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Abnormal Heart Rhythm / Arrhythmia

Abnormal Heart Rhythm, Arrhythmia: Symptoms, Causes, Diagnosis, Treatments | National Heart Centre Singapore

Abnormal Heart Rhythm / Arrhythmia - What it is

Arrhythmias refer to any change in the normal sequence of electrical impulses produced by the heart. The abnormal heart rhythms can be slow or fast in rate, having extra beats, or have rhythm irregularity.

Age increases the probability of experiencing an arrhythmia. It can occur in people who do not have structural heart disease. Arrhythmias often occur during and after heart attacks. Some types of arrhythmias, such as ventricular tachycardia and fibrillation, are serious and potentially life-threatening. Arrhythmias can result in poor blood circulation to the vital organs of the body.

Slow heart rates (less than 60 beats per minute) are called bradycardias. Fast heart rates (more than 100 beats per minute) are called tachycardia

Abnormal Heart Rhythm / Arrhythmia - Symptoms

​Symptoms of an arrhythmia include a fast heartbeat, pounding or fluttering chest sensations, skipping a heartbeat, dizziness, fainting spells, shortness of breath, and chest pains.

Abnormal Heart Rhythm / Arrhythmia - How to prevent?

Abnormal Heart Rhythm / Arrhythmia - Causes and Risk Factors

There are different causes for cardiac arrhythmias, including intrinsic heart problems, endocrinological and metabolic causes. Some common triggers are exercise, stress, caffeine, alcohol, appetite suppressant and decongestants in cough and cold medicines.

Abnormal Heart Rhythm / Arrhythmia - Diagnosis

An abnormal heart rhythm or arrhythmia is diagnosed by a physical examination, electrocardiograms and electrophysiologic studies. However, as arrhythmias are not always present, they may not occur during the physical examination.

Abnormal Heart Rhythm / Arrhythmia - Treatments

The treatment of arrhythmias is targeted at its underlying cause if any, rate control and/or rhythm control, with focus to maintain adequate blood circulation to the rest of the body and to prevent complications of the arrhythmias. 

In some cases, treating the underlying heart disease remove the arrhythmia.  In general, arrhythmias can be treated with drugs, electrical shock (cardioversion), implanting automatic implantable defibrillators, pacemakers, catheter ablation, or surgery. 

Often arrhythmias can be managed by drug therapy alone. Anti-arrthymic drugs are commonly classified using Vaughan Williams cliassification. Response to drugs is usually measured by electrocardiogram (ECG), holter monitor or electrophysiologic study

Pacemakers that send electrical signals to make the heart beat properly can be implanted under the skin during a simple procedure. Pacemakers are used mainly to correct bradycardia.

Automatic implantable defibrillators correct life-threatening ventricular arrhythmias by recognising them and then restoring a normal heart rhythm by pacing the heart or giving it an electric shock. They are usually implanted under the skin at the chest, without major surgery.  They read the cardiac rhythm and store information for future evaluation by physicians. Automatic implantable defibrillators have proven to be more effective in saving lives than drugs alone. They are often used in conjunction with drug therapy.

Ablation, a procedure to alter the heart tissue causing the arrhythmia in order to prevent a recurrence, can be performed through a catheter or surgery. Supraventricular tachycardia can be treated successfully with ablation. Ablation treatments are used when medications fail. 

Maze surgery treats atrial fibrillation by making multiple incisions in the atrium to direct electrical impulses in a appropriate fashion. This is often recommended for patients who have not responded to drugs or cardioversion.

Arrhythmia and Pacemaker Clinic

This clinic evaluates patients with cardiac arrhythmias, providing tertiary service for patients with complex cardiac arrhythmias that require further investigations and evaluations. It also provides follow up monitoring and care for patients with pacemakers or defibrillators

Abnormal Heart Rhythm / Arrhythmia - Preparing for surgery

Abnormal Heart Rhythm / Arrhythmia - Post-surgery care

Abnormal Heart Rhythm / Arrhythmia - Other Information

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