Abnormal Heart Rhythm

The rate of mortality and morbidity of abnormal heart rhythm (arrhythmia) are prevalent in the population aged over 65 years. Globally, an estimated 300 million individuals have an abnormal heartbeat and out of the several types of arrhythmias, the most common one atrial fibrillation affects around 30 million people worldwide. An abnormal heart rhythm develops when the electrical impulses are not functioning properly resulting in the heart either beating too fast, too slow or irregularly. The electrical impulse begins at the sinoatrial (SA) node in the right atrium which produces the electrical impulse needed for the normal rhythm of the heartbeat. Based on the condition, arrhythmia could either be harmless or life-threatening. However, there are several types of medications and procedures available to take care of the condition.

The abnormal heart rhythm can occur as the result of a number of causes such as alcohol, certain medications, cold remedies and with emotional states like with shock or fright. So, when the heart doesn’t function effectively, it cannot properly pump blood to the different parts of the body meaning major organs could become damaged. An arrhythmia could either be ‘silent’ without causing any symptoms or it can include pounding in the chest, palpitations, shortness of breath, chest discomfort, weakness or fatigue. If arrhythmias are recurrent and caused by an underlying heart condition such as valve disorders or coronary artery disease, then it should be evaluated by the physician.

The differences between men and women with the heart rate and the rhythm

Although men and women have similar heart rate and rhythm, women appear to have a faster baseline heart rate which is seen among girls as young as five years old. Also, the shorter sinus node refractory time is evident among women meaning it takes a shorter time for the SA node to recover and fire impulse again. Women’s ECG readings also appear to be different, on average, the QT interval is shorter in men beginning after puberty with a linear increase through their adulthood. So it seems that the androgen and estrogen levels could explain the gender differences with the ECG.

The various types of arrhythmias;

Atrial fibrillation (AF): Atrial fibrillation can occur occasionally, persistently or permanently. This is one of the common arrhythmias and is associated with life-threatening complications such as heart failure, stroke and other forms of heart related problems. Therefore, the most important step to help save lines include knowing the symptoms, getting the right treatment and reducing the risks for stroke or heart failure. The diagnosis of AF is often limited to electrocardiograms (ECGs) which is effective among individuals with persistent AF but has its limitations to detect the condition among early-stage AF. Also, the treatment options can either include medications to return the heart rate to normal, blood thinners to keep clots from developing, electrical cardioversion or a pacemaker.

Supraventricular arrhythmias: Supraventricular arrhythmias (SVT) is the abnormally fast heartbeat that could include different forms of heart rhythm problems developing above the ventricles. When the heart beats more than 100 times per minute, it is known as tachycardia which makes the individual feel like experiencing a racing heart. Almost most cases experiencing this condition could have a healthy life but if they continue to face the problem frequently, particularly when other heart problems coexist, treatment may be recommended. Some of the treatment options include carotid sinus massage, cardioversion or catheter ablation.

Bradycardia: This condition is defined by the slow heart rate meaning the heart beats are less than 60 beats per minute (BPM). There are several reasons for an individual to experience Bradycardia which could include problems with the sinoatrial node, abnormality with the conduction pathways of the heart, metabolic issues such as hypothyroidism, effects of certain medications and with damage to the heart. With the insufficient blood flowing through the body, it could present symptoms such as fatigue, confusion, lightheadedness, difficulty when exercising and in rare cases, cardiac arrest.

Long QT Syndrome: This is defined by the abnormality of the heart’s electrical system. The QT interval is the section on the ECG represented by the times it takes for the electrical system to recharge and fire an impulse again. It can develop as the result of a defect in the ion channels thereby increasing the chance of a torsade de points which is a life-threatening problem. Long QT syndrome can either be acquired developing because of several medications but is usually congenital meaning it is inherited.

Bradyarrhythmias: Bradyarrhythmias are caused by the abnormality in the conduction system at the level of the sinus node or the atrioventricular node. Sinus bradycardia is the unusually slow heartbeat that normally occurs with a deep state of relaxation or can develop in response to certain medications. The condition is based on the duration and the severity as persistent bradycardia can result in symptoms such as the inability to concentrate, fatigue, cognitive impairment, shortness of breath and dizziness.  One of the most important prognostic factors is identifying the site of the block and detecting the presence of other underlying heart problems. There are various types of bradycardia such as sick sinus syndrome that occurs when the SA node fails resulting in the irregular heartbeat and the affected individual could experience a slow beat, fast beat or the beat swapping between fast and slow.

Ventricular Fibrillation: Ventricular Fibrillation (VF) is characterized by the heart rhythm problem that develops when the heart beats rapidly with erratic electrical impulses. This is a medical emergency requiring immediate attention as it can also cause the individual to collapse within seconds, which is one of the most common signs of VF. Although the exact cause of this condition is not known, Ventricular fibrillation usually begins as a rapid heartbeat called ventricular tachycardia (VT) and in most cases, it is associated with a heart-related problem such as scars or damage from a heart attack. Sometimes, VT can last for less than 30 seconds without causing any symptoms but those lasting for longer duration results in dizziness, palpitations or fainting. And, if VT is left untreated, it can lead to ventricular fibrillation.