Overview
Cardiac arrhythmias refer to irregular heartbeats that can range from harmless to life-threatening, and can pose significant challenges to patients and their families. At Heart Care Cardiac Center in Delhi, we understand that every cardiac arrhythmia case requires meticulous attention and expert care, regardless of its severity. Our team of highly skilled cardiologists, electrophysiologists, cardiac nurses, and dedicated support staff work closely with each patient to develop individualized treatment plans that cater to their specific needs and circumstances. Equipped with cutting-edge technology and state-of-the-art facilities, our multidisciplinary team ensures that each patient receives personalized and compassionate care throughout their treatment journey. Cardiac arrhythmia occurs when the heart beats too fast, too slowly, or irregularly due to a problem with the electrical signals that control the heart’s rhythm. While some heart arrhythmias pose no significant risk, others can lead to severe, life-threatening symptoms. Fast cardiac arrhythmias, also known as tachyarrhythmias, can be classified based on their origin. Those originating in the upper two cardiac chambers are termed supraventricular arrhythmias, while those arising in the ventricles represent a different category. We are committed to providing excellent and patient-centric care to those seeking cardiac arrhythmia treatment in Delhi, India.
Cardiac arrhythmias can be classified into two types – supraventricular and ventricular arrhythmias. Supraventricular arrhythmias originate from the heart’s upper chambers, known as the atria, and include Paroxysmal supraventricular tachycardia (PSVT), Atrial flutter, Atrial fibrillation, and Ectopic atrial tachycardia. On the other hand, ventricular arrhythmias arise from the heart’s lower chambers, known as the ventricles, and include Ventricular tachycardia (V-tach) and Ventricular fibrillation (V-fib). Slow cardiac arrhythmia, also known as AV block, is a type of supraventricular arrhythmia that causes a long pause in a heartbeat and may lead to dizziness, blackout, or fall. Understanding the origin of cardiac arrhythmias is crucial for proper diagnosis, treatment, and management.
Causes of Cardiac Arrhythmia Most cardiac arrhythmias can occur in sudden episodes, often without any provocation. The heart is a pump that circulates blood throughout our body. It has a specific group of cells called the sinus node that acts as a pacemaker, sending out electrical signals to regulate the heartbeat. These signals travel down a pathway called the AV node, which informs the upper and lower chambers of the heart when to contract and pump blood. However, certain factors can disrupt this process, leading to arrhythmias. These factors include: – Heart damage and structural heart diseases – Heart attack (myocardial infarction): A heart attack can damage the heart muscle, disrupting the standard electrical signals and leading to arrhythmias. – Coronary artery disease (blocked arteries): Narrowed or blocked arteries can restrict blood flow to the heart’s muscles, including those responsible for generating and transmitting electrical signals, causing arrhythmias. – Cardiomyopathy: Diseases affecting the heart muscle can lead to enlargement or thickening of the heart, causing arrhythmias. – Valvular heart disease: Malfunctioning heart valves, such as mitral valve prolapse or aortic stenosis, can disrupt blood flow and contribute to arrhythmias. – Rheumatic heart disease: A consequence of rheumatic fever, rheumatic heart disease is a structural heart disease that can contribute to the development of arrhythmias. – Infiltrative diseases: Conditions where abnormal substances, such as amyloid deposits or sarcoidosis, infiltrate the heart muscle can lead to structural changes and arrhythmias. – Congenital heart disease: Congenital heart disease is a structural abnormality present at birth, such as septal defects or abnormal heart valves, which can lead to arrhythmias.
It is important to note that the risk of arrhythmia increases when the heart muscle weakens. This can lead to cardiac arrest, which requires immediate medical attention. The symptoms of arrhythmia may include palpitations, lightheadedness, loss of consciousness, chest pain, anxiety, sweating, fatigue, fainting, and shortness of breath (especially in patients with structural heart disease).
