Arrhythmia

This article is about the irregular heartbeat. For the skin condition, see erythema. For other uses, see arrhythmia (disambiguation).

Arrhythmia
Other namesCardiac arrhythmia, heart arrhythmia, dysrhythmia, irregular heartbeat
Ventricular fibrillation (VF) showing disorganized electrical activity producing a spiked tracing on an electrocardiogram (ECG)
SpecialtyCardiology
SymptomsPalpitations, dizziness or lightheadedness, passing out, shortness of breath, chest pain,[1] decreased level of consciousness
ComplicationsStroke, heart failure[2][3]
Usual onsetOlder age[4]
TypesExtra beats, supraventricular tachycardias, ventricular arrhythmias, bradyarrhythmias[3]
CausesProblems with the electrical conduction system of the heart[2]
Diagnostic methodElectrocardiogram, Holter monitor[5]
TreatmentMedications, medical procedures (pacemaker), surgery[6]
FrequencyMillions[4]
Emma's irregular heartbeat
Heart sounds of a girl experiencing arrhythmia after exercising.
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Arrhythmias, also known as cardiac arrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow.[2] A resting heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia, and a resting heart rate that is too slow – below 60 beats per minute – is called bradycardia.[2] Some types of arrhythmias have no symptoms.[1] Symptoms, when present, may include palpitations or feeling a pause between heartbeats.[1] In more serious cases, there may be lightheadedness, passing out, shortness of breath, chest pain, or decreased level of consciousness.[1] While most cases of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure.[2][3] Others may result in sudden death.[3]

Arrhythmias are often categorized into four groups: extra beats, supraventricular tachycardias, ventricular arrhythmias and bradyarrhythmias.[3] Extra beats include premature atrial contractions, premature ventricular contractions and premature junctional contractions.[3] Supraventricular tachycardias include atrial fibrillation, atrial flutter and paroxysmal supraventricular tachycardia.[3] Ventricular arrhythmias include ventricular fibrillation and ventricular tachycardia.[3][7] Bradyarrhythmias are due to sinus node dysfunction or atrioventricular conduction disturbances.[8] Arrhythmias are due to problems with the electrical conduction system of the heart.[2] A number of tests can help with diagnosis, including an electrocardiogram (ECG) and Holter monitor.[5]

Many arrhythmias can be effectively treated.[2] Treatments may include medications, medical procedures such as inserting a pacemaker, and surgery.[6] Medications for a fast heart rate may include beta blockers, or antiarrhythmic agents such as procainamide, which attempt to restore a normal heart rhythm.[6] This latter group may have more significant side effects, especially if taken for a long period of time.[6] Pacemakers are often used for slow heart rates.[6] Those with an irregular heartbeat are often treated with blood thinners to reduce the risk of complications.[6] Those who have severe symptoms from an arrhythmia or are medically unstable may receive urgent treatment with a controlled electric shock in the form of cardioversion or defibrillation.[6]

Arrhythmia affects millions of people.[4] In Europe and North America, as of 2014, atrial fibrillation affects about 2% to 3% of the population.[9] Atrial fibrillation and atrial flutter resulted in 112,000 deaths in 2013, up from 29,000 in 1990.[10] However, in most recent cases concerning the SARS-CoV‑2 pandemic, cardiac arrhythmias are commonly developed and associated with high morbidity and mortality among patients hospitalized with the COVID-19 infection, due to the infection's ability to cause myocardial injury.[11] Sudden cardiac death is the cause of about half of deaths due to cardiovascular disease and about 15% of all deaths globally.[12] About 80% of sudden cardiac death is the result of ventricular arrhythmias.[12] Arrhythmias may occur at any age but are more common among older people.[4] Arrhythmias may also occur in children; however, the normal range for the heart rate varies with age.[3]

  1. ^ a b c d "What Are the Signs and Symptoms of an Arrhythmia?". National Heart, Lung, and Blood Institute. July 1, 2011. Archived from the original on 19 February 2015. Retrieved 7 March 2015.
  2. ^ a b c d e f g "What Is Arrhythmia?". National Heart, Lung, and Blood Institute. July 1, 2011. Archived from the original on 2 March 2015. Retrieved 7 March 2015.
  3. ^ a b c d e f g h i "Types of Arrhythmia". National Heart, Lung, and Blood Institute. July 1, 2011. Archived from the original on 7 June 2015. Retrieved 7 March 2015.
  4. ^ a b c d "Who Is at Risk for an Arrhythmia?". National Heart, Lung, and Blood Institute. July 1, 2011. Archived from the original on 3 March 2015. Retrieved 7 March 2015.
  5. ^ a b "How Are Arrhythmias Diagnosed?". National Heart, Lung, and Blood Institute. July 1, 2011. Archived from the original on 18 February 2015. Retrieved 7 March 2015.
  6. ^ a b c d e f g "How Are Arrhythmias Treated?". National Heart, Lung, and Blood Institute. July 1, 2011. Archived from the original on 17 February 2015. Retrieved 7 March 2015.
  7. ^ Martin CA, Matthews GD, Huang CL (April 2012). "Sudden cardiac death and inherited channelopathy: the basic electrophysiology of the myocyte and myocardium in ion channel disease". Heart. 98 (7): 536–543. doi:10.1136/heartjnl-2011-300953. PMC 3308472. PMID 22422742.
  8. ^ Vogler J, Breithardt G, Eckardt L (July 2012). "Bradyarrhythmias and conduction blocks". Revista Espanola de Cardiologia. 65 (7): 656–667. doi:10.1016/j.rec.2012.01.027. PMID 22627074. S2CID 18983179.
  9. ^ Zoni-Berisso M, Lercari F, Carazza T, Domenicucci S (2014). "Epidemiology of atrial fibrillation: European perspective". Clinical Epidemiology. 6: 213–220. doi:10.2147/CLEP.S47385. PMC 4064952. PMID 24966695.
  10. ^ Naghavi M, Wang H, Lozano R, Davis A, Liang X, Zhou M, et al. (GBD 2013 Mortality and Causes of Death Collaborators) (January 2015). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–171. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442.
  11. ^ Kuck KH (June 2020). "Arrhythmias and sudden cardiac death in the COVID-19 pandemic". Herz. 45 (4): 325–326. doi:10.1007/s00059-020-04924-0. PMC 7181098. PMID 32333026.
  12. ^ a b Mehra R (2007). "Global public health problem of sudden cardiac death". Journal of Electrocardiology. 40 (6 Suppl): S118–S122. doi:10.1016/j.jelectrocard.2007.06.023. PMID 17993308.