What are arrhythmias?

With cardiac arrhythmia, medical professionals describe a disturbed rhythm of the heart . In technical jargon, cardiac arrhythmias are also called arrhythmias. The heart is made up of many cardiac muscle cells. In order for the heart to beat, an electrical impulse is created in the sinus node - a group of cells in the right atrium. This impulse gradually spreads over the whole heart. The cells it reaches contract. The atria and ventricles contract again and again and pump the blood into the body.

A healthy heart beats between 60 and 100 times a minute. In trained endurance athletes, the resting heart rate can sometimes be below 60. While the body is stressed, the pulse rises. It can then go up to 140, 160 or even 180.

There is no single definition of cardiac arrhythmias , because there are many different types of cardiac arrhythmias . They all have in common that the heart beats unusually. The pulse can beat too fast, but it can also beat too slowly. Sometimes the pulse beats at the right frequency, but irregularly. This is also a cardiac arrhythmia.

Arrhythmias: types

There are many different type of cardiac arrhythmias. If the heart beats too slowly, doctors call it bradycardia . It is when the heart beats less than 60 times a minute. If the pulse is above 100, the heart beats too fast. Then doctors speak of tachycardia .

Irregular heartbeat

• In addition to a heartbeat that is too fast or too slow, there is also the case that the heart beats irregularly. This is the case with so-called atrial fibrillation . The clock signals that arise in the sinus node are disturbed and this brings the heartbeat out of rhythm.
• In some cases, in addition to the irregular rhythm, the heartbeat is too fast, in which case doctors call it a tachyarrhythmia .
• Or it is irregular and too slow, in which case doctors speak of a bradyarrhythmia .

Classification according to the origin of the arrhythmia

In addition, doctors differentiate in the designation of cardiac arrhythmias, whether the disrupted rhythm originates in the heart chambers or before. The chambers of the heart are also called ventricles.

• A cardiac arrhythmia that has its origin in the heart chamber is therefore also called ventricular arrhythmia .
• If it develops earlier in the cardiovascular system, it is a supraventricular cardiac arrhythmia .

This term is also used for the so-called extrasystoles . These are additional irregular heartbeats that occur outside of the usual rhythm. Here too there are:

• ventricular extrasystoles
• supraventricular extrasystoles

More examples of cardiac arrhythmias

• Another type of cardiac arrhythmia is sinus node syndrome, also called sick sinus syndrome. Sinus node syndrome is a kind of collective term for various cardiac arrhythmias that have their origin in a disorder of the sinus node. The sinus node is a group of special muscle cells that set the rate at which the heart beats.
• Atrial fibrillation should not be confused with ventricular fibrillation . In atrial fibrillation, only the atria are affected, whereas in ventricular fibrillation, the ventricles are affected. The difference: With atrial fibrillation, people can usually lead a normal life, while ventricular fibrillation can lead to cardiac arrest and death within minutes.
• The ventricular fibrillation in turn differs from ventricular flutter . With ventricular flutter, the heartbeat is extremely high and is between 250 and 350 beats per minute. Ventricular flutter, like ventricular fibrillation, is a medical emergency that requires immediate treatment.

Arrhythmias: Symptoms

Recognizing a cardiac arrhythmia is often not that easy. Some arrhythmias only appear briefly and then go away again . The first time in particular, it can happen that the heart beats irregularly for a short period of time, but then normalizes for weeks or months until the arrhythmia occurs the next time.

The first signs of an abnormal heart rhythm are usually tiredness or a feeling of less strength. Accustomed activities with physical strain are more difficult than usual , such as climbing stairs. Some sufferers also feel their arrhythmia in the form of a heart stumbling, small dropouts or a racing heart.

If the cardiac arrhythmia is already causing the cardiovascular system to lose its rhythm and, for example, the brain is no longer properly supplied with oxygen, dizziness, lightheadedness or brief fainting spells can also occur. And if the heart does not get enough oxygen itself, chest pain or a feeling of tightness in the heart can occur.

Those affected particularly often report that they notice their palpitations or palpitations at night when they are in bed. This is probably because they notice the symptoms well because there are no distracting stimuli. During the day, the signs are less noticeable.

 

Arrhythmias: causes

There are many different triggers for irregular heartbeat, known as the cause of the racing heart and the other symptoms. The most common cause are other heart diseases .

Heart diseases that can lead to an abnormal heart rhythm include:

• Coronary heart disease (CHD)
• Heart attack
• Myocarditis
• Valvular heart disease
• Heart failure
• Congenital heart defect

In addition to these relatively common causes, there are also other triggers for a cardiac arrhythmia. Symptoms such as heart palpitations can result from an overactive thyroid, diabetes and kidney or lung diseases . Disorders of the mineral balance can also promote cardiac arrhythmias, such as a lack of potassium or magnesium .

Vitamin B can have a positive effect on cardiac arrhythmias. This applies to vitamins B3, B9 and B12. There is no larger correlation for vitamin D. However, nobody should take preventive vitamin supplements just to reduce the risk of an arrhythmia. On the one hand, because vitamins from fruits and vegetables have a far greater effect - so if you want to do yourself good, you should eat healthier . On the other hand, such projects should always be discussed with the attending physician, because he can assess any side effects or interactions.

Side effects from medication

There are also some medications that can cause cardiac arrhythmias as one of their possible side effects. These can be heart drugs and blood pressure lowerers, but they can also be antidepressants, antibiotics or cancer drugs.

Stress and lifestyle factors

Lifestyle can also increase the likelihood of arrhythmias. High blood pressure , smoking, too much alcohol, and other drugs can negatively affect the heart rhythm .

In patients who already suffer from heart disease (but in a somewhat weaker form also in healthy people), certain stimuli can also trigger a cardiac arrhythmia. These include, for example, lack of sleep, psychological causes, emotional stress or fear. Those affected repeatedly report that cardiac arrhythmias or palpitations occur after eating. Medically, however, the reasons for this are not exactly clear.

It is not uncommon for women to report symptoms of cardiac arrhythmias when they approach menopause, such as increased palpitations or palpitations.

Treat cardiac arrhythmias

The therapy of cardiac arrhythmias is very different, depending on which cardiac arrhythmia it is in the individual case.

Treat arrhythmias with medication

Medicines, for example in the form of tablets, help against some cardiac arrhythmias. Drugs against cardiac arrhythmias are called antiarrhythmics in technical terms . In addition to such antiarrhythmics, doctors also prescribe drugs to prevent blood clotting , depending on the case . They are supposed to prevent the blood from clumping in one place. If such a blood clot loosens and continues to flush it through the vessels, it can clog a vessel. If this happens in the brain, it can lead to a stroke .

Cardiac arrhythmias can be curable. Whether this is the case in individual cases depends on the type of disorder. And, as in the case of atrial fibrillation, how far the arrhythmia has progressed.

Treat cardiac arrhythmias surgically

In addition to medication, doctors sometimes also perform an operation to treat a cardiac arrhythmia. One of the most common is catheter ablation . A doctor usually obliterates the area in which the pulmonary veins merge into the atrium with heat or cold. He pushes the catheter, a small tube that is inserted into body organs, through a small incision in the groin over the inguinal vein to the heart. Doctors use catheter ablation for rapid cardiac arrhythmias that originate in the atria, the AV node or the ventricles, as well as for atrial fibrillation.

In addition to catheter ablation, there are also the options of a cardiac pacemaker or an implantable defibrillator . The pacemaker sets the pace for the heart with regular signals. The implantable defibrillator recognizes when a dangerous cardiac arrhythmia is looming. Then it sends out an electrical impulse and ends the disturbance.