Cardiac arrhythmia

The heartbeat occurs as a result of electrical impulses that cause the atria and ventricles to contract in an adequate, synchronous and rhythmic way.

The heart rate normally ranges from 60 and 100 beats per minute (bpm), and responds to the following sequence: the heart's electrical impulse starts at the sinus node, located in the right atrium. From there, it passes through the atria to the atrioventricular node, located at the junction of the atria with the ventricles and reaches the ventricles through the bundle of His.

Finally, this stimulus is conducted through the ventricles through the system Purkinje.

Types of arrhythmias

According to its origin:

• Supraventricular: they originate before the Bundle of His, that is, in the atria or in the atrioventricular node.
• Ventricular: originate in the ventricles.

Your heart rate:

• Rapid or tachycardias: frequency greater than 100
• Slow or : frequency below 60

By its mode of presentation:

• Chronicles: of character
• Paroxysmal: they occur occasionally

What can cause an arrhythmia?

Cardiac arrhythmias appear for one of three reasons:

• Electric impulse is not generated
• The electrical impulse originates from the wrong place.
• The paths for electrical conduction are

Signs that can warn you of an arrhythmia?

Arrhythmias can cause symptom such as palpitations, dizziness, syncope, chest pain or loss of consciousness, but they can also go unnoticed and be detected casually when diagnostic tests are performed.

How are they diagnosed?

To make the diagnosis, it is necessary to demonstrate that there is an alteration in cardiac electrical activity.

• The reference diagnostic test is the, but it has the disadvantage that it only records the cardiac electrical activity at the time it is being performed and, therefore, only shows us if there are arrhythmias then.
• Sometimes other tests can be used, such as the one, which records the cardiac electrical activity for a longer period of time (one or more days), or more rarely the implantable Holter monitors, which are placed under the skin through a simple surgical procedure. These can be worn for years and are reserved for patients in whom they are suspected severe arrhythmias that could not be detected by other methods.
• When an arrhythmia related to physical exertion is suspected, a
• Finally, the cardiac conduction system can be studied in depth and an attempt can be made to reproduce arrhythmias through the so-called electrophysiological study, which is performed by introducing cables into the heart, generally from the veins of the legs (femoral vein) that allow the cardiac electrical activity to be recorded and stimulate the heart to reproduce arrhythmias.
• It is also usually important to find out if there is any structural alteration of the heart associated with the arrhythmia, for which it may be necessary to
• get one.

What prognosis do they have?

The prognosis depends on the type of arrhythmia and the baseline state of the patient.

In general, bradyarrhythmias have a good prognosis after being treated, and among tachyarrhythmias, supraventricular ones, have a more favorable prognosis than ventricular ones.

Treatment

It depends on the type of arrhythmia, its cause and the characteristics of the patient:

Bradyarrhythmias

Once possible non-cardiac causes have been resolved, they may sometimes require the placement of a pacemaker, which is a device that is implanted under the skin and has cables that reach the heart, in such a way that they record the electrical activity of the heart and stimulate it when necessary.

Tachyarrhythmias

Cardiology Specialist