“Palpitations” of different types about which you must be knowledgeable of---Part--3

A) Irregular heartbeat or Cardiac arrhythmia

A patient with irregular heartbeat or cardiac arrhythmia is a physical condition when heart’s electrical activity is slower than normal, faster and so irregular. In this condition the heart beat may be irregular because it is either too slow or too fast. When a heartbeat is too fast or above the convention of 100 beats per minute for an adult, the condition is known as tachycardia. And when the heart rate is too slow, such as 60 per minute, the condition is known as bradycardia.

The fact is all the arrhythmias are not fatal, but some of them can be responsible for serious cardiac disorder and can result in cardiac arrest. Arrhythmias attacks take place in the areas like atrioventricular junction, Atria or upper chambers of the heart and also in the ventricles or the lower chambers of the heart. The attack of arrhythmia is not restricted to any age.

Deaths due to arrhythmia are many in the majority of the western countries. The deaths are reported to be sudden. The example: - the patients die before they can be brought to a hospital.

Symptoms of arrhythmia (of different nature)

Some symptoms of arrhythmia are awareness or occurrence of an abnormal palpitation or heart beat with mere un-comforts. Other atrial fibrillation does not come at all with any symptom; if it comes, it may come with only vague symbols. In most of the cases, the patient may be predisposed to the life threatening embolism or stroke.

The patients who use defibrillators / cardiac pacemakers may experience complex arrhythmias due to some technical or mechanical defects or due to wire disturbances.

Another normal phenomenon is sinus arrhythmia. In this condition 2 types of occurrences are there, 1) slowing of the heart rate and 2) alternating mild accelerations, accompanied with total breathing trouble. Children are the most of the victims, but with the progression of the age the problem erodes. For the adults the problem may be seen at the time of breath holding patterns and deep inhaling during meditation.

Another type of arrhythmia is known as Proarrhythmia. In this condition the patient gets rather frequent occurrences of arrhythmia. In many occasions it is due to the precipitations of the arrhythmia therapy. This is a clear indicator that the problem is due to some side effects of some drugs or even due to the arrhythmia medications. In other way, it can be said that the tendency of arrhythmia may give inroads to other arrhythmia. A few of the variants of arrhythmia are minor, so they can be considered as normal arrhythmia. In most of the cases people have the skips of beats, in some cases the extra strong beats can also be experienced by some sufferers, but none of these two are the causes to be worried.

Arrhythmia & its classification

Rate, mechanism and duration of arrhythmia are the basis of classification of the problem. The other cause of classification is its site of origin.

Broadly speaking, arrhythmia is classified into atrial, junctional, ventricular, heart blocks, sudden death syndrome due to arrhythmia etc. These classified terms have further subclassifications under each of these sections.

Signs & symptoms of arrhythmia

Cardiac arrhythmia has different types of cardiac disorders under its name.

The most common symptoms of cardiac arrhythmia are palpitation, which is an abnormal awareness of heartbeat. Palpitations can be infrequent, frequent and also continuous. Some types of arrhythmia although cause no harm, but definitely distracting for any patient. But all are not harmless; rather they can be predisposed to alarming conditions.

Some types of arrhythmia do not have any type of symptoms, nor do they cause any increased mortality. However, some types of arrhythmia are really dangerous. The example: - some types of arrhythmia have the problems of blood clotting within the heart that causes increased risk of insufficiency in the supply of blood in the heart: the reason is weak heartbeat.  The other types of major heart related problems are stroke, embolization, sudden cardiac attack and heart failure.

A few types of embolization cause any of these: too slow heartbeat, too fast heartbeats, too weak to adequately perform the job of fulfilling the needs of the body. Because of these factors, manifestations of low blood pressure are possible. Low blood pressure leads to dizziness, light headedness or fainting i.e. syncope.

Other type of arrhythmia causes sudden death or cardiac arrest.

For diagnosing, assessing and treating these conditions of arrhythmia, electrocardiogram is known to be the best option.

B) Tachycardias

Children over 15 years and adults who have over 100 beats of heart rate per minute are the candidates of tachycardia. The problem makes a person palpitated. But the problem is different from arrhythmia case. Normally if the heart rate is increased, it may be due to either emotional stress or due to physical exercise. Sympathetic nervous system can be the causes of called sinus tachycardia and sinus node through their meditations. Some other reasons of increased activities of sympathetic nervous system are either injected or ingested substances. They are amphetamines or caffeine and also a thyroid gland that is overactive that cause anaemia (hyperthyroidism).

