Arrhythmia

What is a cardiac arrhythmia?
A cardiac arrhythmia is a condition characterized by an accelerated or greatly slowed heartbeat.

The change in heart rate is due to an increase or decrease in electrical activity in the heart muscle.

Contraction and expansion of the heart are controlled by electrical signals or impulses from the brain.
An interruption in the transmission of these electrical impulses can lead to the suspension of a heartbeat.
The values of a normal heartbeat in adults at rest are 60 to 100 beats per minute.
Anyone who has a heartbeat outside this range should talk to their doctor about it.

Arrhythmia is often a contraindication for sports.

When to worry?

Benign arrhythmias manifest themselves at the level of the atria (for example, atrial fibrillation) or the atrioventricular sinus. They do not lead to the death of the person.
Malignant arrhythmias that can lead to death are tachycardia and ventricular fibrillation.

Causes of cardiac arrhythmias

Here are the main causes of irregular heartbeat and arrhythmias:

1. Coronary artery disease is a common cause of arrhythmia. It is a disorder in which blood circulation in the coronary arteries is obstructed.
2. Stimulants such as smoking, alcohol abuse, drugs and caffeine.
3. Abnormal level of sodium or potassium in the blood.
4. Some stomach disorders, such as hiatal hernia (diaphragmatic hernia) or gastroesophageal reflux.
5. Stimulants in medicines for cough and cold.
6. They can occur during convalescence after heart surgery.
7. Hypertension or high blood pressure.
8. Dysfunction of the thyroid gland or hyperthyroidism are less common causes of arrhythmias.
9. Myocardial damage or fibrosis of the heart due to heart attack.
10. Diabetes and insulin.

Symptoms of cardiac arrhythmias

The symptoms of an irregular heartbeat are very undetermined.
Sometimes the patient does not feel anything about it.
Patients with serious arrhythmias may have few symptoms, while others with clear symptoms may present a less severe clinical picture.

Symptoms include:

1. Intermittent chest pain or angina, the most common symptom of an irregular heartbeat
2. Fast and irregular frequency, strong beating of the heart
3. Fainting or syncope
4. Difficult breathing, especially under exertion
5. Excessive sweating
6. Fear and restlessness
7. General malaise
8. Dizziness or lightheadedness
9. Fatigue

Asymptomatic arrhythmia Asymptomatic arrhythmia
is not always harmless and can lead to blood clotting in the heart and/or a reduction in the amount of blood pumped.

Cardiac arrhythmia at night

Nocturnal irregular heartbeat can have various causes. The most common are:

• Diabetes
• Overactive thyroid gland (hyperthyroidism)
• high blood pressure or hypertension
• Other heart diseases
• Some medications
• Smoke
• Stressful
• Some natural remedies

Arrhythmia after eating

When we eat, a large amount of blood is diverted to the digestive tract.
The body reacts immediately to this situation and tries to maintain normal blood pressure by increasing the heart rate and narrowing certain arteries.
If this mechanism does not work, postprandial hypotension (dropping blood pressure after eating) can occur.
Elderly people may have arrhythmias after eating.
People who may have cardiac arrhythmias after eating include those who suffer from high arterial blood pressure or Parkinson’s disease.

Causes and symptoms of the disorder can vary from person to person, possibilities include:

1. Some people suffer from tachycardia only in certain situations, for example, at night in bed, after eating sweet foods or foods with a high sodium content, etc.
2. Insufficient water intake, causing the blood to thicken and thus the heart has to work harder to pump the blood.
3. Dysfunction of an endocrine gland.
4. Problems of the digestive system.
5. Excessive consumption of coffee and other stimulants.
6. Disorders of the vagus nerve.
7. Hiatal hernia (diaphragmatic hernia).
8. Gastroesophageal reflux.
9. Liver or kidney disease.
10. People with a rapid resting heartbeat may have arrhythmias after eating.

Atrial fibrillation (AF)

Atrial fibrillation is the most common type of arrhythmia. In this disease, the heart beats irregularly and much too fast.
AF can be chronic, persistent or paroxysmal.
Paroxysmal atrial fibrillation occurs occasionally and transiently and is of short duration, from a few seconds to a few days.

Ventricular arrhythmia

This is a disease of the heart in which the irregular heart rhythm and heartbeats originate from the heart chambers.
It can be divided into: ventricular tachycardia, ventricular bradycardia and ventricular fibrillation. Tachycardia means that the heart rate exceeds 100 beats per minute, while bradycardia is characterized by beats below 60 per minute.
Ventricular fibrillation is a disease in which the heart beats quickly and irregularly. The result is a reduction in the pumped blood.

Causes

1. Adverse drug reactions
2. Caffeine
3. Nicotine
4. High levels of sodium and potassium in the blood
5. Necrosis and fibrosis of the heart muscle
6. Cardiomyopathy
7. Myocarditis
8. Valvular heart disease
9. Congenital heart disease

Respiratory sinus arrhythmia (RSA)

Respiratory sinus arrhythmia refers to a change in heart rate that occurs during a natural breathing cycle.
The vagus nerve is a cranial nerve that runs from the brainstem to the abdomen and plays an important role in regulating the heartbeat.
It reduces the contractile force and the frequency of the heart.
When inhaling and exhaling, the cells of the elongated medulla (medulla oblongata) send a signal from the parasympathetic nervous system via this cranial nerve to the heart. This causes a cyclic variation of the heart rate.
Respiratory sinus arrhythmia is a physiological variant and is not considered abnormal.
In fact, it is the loss of this normal reflex that signals a heart problem.

