Arrhythmia is a heart rhythm abnormality now this can either be due to the fact that the heart is beating too slowly which is called a bradycardia or too quickly which is called a tachycardia.
The most common cause of bradycardia is intrinsic disease within the conducting tissue of the heart and this is normally treated with a pacemaker if your heart beats too quickly this is called a tachycardia and the most common reason for a tachycardia is atrial fibrillation now this diagnosis is prevalent in more than 5% of the population above 60 years of age and the most common risks that predispose patients to atrial fibrillation include hypertension diabetes or a previous history of a heart attack.
It can be diagnosed in several ways. Usually the patient complains of symptoms. They may feel their heart suddenly beating too fast or too slowly. They may complain of feeling dizzy because their heart rate is too slow and their blood pressure drops as a consequence.
They may feel faint. They may actually faint and lose consciousness.Aside from what the patient tells us, there are a number of simple tests that we can do to make the diagnosis. Probably, the commonest is to do an ECG, that’s to record the electrical activity of the heart just by putting a series of electrodes on the outside of the chest wall and recording that and we can see from the ECG whether the heart is in the normal rhythm or an abnormal rhythm very readily.
If we still can’t obtain a diagnosis, then we can introduce tiny, little electrodes through the vein at the top of the leg and pass those round to the heart and record the electrical signals directly from within the heart and work out from that procedure whether the individual has an extra electrical connection or an irritable focus inside the heart that can make the heart suddenly speed up.Equally, we can also assess how the heart’s own pacemaker functions in whether it’s not functioning properly.
If the arrhythmiais due to a slow heart rate, or bradycardia, this is usually only resolved with a permanent pacemaker implantation.If the arrhythmia is due to a tachycardia, the most common of which is a diagnosis of atrial fibrillation, then there are several strategies in a step-wise manner that can be applied to treat the arrhythmia.The first is to try and modify risk factors that provoke arrhythmia. This may be to do with lifestyle changes, treating obesity, treating diabetes and hypertension.In patients who continue to have frequent arrhythmic episodes, then drugs could be tried and in the case where the drugs fail, then the option of catheter ablation, which is a specialized keyhole cardiac surgical procedure, can be performed in selected individuals who fulfill the criteria. These procedures are normally performed by a cardiac electrophysiologist in a specialized catheter laboratory such as this.
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