Sinus tachycardia, which normally is the result of the normal cardiac cycle’s additional abnormal impulses, is not considered as tachycardia. Abnormal impulses causes from any of the three mechanisms like 1) automatic, 2) triggered or 3) re-entered activity. A specialised form of the “re-entered activity”, (the problem that is the 3rd one mentioned here) is known as fibrillation.

The body condition, “tachycardia” has a historical attachment, which is subjected to the arrhythmias’ cataloguing base, is still a subject for discussions.

Defects in heart

If the heart defects are congenital, they are diagnosed in the medical world as the problems of electrical or structural pathway since birth. The problem may affect any one. Importantly in the initial stage, this problem does not affect the overall health of a person. But, this problem of electrical or structural pathway of heart can affect a person very fast; in some cases it can turn to be deadly arrhythmias. One of the examples of this electrical pathway problem is Wolff-Parkinson-White syndrome, which is made up of heart’s electrical muscle tissues. These tissues trigger electrical impulses of the heart for their rapid occurrences. Ventricular tachycardia is the most common type of condition among healthy individuals and is known as the Right Ventricular Tachycardia.

The cause of this problem

The reason it is called ‘Right Ventricular Tachycardia’ is the defect in the right ventricle’s node, which is situated just at the beginning of the pulmonary artery. In case of the stimulation of the node, the patient suffers from ventricular tachycardia. In this condition, the afflicted person does not receive sufficient blood to his heart due to the disturbance of ventricular tachycardia.

C) Long QT syndromes

One more complex of our heart is ventricular tachycardia. This is a known single factor for death in cases.

Treatments

Different methods are there for treating this ‘Long QT syndromes’. The methods are medication treatment, cardiac ablations and altering the sufferer’s lifestyles. The third one is to lower the stress as well the exercises. Even with this life threatening condition, a sufferer can live a full & happy life.

D) Automaticity

The condition of Automaticity means automatic firing off a cardiac muscle cell’s impulse. Each cell in the heart can automatically initiate the potential of an action, but only a few of them are capable of routinely triggering off the beats of the heart. The conduction system of heart has these cells and includes bundle of Purkinje fibres, SA node and AV node. Atrial has the singly specialized located node i.e. Sino atrial node. This node has the faster pace making capacity or higher automaticity, if compared with the others in the heart. Hence it is responsible for initiating each heart beat and also setting the rate of the heart.

Any of the parts of the heart that starts the impulse, even before Sino atrial node becomes active, is known as ectopic focus. This is defined as pathological phenomenon. For which a single premature “now & then” beat may be caused. It may also happen that firing of ectopic focus is more often if compared with the Sino atrial node. A sustained abnormal rhythm can be produced by it. An atrioventricular node or an ectopic focus produces rhythms in the atria. These types of dysrhythmias are least dangerous, but there is every possibility that they can bring down the pumping efficiencies of the heart. The reason is heart-muscle’s various parts receive signals with different timing than they usually receive, leading to the poorly coordinated contraction.

The automaticity increasing conditions are inclusive of hypoxia and stimulation in sympathetic nervous system. Because of this the heart system depends on the beginning of the first signal. The rhythm is although rapid but normal, if the node is Sino atrial. But in case it is an ectopic focus, dysrhythmia of different types may ensue.

E) Re-entry

Arrhythmias’ re-entry takes place if an electrical impulse travels in a repeated way through a tight cycle within the heart, instead of moving from one to other end of heart and then stopping. Each of the cardiac cells has the capacity to transmit excitation’s impulses in every direction, but can do such in a short time only.

The impulses of action potential, in normal conditions, get transmitted through heart in a quicker way, making each cell to respond just once. In case of refractory period’s some essential heterogeneity or in case the conduction is significantly slow in some areas; the myocardial cells will fail to activate the fast sodium channel. Because of this, some portion of impulse will reach there late, for which it will be reasonably considered as a new impulse. Here, a time dependant sustained abnormal circuit rhythm will be produced.

Due to the many of the dangerous ventricular tachycardia and paroxysmal supraventricular tachycardia, re-entry makes it way. WPW syndromes are different from this type of re-entry circuits, in which actual pathways exists.

Treatments

 

Normally, Fish oil extracted moega-3 fatty acids work as the protection against arrhythmias, but due to the re-entry of arrhythmias, fish oil can be worsening factor.

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