Diagnosing cardiac arrhythmia requires a coordinated and multidisciplinary approach that involves several specialties, especially imaging. The Max Institute of Heart and Vascular Sciences has a dedicated and specialized unit called the Department of Electrophysiology, which is led by internationally acclaimed electrophysiologists. MIHVS is now one of the highest-volume electrophysiology centers in the country, where highly complex arrhythmias are treated routinely. The diagnosis of arrhythmia involves individualized investigations that are tailored to a specific arrhythmia and the clinical aspects of the disease. This approach involves a combination of medical history, physical examination, and various tests to assess the heart’s electrical activity and function. Here are the steps involved in the diagnosis of arrhythmia: 1. Medical history evaluation and physical examination: The doctor will take a detailed medical history, including a family history of arrhythmias, current medications, and past or present heart conditions. They will also conduct a physical examination to check for signs of heart disease or other underlying conditions. 2. Electrocardiogram (ECG or EKG): An ECG is a non-invasive test that measures the heart’s electrical activity, providing insights into its rhythm and rate. It can detect arrhythmias that are present at the time of the test. 3. Holter monitoring: A Holter monitor is a portable ECG device that is worn for an extended period, typically 24-48 hours, to record the heart’s activity continuously during daily activities. This allows for the detection of arrhythmias that may occur intermittently. 4. Event recorder: An event recorder is another portable ECG device worn for up to 30 days. It is primarily used to detect arrhythmias that occur infrequently. The device typically records data when triggered by the patient pressing a button upon experiencing symptoms. 5. Echocardiogram: An echocardiogram is a non-invasive test that utilizes sound waves to create detailed images of the heart’s structure, valves, and blood flow patterns. It can identify any structural abnormalities or underlying conditions contributing to arrhythmias. 6. Stress test: A stress test evaluates the heart’s response to physical exertion, as certain arrhythmias are triggered or worsen during exercise. 7. Tilt table test: A tilt table test assesses the heart’s and nervous system’s responses to changes in body position, particularly when transitioning from lying to standing. It is primarily used for individuals experiencing fainting episodes. 8. Electrophysiological (EP) testing and mapping: An EP study utilizes electrical stimulation to map the heart’s electrical pathways and is particularly useful for diagnosing specific types of arrhythmias, particularly tachycardia, and identifying the precise location of the faulty signaling.
Once a doctor identifies an Arrhythmia, they will assess its severity to determine if it’s abnormal or a normal heart process. In case the arrhythmia is abnormal and clinically significant, the doctor will recommend a treatment plan. At Max Institute of Heart and Vascular Sciences (MIHVS), we offer the latest and most advanced arrhythmia treatments. These include Leadless Pacemaker Implant, Alternate Site Right Ventricular Pacing, His Bundle Pacing, and Left Bundle Pacing. We use a sophisticated 3-dimensional electroanatomical mapping system to increase success rates and reduce X-ray exposure to patients. Our approach to treating complex arrhythmia aims to provide patients with the best possible outcome. We offer several treatment options for arrhythmia, including medication. Medications are essential to control arrhythmias and prevent complications. The specific medication prescribed will depend on the type of arrhythmia and its severity. Commonly prescribed medicines for arrhythmias include: – Antiarrhythmic drugs: These drugs work by altering the electrical signals in the heart to control the heart’s rhythm. – Beta-blockers: These drugs help slow the heart rate and lower blood pressure, which can benefit certain types of arrhythmias. – Calcium channel blockers: These drugs help to relax the heart muscles, which can help control certain arrhythmias. – Anticoagulants: These drugs help prevent blood clots, which can be a risk for certain arrhythmias, especially those associated with atrial fibrillation.
Procedures Cardioversion is a procedure used to restore a regular heartbeat in individuals who have an abnormal heart rhythm, particularly atrial fibrillation (AF) or atrial flutter. This is typically done by delivering a controlled electric shock to the heart either externally through paddles placed on the chest or internally via catheters to reset the heart’s electrical activity. Catheter ablation is a safe medical procedure used to treat some arrhythmias. It involves using radiofrequency (RF) energy. Specific treatment for cardiac arrhythmia usually involves interventions such as radiofrequency catheter ablation, implanting devices such as permanent pacemakers and ICDs (implantable cardioverter-defibrillator). Surgery is very rarely required. Radiofrequency Ablation Therapy is applicable for the treatment of many arrhythmias, for many it is a cure (PSVT, WPW Syndrome Tachycardia, Atrial Flutter, Atrial Fibrillation, some Ventricular Tachycardia in a normal heart). In such patients, the success rates are very high, and the recurrence rate is only 1-2%. In cases where the heart beats very slowly, known as bradyarrhythmia, implantable pacemakers are usually needed as treatment. Bradyarrhythmias caused by a disease of the electrical conduction system are severe conditions that can lead to loss of consciousness. An implantable cardioverter-defibrillator (ICD) is a device that is surgically implanted in the chest to monitor the heart’s rhythm and deliver an electrical shock to the heart if it detects a dangerous arrhythmia, such as ventricular tachycardia or ventricular fibrillation. It is used to prevent sudden cardiac death. An automated external defibrillator is a portable device that inspects the heart rhythm. It can send an electric shock to the heart to restore a normal rhythm if required. It is commonly used to treat sudden cardiac arrest. Surgery may sometimes be necessary to treat arrhythmias, such as those caused by heart valve problems or heart muscle damage. The type of surgery required will depend on the specific underlying condition. Healthy lifestyle habits can significantly impact the management of arrhythmias and overall heart health. These changes include maintaining a healthy weight, exercising regularly (after consulting with a Cardiac arrhythmias doctor), eating a healthy diet, avoiding smoking and excessive alcohol use, and managing stress in healthy ways. Chronic stress can trigger the release of hormones that affect the heart’s electrical activity. Finding healthy ways to manage stress, such as yoga, meditation, or time in nature, can benefit heart health.
