​Arrhythmia: An in-depth look at heart rhythm abnormalities

January 23, 2019
Healthcaretoday, Dr Ernest Ng Wee Oon, Pantai Hospital Kuala Lumpur, Arrhythmia, heart health, cardiology, tachycardia, bradycardia, heart rhythm, electrophysiology, heart disease, cardiac care, arrhythmia awareness, ventricular tachycardia, supraventricular tachycardia, cardiac health, heart function,
Arrhythmia is a condition characterized by irregular heart rhythms, which can significantly impact overall health. A normal heart rhythm involves a consistent sequence of contractions in the heart's chambers—the atria (top chambers) and the ventricles (bottom chambers). 

What is arrhythmia?
Arrhythmia refers to any deviation from the normal rhythm of the heart. According to Dr Ernest Ng Wee Oon (pix), a consultant interventional cardiologist and electrophysiologist at Pantai Hospital Kuala Lumpur, "Anything that’s different from the normal rhythm is called arrhythmia." This condition can manifest in several ways, affecting how the heart beats and functions.

Causes of arrhythmia
Arrhythmias can arise from various factors and are broadly classified into two categories based on heart rate:

Tachycardia: This condition occurs when the heart beats faster than 100 beats per minute. Tachycardia can be further divided into:
  • Normal tachycardia: This may occur during physical exertion, anxiety, or excitement.
  • Abnormal tachycardia: This is associated with underlying health issues, such as hormonal disorders like hyperthyroidism or high fibroid levels, which can cause the heart to beat faster.

​Dr Ernest notes that when tachycardia arises from abnormal heart rhythms, it is termed tachyarrhythmia. This can affect the top chamber (supraventricular tachyarrhythmia), where extra beats may occur, sometimes exceeding 180 to 200 beats per minute. Patients may experience symptoms like dizziness and breathlessness. Treatment often involves anti-arrhythmic medications and, in more complex cases, procedures like electrophysiology studies and radiofrequency ablation.

Bradycardia: This condition is characterized by a slow heart rate, defined as fewer than 60 beats per minute. While bradycardia can be benign in some individuals, it may indicate underlying health issues that require medical attention.

Types of arrhythmia
Arrhythmias can be categorized based on their origin and severity:
  • Supraventricular tachyarrhythmia: As mentioned, this type originates in the atria and can cause rapid heartbeats. Patients may feel unwell, dizzy, or breathless, necessitating medical intervention.
  • Ventricular tachyarrhythmia: This type originates in the ventricles and can lead to very fast heartbeats. While some ventricular beats may be harmless, they can also be bothersome for patients. Advanced mapping techniques can help locate the source of these extra beats.
  • Ventricular tachycardia and ventricular fibrillation: These are more dangerous forms of arrhythmia occurring in the ventricles. They often signal a structural problem within the heart, which may be genetic or acquired. Factors such as excessive alcohol consumption or viral infections can lead to heart damage, increasing the risk of these life-threatening arrhythmias.

Symptoms of arrhythmia
Symptoms can vary widely among individuals and may include:
  • Palpitations or the sensation of a racing heart
  • Dizziness or lightheadedness
  • Shortness of breath
  • Chest pain or discomfort
  • Fatigue or weakness

In some cases, arrhythmias may be asymptomatic and discovered incidentally during a routine check-up.

Arrhythmia is a complex condition that requires careful evaluation and management. Understanding its causes, symptoms, and types can empower individuals to seek timely medical advice and treatment. If you experience any symptoms associated with irregular heart rhythms, consult a healthcare professional for a thorough assessment and appropriate management.

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