When the heart beats irregularly – causes, symptoms, treatment

Arrhythmia is a condition in which the heart’s contractions become abnormal. It is caused by abnormal generation of electrical signals, which in turn makes the heart’s contractions abnormal as well. It is found more often in men than in women. Normally it is found in about 1–2%, and the incidence increases with age. In people aged 70–80 years, the rate increases to as high as 5%.

Symptoms

Palpitations may begin either at rest or after activity, with easy shortness of breath or chest tightness/pain. There may be dizziness, fatigue, weakness, or fainting. In some cases, it may result from complications of the disease, such as stroke (cerebral vessel blockage) or heart failure.

Preliminary diagnosis

Diagnosed by checking the pulse. If the pulse is irregular or fast, you should see a doctor for an electrocardiogram (ECG) examination, which will be used for diagnosis.Based on an ECG showing an irregular rhythm and a P-wave frequency greater than 350 times per minute.

Mechanism of occurrence

1. Abnormal electrical focus (focal activation)
2. Multiple reentrant electrical circuits (multiple reentrant circuits)
3. Combination of types 1 and 2

Causes of arrhythmia

1. Caused directly by heart and coronary blood vessels, whether due to diseases of the heart muscle, pericardium, coronary artery narrowing, or high blood pressure that can subsequently lead to heart conditions.
2. Caused by the effects of other systemic diseases; commonly found in patients with hyperthyroidism, emphysema, certain electrolyte abnormalities such as low magnesium or low potassium, or substance abuse and certain stimulants, including excessive amounts of tea and coffee, which can trigger arrhythmias.
3. Can occur on its own without a cause (idiopathic).

Treatment

The main objectives of treatment are to relieve symptoms and reduce complications of the disease.

1. Using medication to control the heart rate so it is not too fast, both at rest and during exercise.
2. Using medication to control the heart rhythm, converting an abnormal rhythm to a normal rhythm and preventing future rhythm disturbances.
3. Using blood-thinning (anticoagulant) medication. Patients can easily develop blood clots in the upper chambers of the heart, and whenever a clot breaks loose, it can cause blockages in important organs, leading to weakness or paralysis. Therefore, if indicated, the doctor needs to use anticoagulant medication in this group.
4. Using radiofrequency energy to ablate the area sending abnormal signals by inserting a catheter into the patient’s blood vessel, using radiofrequency to interrupt the abnormal signaling circuit and perform ablation.
5. Surgery: removing/ablating tissue in the upper heart chamber that is sending abnormal signals.

Currently, there are methods to prevent blood clots besides using medication. By inserting a device to occlude the upper heart chamber area, which is the area where heart blood clots most commonly form.
In cases where the patient has an arrhythmia and unstable vital signs, such as low blood pressure, or has severe symptoms that cannot be controlled with medication, and presents as an emergency, an electrical shock is used to reset the rhythm, called cardioversion.

The severity of arrhythmia

In chronic cases, the heart has to work harder or beat fast all the time. After a period of time, a heart that used to pump well will begin to pump poorly, leading to reduced pumping function (heart failure) and potentially pulmonary edema. In severe cases, this can cause chronic pulmonary edema and may result in death from heart failure.

Recommendations for prevention and care

1. Stop smoking. It has been found that within the first year of quitting, the risk of coronary artery disease—which is one cause of arrhythmia—can be reduced to about half compared with smokers. If you can quit for 2 years or more, the risk can decrease to the same level as a normal non-smoker.
2. Exercise in a not-too-excessive amount, such as walking or light jogging, for 15–30 minutes per day, 5 days per week.
3. Avoid or stop drinking tea, coffee, and energy drinks.

Avoiding various risk factors, including choosing healthy foods and exercising regularly. If abnormalities are found, you should see a doctor promptly; this will help you stay away from this disease.