RSA is common in children and adolescents and usually passes on its own with growth.
However, a doctor should be consulted for:

1. very fast and irregular heartbeat,
2. very slow heartbeat,

Cardiac arrhythmia in children

What are the specific causes of cardiac arrhythmias in children?

1. Congenital heart defect
2. Side effects on medicines

Cardiac palpitations during pregnancy

What are the causes?

1. Mental stress
2. Body changes
3. Excessive caffeine consumption
4. Physical stress
5. Anaemia
6. Lack of magnesium
7. Side effects of medications

Diagnostics and examination

Cardiac arrhythmias are diagnosed by listening with the stethoscope or by an electrocardiogram (ECG).
For fetal arrhythmias, echocardiography is usually performed; at the 20th week of pregnancy, a morphological ultrasound is usually performed. If the gynecologist sees a congenital anomaly, he may request echocardiography, as this examination is much more thorough.

Treatment of cardiac arrhythmia

Some arrhythmias do not require therapy, while others require rapid treatment to prevent heart failure.

Possible treatments include:

Physical exercises
There are various physical exercises (physiokinesitherapy) that stimulate the parasympathetic nervous system (the part of the nervous system that affects rest, digestion, energy recovery and recovery).
The techniques that act on the vagus nerve (vagal maneuvers) affect the parasympathetic nervous system and promote heart health.

With regard to nutrition, stimulating foods, such as coffee and chocolate, are not recommended because they can affect the heart rate.

Treatment of accelerated heartbeat

Cardioversion. If the tachycardia originates from the atria (for example, in atrial fibrillation), the doctor may perform cardioversion. This is an electric shock that serves to return the heart to its normal rhythm.
This procedure is usually performed in a monitored environment and does not cause pain.
Emergency cardioversion (defibrillation) is also used for ventricular fibrillation and ventricular tachycardia.

Ablation therapy. In this procedure, a catheter is inserted through the blood vessels to the heart.
It is placed over the place where the arrhythmias arise.
The electrodes at the catheter tip heat up by high-frequency energy.
Another method involves cooling via the catheter to freeze the tissue that is not working properly.
Both methods destroy (ablatate) a small part of the heart tissue and create an electrical blockage along the path that causes the arrhythmia.Implantable devices

Pacemaker. A pacemaker or pacemaker is an implantable device that helps regulate a slow heartbeat (bradycardia).
A small device is placed under the skin near the collarbone.
An insulated wire leads from the device to the heart, where it is anchored.
If the pacemaker registers a heart rate that is too low or a stop of the heartbeat, electrical impulses are emitted that stimulate the heart to a faster heartbeat or to continue the heartbeat.
Most pacemakers have a detection device that turns off when the heart rate is above a certain threshold turns on when the frequency becomes too slow again.

Implantable cardioverter defibrillator (ICD).
The doctor may prescribe this device to a patient who is at great risk for malignant and potentially fatal arrhythmias: ventricular tachycardia or ventricular fibrillation.
An ICD is a system with a battery that is implanted near the left collarbone.
One or two electrodes go from the ICD through veins to the heart.
The ICD continuously monitors the heart rhythm.
If a rhythm is too slow, it stimulates the rhythm like a pacemaker.
In the case of fibrillation or ventricular tachycardia, it sends out low-energy pulses to restore a normal heart rhythm.

Surgical treatment

In some cases, surgical intervention may be recommended to treat cardiac arrhythmias:

Labyrinth process. The surgeon makes a series of incisions in the atria.
These lesions heal in the form of fibrous scar tissue that has an insulating effect.
In this way, the electrical impulses are directed in correct paths, allowing an efficient heartbeat.
The surgeon can use an instrument that freezes the tissue, a high-frequency probe, or a scalpel to create scars.

Coronary bypass surgery. In case of severe coronary artery disease and frequently occurring ventricular tachycardia, the doctor may advise coronary bypass surgery.
This can improve blood flow to the heart and reduce the frequency of ventricular tachycardia.

Drug therapy

Many medications are available to treat cardiac arrhythmias. Some of the prescribed medications are listed here.
Antiarrhythmics
These drugs are used to reduce symptoms in tachycardia.

Medications prescribed for this purpose are:

1. Amiodarone (Cordarex)
2. Dronedarone (Multaq)
3. Flecainide (Tambocor)

Calcium channel blockers
These drugs prevent calcium from entering the heart cells and blood vessels. As a result, the blood vessels relax and arterial blood pressure drops.

Calcium channel blockers prescribed for cardiac arrhythmias include:

1. Amlodipine (Norvasc)
2. Diltiazem (Dilzem)
3. Nifedipine (Adalat)

Beta-blockers
These drugs block the action of adrenaline, thereby lowering blood pressure and cardiac output.
The most commonly prescribed beta-blockers are:

1. Metoprolol (Beloc)
2. Nebivolol (Nebivolol Heumann)

Anticoagulants

They are known as blood thinners and prevent the formation of blood clots.
The use of these drugs is important for preventing complications and risks of cardiac arrhythmias.

1. Warfarin
2. Aspirin

Natural remedies for arrhythmia

Among the herbal remedies in case of cardiac arrhythmias, hawthorn and lime are used, which reduce tachycardia and cardiac palpitations.

• Indigestion or indigestion
• Extrasystoles
• Personality disorder