- by Dr SUNIL DWIVEDI
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- Mar 04 2017
Causes of ARRHYTHMIA-(problem in either the rate or rhythm of the heart beat )
Arrhythmias occur if there is a block or delay in the electrical pathways, irregular signal generation from pacemaker node, irregular impulse conduction or due to impulse generation in any part of heart except the pacemaker node. This could happen:
- As a side effect of excessive smoking, alcohol use, caffeine and nicotine use, illicit drug abuse, or as side effect of certain over the counter or prescription drugs.
- Due to strong emotional stress and anger outbursts.
- Due to high blood pressure, coronary heart disease, rheumatic heart disease, heart attack, heart failure, or under or over active thyroid gland.
- Since birth called congenital arrhythmia (for example Wolff-Parkinson-White syndrome).
- At times no cause is found.
Types of Arrhythmia
The four main types of arrhythmia are extra or premature beats, supraventricular arrhythmias, ventricular arrhythmias, and bradyarrhythmias.
- Premature Beats
These are the most common types of arrhythmia. They are of two types depending on where the extra betas occur: premature atrial contractions (PAC) and premature ventricular contractions (PVC).
Both PAC and PVC are usually harmless, can occur without a cause or due to stress, exercise, caffeine or nicotine intake, and need no treatment. There are no signs and symptoms except a feeling of flutter in chest or extra heart beat. At times they occur in heart disease and need treatment.
- Supraventricular Arrhythmias
Supraventricular arrhythmias are basically tachycardias or tachyarrythmias originating in the atria or AV node. Examples: atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia (PSVT), congenital (Wolff-Parkinson-White syndrome)
- Atrial Fibrillation
In atrial fibrillation electrical impulse is generated anywhere in the atria or pulmonary veins and travels through out the atria in a disorganized manner. The atria quiver or fibrillate in a fast and irregular way instead of contracting properly.
Cause: Usually occurs due to coronary heart disease, rheumatic heart disease or high blood pressure, in hyperactive thyroid gland, with advanced age, or in alcohol abuse. Sometimes no cause is identified.
Complications: When rate of quivering becomes as 300 per minute or more, it may cause quivering of ventricles and heart failure. Blood pools in quivering atria and forms clots, which can break and travel to brain causing stroke.
- Atrial Flutter
This is similar to atrial fibrillation, except that the electrical impulses travel in an organized manner.
- Paroxysmal Supraventricular Tachycardia
PSVT occurs when the signals go from atria to ventricles and come back to atria causing extra beats and short spurts of very fast heart rates. PSVT can occur during physical activity or without a cause in young people. Usually it is not dangerous.
In another PSVT type in Wolff-Parkinson-White syndrome, electrical impulses travel from the atria into the ventricles along an extra pathway as well.
- Ventricular Arrhythmias
Ventricular arrhythmia start in the ventricles, are usually serious and require urgent medical care. They occur in heart attack, coronary heart disease, and conditions causing weak heart muscles. There are two main types of ventricular arrhythmias:
- Ventricular Tachycardia
Ventricular tachycardia is spurts of very fast but regular beating of ventricles. It is the less serious type of ventricular arrhythmia, and can become dangerous only if it lasts long.
- Ventricular Fibrillation (V-fib)
In V-fib, highly disorganized electrical signals make the ventricles quiver or fibrillate instead of contracting properly. This can be extremely dangerous as it can result in sudden cardiac arrest and death. This needs urgent treatment by electrical shock therapy through a defibrillator.
In addition to above mentioned causes, it can occur if you suffer from potassium, calcium, and magnesium imbalance due to kidney disease or as effect of certain medications.
Bradyarrhythmias are heart rates slower than 60 beats per minute. This can be a normal finding in active adults. However, bradyarrhythmia can occur due to electrolyte imbalance, heart attack, underactive thyroid or use of drugs such as beta blocksrs, digoxin, calcium channel blockers.
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