid strain on the heart and the possibility of development of heart failure.
Because the chamber of the heart called the atrium may not be contracting adequately, there is a risk of the development of a blood clot, which may then break off and travel into the circulation. For this reason, some patients receive blood-thinning (anticoagulation) therapy as well.
Notify Our Office If ...
- You experience the onset of an irregular or rapid heart rate.
AFLUTTER
General Information
Rapid heartbeat, called tachycardia, may have many causes. One such cause is atrial flutter. This problem occurs with increased frequency in elderly patients. It occurs both with coronary artery disease (hardening of the arteries that feed blood to the heart) and with chronic bronchitis-like lung disease. Some cardiac drugs given for therapeutic purposes may alter the rhythm of the heart and produce atrial flutter as well.
The rapid heart action caused by atrial flutter is regular, with the heartbeat at 150 beats per minute. The change from a normal to a rapid rate occurs suddenly, and often, but not always, the patient is aware of this change. Most patients can tolerate this rate change, and it poses no immediate threat to health, but the underlying problem that has caused the atrial flutter may be of great importance.
Important Points in Treatment
It is possible to restore the heart rate to normal by using drugs or, rarely, cardiac shock therapy. Prevention of atrial flutter is better than treating it. Prevention rests with adequate treatment of the underlying cause.
Notify Our Office If ...
- You notice a sudden change to a rapid heart rate.