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What are cardiac arrhythmias ?

The heart beats at a regular rhythm at a variety of rates (beats per minute) based on the demands of the body. A regular rhythm makes the pumping action of the heart most efficient. Abnormalities of heart rhythm are called arrhythmia. It may beat either too slowly, too quickly or irregularly. Extra heart beats (ectopics) are quite common and if infrequent, are not considered abnormal.


How do they affect the heart ?

Abnormal heart rhythms lead to inefficient pumping by the heart, and over a period of time, could cause heart failure. 


What are the symptoms of arrhythmia?

Arrhythmias can cause palpitations, breathlessness, chest pain or fainting, however, these do not always suggest abnormalities of heart rhythm. Fainting on exercise can be caused by life threatening arrhythmias and need prompt investigations and treatment.


How are they detected?

Arrhythmias can be diagnosed by performing an electrocardiogram (ECG) that may show an underlying problem related to the electrical circuits in the heart. More often, further tests such as a longer period of monitoring of heart rhythm for periods ranging from 24 hours upto 14 days may be required with different types of portable monitors (Holter, Event recorders). If the symptoms suggestive of arrhythmias occur with exercise, an exercise test using a bike or treadmill with recording of ECG may help document the problem.


What is the treatment ?

Treatment options depend upon the burden of symptoms and underlying problems. If infrequent and not life-threatening, one could wait and assess the frequency and severity of the condition. Medications are effective in controlling the heart rate or rhythm and have to be taken daily. Electrophysiological studies is an invasive procedure whereby wires are used to map the abnormal electrical circuits in the heart with a plan to zap them (ablation) and provide a definitive cure. Direct current cardioversion is occasionally used to shock the heart out of any abnormal rhythm. For slow heart beats, pacemakers are used to stimulate the heart and maintain a healthy heart rate. An implantable cardioverter defibrillator device allows for rapid detection and provides treatment by delivering a shock and is a life-saving device for life-threatening arrhythmias.

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