Cardiac arrhythmias, often referred to simply as arrhythmias, are conditions characterised by an abnormal heart rhythm. The heart might beat too fast, too slow, or irregularly, which can disrupt the efficient pumping of blood to the body’s tissues and organs.
Arrhythmias occur when the electrical impulses that control your heartbeats are interrupted or become irregular. They can range from being harmless (benign) to life-threatening, depending on their type and severity. Some common types of arrhythmias include atrial fibrillation (AFib), atrial flutter, ventricular tachycardia, and ventricular fibrillation.
Arrhythmias are important to treat for several reasons:
- They can cause uncomfortable symptoms like palpitations, shortness of breath, dizziness, or fatigue. Treating the arrhythmia can help alleviate these symptoms and improve a person’s quality of life.
- If left untreated, they can lead to serious complications such as stroke or heart failure. AFib, for example, can cause blood to pool in the heart, forming clots that can travel to the brain and cause a stroke.
- In severe cases, they are medical emergencies as they can lead to sudden cardiac death. Prompt treatment is critical to restore normal heart rhythm and save the person’s life.
- By restoring the heart’s normal rhythm or controlling the rate of fast rhythms, treatments can help the heart pump blood more efficiently. This can be beneficial in people with heart diseases.
Given the potential severity and complications associated with this condition, it’s crucial to seek professional medical attention if you suspect you have an irregular heartbeat. Through a combination of lifestyle changes, medications, and possibly procedures or surgery, most of these can be effectively managed.
How are cardiac arrhythmias treated?
Common treatment options include:
Medications
Antiarrhythmic medications are often the first line of treatment for many types of arrhythmias. These drugs help regulate the heart’s electrical activity and restore normal rhythm. The choice of medication depends on the specific arrhythmia and your overall health.
Cardioversion
Cardioversion is a procedure that involves delivering a controlled electric shock to the heart to convert an irregular or fast heart rhythm back to a normal sinus rhythm. It can be done using external paddles (external cardioversion) or through catheters placed inside the heart (internal or transvenous cardioversion).
Catheter ablation
Catheter ablation is a minimally invasive procedure used to treat certain types of arrhythmias, such as atrial fibrillation and supraventricular tachycardia. During the procedure, a thin, flexible catheter is threaded through large blood vessels accessed from the periphery and which travel to the heart. Once at the site of the abnormal electrical signals, the tissue causing the arrhythmia is destroyed or isolated using heat or cold energy.
Implantable devices
In some cases, implantable devices like pacemakers and implantable cardioverter-defibrillators (ICDs) are used to manage arrhythmias. Pacemakers help regulate slow heart rhythms by sending electrical impulses to the heart when it beats too slowly. ICDs continuously monitor heart rhythm and deliver a shock to restore normal rhythm if a life-threatening arrhythmia is detected. They can also sometimes pace-terminate the arrhythmia where needed.
Lifestyle modifications
Lifestyle changes can play a significant role in managing arrhythmias and improving heart health. This may include quitting smoking, reducing alcohol and caffeine intake, managing stress, maintaining a healthy weight, and engaging in regular exercise.
Surgical interventions
In some complex cases or when other treatments are ineffective, surgical interventions may be considered. Surgical procedures like the Maze procedure are performed to treat atrial fibrillation by creating scar tissue in the heart to redirect electrical impulses and restore normal rhythm.
Hybrid approaches
In recent years, hybrid approaches that combine medications, catheter ablation, and surgical techniques have shown promising results in certain complex cases of arrhythmias.
It is essential to note that treatment plans are highly individualised, and what works for one person may not be suitable for another. The treatment approach will depend on factors such as:
- The type of arrhythmia
- The patient’s overall health
- Their preferences
Close collaboration with a skilled team of cardiologists and electrophysiologists is crucial to tailor the treatment plan for each patient. Regular follow-up visits and continuous monitoring are also important to assess treatment effectiveness and make any necessary adjustments.
What tests can check for cardiac arrhythmias?
Electrocardiogram (ECG or EKG)
This is the most basic and widely used test for diagnosing arrhythmias. It records the electrical activity of the heart and displays it as a graph. An ECG can detect abnormal heart rhythms and provide valuable information about the heart’s overall health.
