In the day to day of my professional practice, as a cardiologist specially trained in cardiac arrhythmias, I am frequently consulted for an "arrhythmia". In summary and colloquial, I would like these phrases to serve to guide those who have this concern. Perhaps, using the usual questions, it will be easier to respond.
What are arrhythmias
The term arrhythmia encompasses all those alterations of the normal heart rhythm , from the most trivial or benign ones that do not even generate discomfort, like extrasystoles or anticipated beats, that do not require treatment; to the most dangerous and much less frequent that can lead to the appearance of a sudden death.
Types of arrhythmias
- Benign , which do not compromise the life of the individual, but who have different medical management. Among them we could highlight, for being the most common:- Extrasystoles, which are anticipated beats and generally do not require treatment unless they generate a lot of discomfort.- The paroxysmal supraventricular tachycardias (reentrant tachycardia, by concealed accessory pathways or Wolff-Parkinson-White, which are often troublesome and require treatment with catheters with good results and negligible risks).- Atrial fibrillation (and atrial flutter), depending on the characteristics of the patient (age, risk factors, etc.), are treated with drugs, or even eliminated with catheters with a somewhat smaller success than previous ones and more risk of complications.
- Malignant , which can potentially lead to death of the individual. Among them are ventricular tachycardias , which may be of different origin, either genetic or heart damage, and whose treatment is highly variable and more complex: from treatment with drugs, catheters, to the implantation of subcutaneous defibrillators (implantable defibrillator or DAI).
Why arrhythmias occur
Malignancies may have a genetic or genetic cause or a cause derived from damage to the structure of the heart , such as infarction or dilation and loss of left ventricular strength.
In the case of the benign ones, the causes are generally of different origin:
- Extrasystoles are usually more frequent when you are taking exciting foods / drinks, you are in stressful situations anxiety, etc.
- Supraventricular paroxysmal tachycardias have their origin in small congenital abnormalities, in which the electrical system of the heart presents some "nerve or extra pathway", which in certain circumstances leads to a short circuit, initiating tachycardia.
- Atrial fibrillation is a very common arrhythmia in the population, characterized by a rapid and irregular rhythm, and is more prevalent at an older age or presence of hypertension, diabetes, or disorders in the anatomy of the heart. This arrhythmia has been and is protagonist in the last decade by the advances in the treatment of the same one.
Are people more prone to arrhythmias?
There are some causes that are genetic, so the relatives will be more likely to present them; not so congenital, which are disorders in the development of the embryo and do not have to be inheritable. Others, due to unfavorable lifestyle habits and presence of risk factors such as hypertension, and those due to damages, such as the history of a myocardial infarction.
How to prevent them
In some cases, such as supraventricular tachycardias or those with a genetic cause, they will appear capriciously, but others such as atrial fibrillation or those caused by damage to the heart at the lake of life are preventable, leading to healthy living habits , with controlled risk factors.
The follow-up of a patient with arrhythmias
With all of the above, it is clear that the follow-up will have to be individualized in each case, but it is undoubtedly that, in the presence of palpitations, it is essential to assess by a cardiologist who detects or identifies the arrhythmia, and gives the information treatment possibilities in each case.