Arrhythmia is what?

Written by Chen Tian Hua

Cardiology

Updated on September 15, 2024

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Arrhythmia refers to abnormalities in the frequency, rhythm, origin, or conduction of the heartbeats. It can occur in healthy individuals as well as those with related diseases, and may involve cardiac diseases or other medical conditions.

The primary mechanism behind the occurrence of arrhythmias is the abnormal formation of cardiac impulses or the abnormal conduction of these impulses. It is important to actively seek the causes of arrhythmias and control the factors that trigger them. For diseases associated with arrhythmias, proactive management is necessary. When severe arrhythmias occur, timely and effective treatment is crucial to prevent adverse outcomes.

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Causes of sinus arrhythmia

Sinus arrhythmia, the most common cause of which is instability of the nerves that regulate the heart, referred to as the autonomic nervous system. This instability leads to sinus arrhythmia, which is commonly seen in children during their growth phase, women during menopause, or individuals who often stay up late and are under significant work stress, leading to dysfunction of the autonomic nervous system. It can also be caused by patterns of breathing that lead to arrhythmias; the heart rate increases during inhalation and slows during exhalation, producing this type of physiological arrhythmia. Generally, this kind of arrhythmia does not require drug treatment. By improving physical exercise, ensuring adequate sleep, and avoiding stimulating beverages or coffee, this type of heart rate can return to normal.

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Can arrhythmia be cured?

Arrhythmias come in many types, most of which are curable. Once arrhythmia occurs clinically, an electrocardiogram should be performed as soon as possible to determine the type of arrhythmia. Common arrhythmias can be classified into tachyarrhythmias and bradyarrhythmias, and based on the location of occurrence, into supraventricular arrhythmias and ventricular arrhythmias. Clinically common are supraventricular arrhythmias, such as sinus tachycardia, junctional tachycardia, along with atrial tachycardia, atrial fibrillation, and atrial flutter. These generally do not affect the stability of hemodynamics and are relatively easy to treat. On the other hand, ventricular arrhythmias such as ventricular fibrillation, ventricular tachycardia, and sinus arrest are clinically challenging to cure and require aggressive resuscitation.

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Does arrhythmia require hospitalization?

Arrhythmia treatment should be determined based on the patient's symptoms, type of arrhythmia, and its impact on hemodynamics. For instance, minor conditions like slight sinus bradycardia, irregular sinus rhythm, occasional atrial premature contractions, and first-degree atrioventricular block, which have minimal impact on hemodynamics and no significant clinical manifestation or structural heart disease, do not necessitate hospitalization. However, more severe arrhythmias such as sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and sustained ventricular tachycardia, which can cause symptoms like palpitations, chest tightness, dizziness, low blood pressure, sweating, and in severe cases, fainting, Adam-Stokes syndrome, and even sudden cardiac death, require prompt medical attention and hospitalization for treatment.

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How to treat arrhythmia?

The treatment of arrhythmias should be based on the symptoms of the patients with arrhythmias, the type of arrhythmias, and their impact on hemodynamics. Control of arrhythmias during episodes involves removing the cause and focus of the disease and preventing recurrence, which can be divided into non-pharmacological and pharmacological treatments. Non-pharmacological treatments include methods such as eyeball compression, carotid sinus massage, pinching the nose to exhale forcefully and hold breath to reflexively excite the vagus nerve, along with electrical treatments like electrical cardioversion, defibrillation, pacemaker implantation, and ablation surgery. There are mainly four types of drugs used: sodium channel blockers; beta-adrenergic blockers; drugs selectively prolonging the repolarization process, such as amiodarone; and calcium channel blockers. However, long-term use of these antiarrhythmic drugs can have varying degrees of side effects, and severe cases can cause ventricular arrhythmias or cardiac conduction block which can be fatal. Therefore, in clinical application, it is essential to strictly control the indications, monitor for adverse reactions, and rigorously follow the doctor's orders.

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Does arrhythmia premature beat have danger?

Premature beats, also known as premature contractions, abbreviated as premature beats, are a type of early ectopic heartbeats. They can be classified according to their origin into sinus, atrial, junctional, and ventricular, with ventricular being the most common. Premature beats are a common type of ectopic rhythm that can occur on the basis of sinus or ectopic rhythms, such as atrial fibrillation. They can occur occasionally or frequently and may irregularly or regularly follow each or several normal beats, forming a bigeminy or trigeminy pattern of premature beats. Generally, sinus, atrial, and junctional premature beats do not involve rapid ventricular rates and are usually not life-threatening. Although most premature beats are functional and do not cause damage to the heart, some pathological premature beats occurring on the basis of structural heart disease may further induce arrhythmias. In particular, ventricular premature beats may provoke ventricular tachycardia or ventricular fibrillation and in severe cases, may lead to sudden cardiac death. Additionally, multifocal atrioventricular premature beats are often a precursor to atrial fibrillation.