Holter monitor
A Holter monitor is a portable device that continuously records the heart’s electrical activity over a period of 24 to 48 hours, or even longer. It allows doctors to capture any irregularities that might not show up during a short ECG.
Event monitor
Similar to a Holter monitor, an event monitor is also a portable device that patients wear to record their heart’s electrical activity. However, an event monitor is typically used for a more extended period, ranging from several days to a few weeks. It is activated by the patient when they experience symptoms, enabling the monitoring of specific events.
Exercise stress test
This test evaluates the heart’s response to physical activity. Patients are asked to walk on a treadmill or ride a stationary bike while connected to an ECG machine. It helps identify arrhythmias that may only occur during exercise.
Echocardiogram
An echocardiogram uses sound waves to create images of the heart’s structure and function. It provides valuable information about the heart’s size, shape, and pumping ability, which can help identify underlying conditions contributing to arrhythmias.
What are the potential complications that can arise from cardiac arrhythmias?
Cardiac arrhythmias, if left untreated or uncontrolled, can lead to various complications, ranging from mild to life-threatening. These include:
- Stroke: Certain types of arrhythmias, particularly atrial fibrillation (AFib), can lead to blood pooling in the heart, forming clots. These clots can then travel to the brain, causing a stroke. Strokes resulting from AFib tend to be more severe than other types of strokes.
- Heart Failure: Persistent or untreated arrhythmias can weaken the heart over time, leading to heart failure. Heart failure occurs when the heart cannot pump enough blood to meet the body’s needs, resulting in symptoms like fatigue, shortness of breath, and fluid retention.
- Sudden Cardiac Arrest: Ventricular arrhythmias, such as ventricular fibrillation (VF), can cause sudden cardiac arrest. In VF, the heart’s electrical activity becomes chaotic, and the heart cannot effectively pump blood. Sudden cardiac arrest requires immediate cardiopulmonary resuscitation (CPR) and defibrillation to restore a normal rhythm.
- Cardiomyopathy: Long-term arrhythmias can contribute to the development of cardiomyopathy, a condition where the heart muscle becomes weakened and enlarged. This impairs the heart’s ability to pump blood effectively and can lead to heart failure.
- Fainting (Syncope): Some arrhythmias can cause a sudden drop in blood pressure or heart rate, leading to fainting spells or loss of consciousness.
- Blood Clots and Pulmonary Embolism: Certain arrhythmias, such as atrial flutter or ventricular tachycardia, can increase the risk of blood clots forming in the heart chambers. If these clots travel to the lungs, they can cause a pulmonary embolism, a potentially life-threatening condition.
- Reduced Exercise Tolerance: Persistent arrhythmias can limit a person’s ability to engage in physical activities, leading to reduced exercise tolerance and overall quality of life.
- Anxiety and Mental Health Issues: Living with a cardiac arrhythmia can be stressful and anxiety-inducing. The fear of sudden complications can affect a person’s mental health and well-being.
It’s essential for individuals with known or suspected arrhythmias to seek timely medical evaluation and treatment to reduce the risk of complications. With appropriate management, many arrhythmias can be controlled, and the risk of associated complications can be minimised. Regular follow-ups with healthcare professionals and adherence to prescribed treatments are crucial for maintaining heart health and preventing serious complications.
Where can I go if I need treatment for cardiac arrhythmias in the Western suburbs?
You can receive treatment for cardiac arrhythmias in the Western suburbs at HeartWest, the largest cardiology group in the western and northwestern corridors of Melbourne, with 4 major locations and 3 satellite sites.
At HeartWest, our qualified experts will provide you with the professional cardiology care. You will experience nothing but professionalism, care and courtesy; from your first interaction with our staff, to going through tests, procedures and consultations.
Our cardiologists have expertise in all fields of adult cardiology, including;
- General cardiology
- Heart failure
- Cardiac imaging (including stress echocardiography)
- Interventional cardiology
- Electrophysiology & pacing
- Cardiothoracic surgery
Contact us for efficient and affordable specialist heart care services.