ARRHYTHMIA

• Arrhythmia is a term for any of a large and

heterogeneous group of conditions in which
there is abnormal electrical activity in the
heart.
• The heart beat may be too fast or too slow,
and may be regular or irregular.
• can occur with a normal heart rate, or with
heart rates that are slow and also rapid heart
rates
 CAUSES OF ARRHYTHMIA
1. Coronary artery disease
- produces scar tissue in the heart that disrupts the transmission of
signals which control the heart rhythm

2. Changes in heart muscle

- abnormal enlargement, thickening and stiffening of heart muscles

3. Healing process after heart surgery

- may take some changes in order to for heart to function normally.

4. Congenital
- born with the condition
 TYPES OF ARRHYTHMIAS
1. Premature atrial contractions
- Due to premature discharge of an electrical
impulse in the atrium
- These are early extra beats that originate in
the atria

2. Premature ventricular contractions

- cause by stress, heart disease or too much
exercise
3. Atrial fibrillation
- common irregular heart rhythm that causes the
atria, the upper chambers of the heart to contract
abnormally

4. Paroxysmal supraventricular tachycardia

- there are 2 types:
a) AV nodal reentrant tachycardia
- due to more than one pathway through
the AV node
- can cause heart palpitations, fainting or
heart failure
 b) Accessory pathway tachycardias
- due to an extra abnormal pathway
between the atria and the ventricles.

5. Atrial flutter
- caused by one or more rapid circuits in the atrium
- occurs most often in people with heart disease in
the first week after heart surgery.
- often converts to atrial fibrillation
6. Ventricular tachycardia
- originating from the lower chambers (or
ventricles)
- rapid rate prevents the heart from filling
adequately with blood cause less blood is
able to pump through the body

7. Ventricular fibrillation
- disorganized firing of impulses from the
ventricles
- The ventricles quiver and are unable to contract
or pump blood
8. Sinus node dysfunction
- due to an abnormal SA (sinus) node

9. Heart block
- A delay or complete block of the electrical
impulse as it travels from the sinus node to
the ventricles
- heart may beat irregularly and, often, more
slowly
 SYMPTOMS OF ARRHYTHMIAS
Most common symptoms:
• palpitations or rapid thumping in your
chest
• feeling tired or light-headed
• loosing consciousness
• shortness of breath
• chest pain.
Symptoms that lead to fast heart rate:
• heartbeat might feel like a strong pulse in
neck
• a fluttering, racing beat in chest
• feelings of discomfort
• Weakness
• shortness breath
• faint
• sweaty
• dizzy
Symptoms that lead to slow heart rate:
• feeling tired
• short of breath
• dizziness
 How are arrhythmias diagnosed?

1. Electrocardiogram
- Small patches called electrodes are placed
on our chest, arms and legs, and are
connected by wires to the ECG machine.
- Our heart's electrical impulses are translated
into a wavy line on a strip of moving paper
- enabling doctors to determine the pattern of
electrical current flow
2. Holter monitor
- a small, portable machine that we wear for
24 hours
- enables continuous recording of our ECG

3. Tilt Table Test

- used to diagnose fainting or black-out spells
(vasovagal syncope) by trying to reproduce the
black-out episodes
- You will be tilted upright to about 60 degrees
on a special table for a period of time
4. Electrophysiology study (EPS)
- Special catheters are threaded through
veins into the heart.
- electrical impulse generated by the heart
shows up on a computer screen.
- Electrical impulses are utilized to evaluate
for arrhythmias

5. Stress Test
- enables physicians to record our heart's
electrical activity which may not occur at
rest.
6. Magnetic Source Imaging
- used as an overlay to magnetic resonance
imaging
- The device senses weak magnetic fields
generated by heart muscle tissue
- localizes the arrhythmia non-invasively to
save time during the invasive study.

7. Event Recorder
- small portable transtelephonic monitor that
may be worn for several weeks.
- The monitor "loops" a two-minute recording
into its memory that is continually overwritten
 TREATMENT OF ARRHYTHMIAS
1. Lifestyle Changes
- avoid activity that lead to irregular heart
rhythm
- stop smoking
- stop drink alcohol
- Limit or stop using caffeine
- Stay away from stimulants used in cough
and cold medications
2. Medications
- Antiarrhythmic drugs (control heart-rate)
- Anticoagulant or antiplatelet therapy
(reduce the risk of blood blood clots)

3. Surgical Procedures
a) electrical cardioversion
- After administration of a short-acting
anesthesia, an electrical shock is delivered
to our chest wall that synchronizes the
heart and allows the normal rhythm to restart.
b) pacemaker
- a device that sends small electrical
impulses to the heart muscle to maintain a
suitable heart rate
- primarily prevent the heart from beating
too slowly.
- has a pulse generator (which houses the
battery and a tiny computer) and leads
(wires) that send impulses from the pulse
generator to the heart muscle.
4. implantable cardioverter-defibrillator (ICD)
- to treat ventricular tachycardia and
ventricular fibrillation, two life-threatening
heart rhythms
- When it detects a very fast, abnormal heart
rhythm, it delivers energy to the heart
muscle to cause the heart to beat in a
normal rhythm again
5. catheter ablation
- high-frequency electrical energy is delivered
through a catheter to a small area of tissue
inside the heart that causes the abnormal
heart rhythm
- This energy "disconnects" the pathway of the
abnormal rhythm.

6. heart surgery
- needed to correct heart disease that may be
causing the arrhythmia
- During this procedure, a series (or "maze") of incisions
are made in the right and left atria to confine the
electrical impulses to defined pathways