Max Institute of Heart and Vascular Sciences is a cardiac care center with modern technology that offers diverse heart care programs to patients. We provide treatment for end-stage heart failure patients with procedures like Pacemaker, ACD, CRT, Heart Hole surgeries (ASD, VSD, PDA), Paediatric Cardiac Surgery, Angioplasty/Angiography, and more. We offer invasive and interventional cardiology, electrophysiology, pacemaker and arrhythmia services, managing abdominal and descending thoracic aneurysms, and varicose veins. Our state-of-the-art facilities include CATH labs, operation theatres, ICU beds, and other heart care technologies. Cardiac arrhythmia is a complex disorder with many electrical disorders in the heart, including genetic abnormalities. It is managed by cardiologists called electrophysiologists. At Max Institute of Heart and Vascular Sciences, we have a team of expert cardiologists who specialize in treating arrhythmia with Antiarrhythmic agents, Automated External Defibrillators, CCBs, Cardioversion, Catheter Ablation, and other amenities. Here are some frequently asked questions about cardiac arrhythmia: – How severe is cardiac arrhythmia? The severity of cardiac arrhythmia can vary depending on the specific type, the underlying cause, and the individual’s overall health. Some arrhythmias are harmless and do not require any treatment, while others can be life-threatening. – Can cardiac arrhythmia be cured completely? Whether cardiac arrhythmia can be cured completely depends on the type of arrhythmia and its underlying cause. Some arrhythmias, such as supraventricular tachycardia (SVT), can be cured with ablation, which involves destroying the abnormal electrical pathways in the heart. However, other types of arrhythmias, such as atrial fibrillation (Afib), cannot be cured entirely and require ongoing management to control symptoms and prevent complications. – What are premature heartbeats? Premature heartbeats are extra beats that occur one at a time, sometimes in patterns that alternate with a regular heartbeat. – What are premature atrial contractions (PACs) and premature ventricular contractions (PVCs)? PACs occur when the extra beats come from the top chamber of the heart, while PVCs happen when they come from the bottom chamber. – How might a premature heartbeat feel? A premature heartbeat may feel like your heart skipped a beat. – Are premature heartbeats generally a cause for concern? Generally, premature heartbeats are not a concern. They rarely mean you have a more severe condition. – Can premature heartbeats trigger longer-lasting arrhythmias? Yes, a premature beat can trigger a longer-lasting arrhythmia, especially in people with heart disease. – What might happen if there are persistent premature ventricular beats? Having persistent premature ventricular beats may occasionally lead to a weak heart. – When do premature heartbeats occur? Premature heartbeats may occur when resting, and they can also be triggered by stress, heavy exercise, and the use of stimulants such as caffeine or nicotine. – What is bradycardia? Bradycardia is a medical condition characterized by a slow heart rate of fewer than 60 beats per minute. – What are the types of bradycardias? Types of bradycardias include Sick Sinus Syndrome and Conduction Block. – Does a heart rate below 60 beats per minute always indicate a problem? A low resting heart rate doesn’t necessarily indicate a problem, especially in physically fit individuals whose hearts can efficiently pump enough blood with less than 60 beats per minute. – What is Sick Sinus Syndrome, and what causes it? Sick Sinus Syndrome occurs when the sinus node, which sets the heart’s pace, malfunctions, causing the heart rate to fluctuate between slow and fast. It is often caused by scarring near the sinus node and is more common among older adults. – Who is most susceptible to Sick Sinus Syndrome? Sick Sinus Syndrome is most common among older adults. – What are the potential causes of scarring near the sinus node in Sick Sinus Syndrome? Scarring near the sinus node in Sick Sinus Syndrome can be caused by factors that slow, disrupt, or block heartbeat signals. – How does the Conduction Block affect the heart? Conduction Block blocks the heart’s electrical pathways, leading to slowed or stopped signals that trigger heartbeats. Some blocks may be asymptomatic, while others can cause skipped beats or slowed heartbeats.