Heart Rhythm Disorders

What are heart rhythm disorders?

Heart rhythm disorders fall under the category of arrhythmias. Arrhythmias may cause the heart to beat too slow (less than 60 beats per minute is bradycardia) or too fast (greater than 100 beats per minute is tachycardia). Arrhythmias may occur from the upper two chambers of the heart, called atrial arrhythmias or supraventricular arrhythmias or may originate from the lower chambers of the heart, called the ventricles. Some arrhythmias are benign, and have little, if any, clinical significance. Other arrhythmias are malignant, and may be life-threatening. A given arrhythmia may have different clinical significance in different individuals, primarily depending upon whether or not the individual has structural heart disease, or most importantly, diminished cardiac performance (congestive heart failure).

Examples of arrhythmias seen on an electrocardiogram (EKG):

Sinus Bradycardia (Heart rate is less than 60 beats per minute)

Sinus Tachycardia (Heart rate is greater than 100 beats per minute)

Premature ventricular contractions (PVCs)

Premature atrial contractions (PACs)

Ventricular Fibrillatoin (causes immediate collapse of the cardiovascular system and is a frequent cause of sudden cardiac death. It almost always occurs in the presence of significant heart disease)

Ventricular tachycardia (is a potentially life-threatening rhythm disturbance. It occurs when rapid, abnormal electrical impulses arise from the ventricles. It can result in heart rates of up to 300 beats per minute!)

What are the warning signs and symptoms of heart rhythm disorders?

An individual's response to any particular arrhythmia may be varied. Individuals may have no symptoms whatsoever, or may present with sudden, catastrophic collapse with either loss of consciousness or sudden death. In between these two extremes, is an entire gamut of symptoms including insignificant palpitations to marked fluttering in one's chest associated with shortness of breath, chest pain, sweating, and lightheadedness. These are important symptoms to recognize and should not be ignored. These should be discussed with your physician to help determine their significance

How are heart rhythm disorders detected?

Your doctor has several ways of evaluating heart rhythm disorders. The electrocardiogram (ECG) is a common, noninvasive, quickly performed test that allows your physician to assess exactly what rhythm your heart is in. This test, however, does not provide any information as to what heart rhythm you may have had at any time in the past, particularly associated with one or more symptoms. To help evaluate rhythm disturbances that may occur while you are not at the doctor's office, you may have a 24 hour ambulatory electrocardiographic monitoring test (24 hour Holter monitor recording) or a long term ECG analysis called an event monitor which may allow for recording of abnormal heart rhythms for 14 days or 1 month. Other adjunctive tests that may be helpful include treadmill testing, or electrophysiology testing which is an invasive procedure involving placement of catheters into the vascular system.

What are the treatment options for heart rhythm disorders?

What treatment is provided to a given patient depends entirely on the severity of the heart rhythm problem. Many heart rhythm problems do not require any treatment at all, other than reassurance. Other heart rhythm problems may be easily treated with various anti-arrhythmic medications. Some rapid heart rhythm problems may be treated with catheter ablation or implantation of a pacemaker-type device known as an implantable cardioversion defibrillator. Finally, and rarely, one may require an open-heart surgical procedure to eliminate the source of heart rhythm problems.