ARRHYTHMIA | HEART RHYTHM DISORDERS
Arrhythmia is a disorder of the heart's rhythm caused by abnormal electrical signals that control the heartbeat. The heart may beat too fast, too slowly or irregularly, and the significance of the condition depends on the type of arrhythmia, its cause and the presence of other heart conditions.
TYPES OF HEART RHYTHM DISORDERS
Common types of arrhythmias include:
• Atrial fibrillation.
• Atrial flutter.
• Tachycardia.
• Bradycardia.
• Premature heartbeats.
• Certain ventricular arrhythmias.
• Heart conduction disorders.
SYMPTOMS OF ARRHYTHMIA
Some arrhythmias cause no symptoms, while others may cause:
• Palpitations or awareness of strong, rapid or irregular heartbeats.
• A very fast or slow heartbeat.
• Dizziness or lightheadedness.
• Fainting or near-fainting.
• Shortness of breath.
• Fatigue and reduced energy.
• Chest pain or discomfort.
• Reduced exercise tolerance.
WHEN CAN AN ARRHYTHMIA BE SERIOUS?
The seriousness of an arrhythmia depends on its type, heart rate, underlying cause and the presence of other heart conditions.
Urgent medical evaluation is important when an abnormal heartbeat is associated with severe chest pain, significant shortness of breath, fainting, severe dizziness or sudden weakness.
HOW ARE ARRHYTHMIAS DIAGNOSED?
Diagnosis begins with a detailed medical history, assessment of symptoms and physical examination. Depending on the situation, investigations may include:
• Electrocardiogram (ECG).
• Holter monitoring for 24 hours or longer.
• Echocardiography (Echo).
• Blood tests when appropriate.
• Exercise stress testing in selected cases.
• Additional cardiac rhythm investigations when required.
THE ROLE OF HOLTER MONITORING
Holter monitoring is an important test for detecting intermittent heart rhythm abnormalities that may not appear during a standard ECG.
The portable device continuously records the heart's electrical activity while the patient continues normal daily activities. This allows the doctor to correlate symptoms such as palpitations, dizziness or fainting with the heart rhythm at the time they occur.
CAUSES OF ARRHYTHMIA
Arrhythmias may develop due to a variety of conditions and factors, including:
• Coronary artery disease.
• High blood pressure.
• Heart valve disease.
• Cardiomyopathy or weakened heart muscle.
• Thyroid disorders.
• Abnormal blood electrolyte levels.
• Certain medications and stimulants.
• Smoking.
• Stress and lack of sleep in some cases.
• Some arrhythmias may occur without an identifiable underlying cause.
TREATMENT OF ARRHYTHMIA
Treatment depends on the type of arrhythmia, its underlying cause, the severity of symptoms and the patient's overall health.
Treatment may include:
• Observation and regular follow-up for mild or low-risk arrhythmias.
• Lifestyle modification and avoidance of specific triggers when appropriate.
• Medications to control heart rate or rhythm.
• Other medications according to the specific type of arrhythmia.
• Anticoagulant medication for selected patients, particularly some patients with atrial fibrillation.
• Interventional electrophysiology procedures when appropriate.
• Catheter ablation for selected types of arrhythmia.
• Pacemaker implantation or other cardiac devices in specific conditions.
ATRIAL FIBRILLATION
Atrial fibrillation is one of the most common heart rhythm disorders and is characterized by an irregular rhythm of the atria.
Patients with atrial fibrillation require assessment of their risk of stroke and may need anticoagulant treatment. Evaluation of heart rate, symptoms and overall cardiovascular condition also helps determine the most appropriate treatment strategy.
PALPITATIONS AND IRREGULAR HEARTBEATS
Not every sensation of a racing or irregular heartbeat indicates a serious heart rhythm disorder. However, recurrent palpitations, particularly when associated with dizziness, fainting, chest pain or shortness of breath, should be medically evaluated.
An ECG or Holter monitor may help identify the cause of palpitations and determine whether a significant rhythm abnormality is present.
SPECIALIZED CARDIAC EVALUATION
Heart rhythm disorders vary significantly from one patient to another. Accurate diagnosis of the rhythm abnormality and its underlying cause is essential for selecting the appropriate treatment and follow-up plan.
Dr. Ghassan Shawabkeh evaluates patients with palpitations and suspected heart rhythm disorders and correlates symptoms with ECG, Holter monitoring, echocardiography and other cardiac investigations when required.
If you experience recurrent palpitations, an irregular heartbeat, dizziness or fainting, a cardiac evaluation can help determine the underlying cause and identify the appropriate management plan.