arrhythmia


Arrhythmia is caused by what?
Arrhythmia is caused by abnormal excitation of the sinoatrial node or excitation originating outside the sinoatrial node, with slow conduction, blockage, or conduction through abnormal pathways. This results in the frequency and (or) rhythm abnormalities of heartbeats, which are collectively referred to as arrhythmias. Most of the causes include the following: one is genetic arrhythmias, often due to gene channel mutations, such as the commonly seen long QT syndrome, short QT syndrome, Brugada syndrome, etc. There are also acquired arrhythmias, seen in various organic heart diseases, including coronary atherosclerotic heart disease, commonly referred to as coronary heart disease, cardiomyopathy, myocarditis, and rheumatic heart disease, particularly prevalent during heart failure or acute myocardial infarction. Arrhythmias are also not uncommon in basically healthy individuals or patients with autonomic dysfunction. Other causes include electrolyte imbalance or endocrine disorders, and sometimes anesthesia, hypothermia, or surgery, such as thoracic or cardiac surgery, or medications, central nervous system diseases may also cause arrhythmias, but the specific reasons are not very clear.


Can arrhythmia cause sudden death?
The clinical manifestations of hemodynamic changes caused by arrhythmias mainly depend on the nature, type, cardiac function, and the extent of impact on hemodynamics. Mild conditions such as slight sinus bradycardia, sinus arrhythmia, occasional atrial premature contractions, and first-degree atrioventricular block have minimal impact on hemodynamics and therefore do not exhibit significant clinical manifestations, and sudden death is generally not expected. However, more severe arrhythmias, such as sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and sustained ventricular tachycardia, can lead to palpitations, chest tightness, dizziness, hypotension, and sweating. In severe cases, syncope, Adams-Stokes syndrome, or even sudden death may occur.


Arrhythmia is what?
Arrhythmia refers to abnormalities in the frequency, rhythm, origin, or conduction of the heartbeats. It can occur in healthy individuals as well as those with related diseases, and may involve cardiac diseases or other medical conditions. The primary mechanism behind the occurrence of arrhythmias is the abnormal formation of cardiac impulses or the abnormal conduction of these impulses. It is important to actively seek the causes of arrhythmias and control the factors that trigger them. For diseases associated with arrhythmias, proactive management is necessary. When severe arrhythmias occur, timely and effective treatment is crucial to prevent adverse outcomes.


Does arrhythmia require hospitalization?
Arrhythmia treatment should be determined based on the patient's symptoms, type of arrhythmia, and its impact on hemodynamics. For instance, minor conditions like slight sinus bradycardia, irregular sinus rhythm, occasional atrial premature contractions, and first-degree atrioventricular block, which have minimal impact on hemodynamics and no significant clinical manifestation or structural heart disease, do not necessitate hospitalization. However, more severe arrhythmias such as sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and sustained ventricular tachycardia, which can cause symptoms like palpitations, chest tightness, dizziness, low blood pressure, sweating, and in severe cases, fainting, Adam-Stokes syndrome, and even sudden cardiac death, require prompt medical attention and hospitalization for treatment.


How to relieve arrhythmia
The relief of arrhythmia mainly involves removing any triggers if they exist, as well as using non-pharmacological methods, including ocular compression, carotid sinus massage, pinching the nose and forcefully exhaling, and breath-holding, which are methods to reflexively stimulate the vagus nerve. If relief is unachievable and the episodes are accompanied by hypotension, fainting or near-fainting, seizures, angina, or heart failure, it is crucial to seek medical attention promptly for pharmacological interventions against arrhythmias, or even consider electrical treatments such as cardioversion, defibrillation, pacemaker implantation, and ablation, as well as surgical options.


Causes of arrhythmia
There are many causes of arrhythmia, which can be physiological or pathological. Pathological causes can originate from the heart itself or from other diseases. For instance, normal individuals might experience sinus arrhythmia, and circumstances such as staying up late, emotional excitement, or excessive fatigue can lead to premature beats or sinus tachycardia, among others. Other diseases, such as hyperthyroidism or fever, can cause an increased heart rate. For example, pulmonary embolism can lead to atrial fibrillation. Heart-related diseases, like heart failure, can cause ventricular premature beats, and diseases of the sinoatrial node itself can lead to sick sinus syndrome, among others.


Arrhythmias include:
Arrhythmia is a very common disease in our daily life. What does arrhythmia include? Generally speaking, arrhythmia often includes the following aspects: First, irregular heartbeat, such as sinus arrhythmia, atrial fibrillation, and frequent premature beats. Second, tachycardia, such as paroxysmal supraventricular tachycardia, ventricular tachycardia, and so on. Third, bradycardia diseases, such as sinus bradycardia, severe atrioventricular block, and sick sinus syndrome, etc.


Causes of sinus arrhythmia
Sinus arrhythmia, the most common cause of which is instability of the nerves that regulate the heart, referred to as the autonomic nervous system. This instability leads to sinus arrhythmia, which is commonly seen in children during their growth phase, women during menopause, or individuals who often stay up late and are under significant work stress, leading to dysfunction of the autonomic nervous system. It can also be caused by patterns of breathing that lead to arrhythmias; the heart rate increases during inhalation and slows during exhalation, producing this type of physiological arrhythmia. Generally, this kind of arrhythmia does not require drug treatment. By improving physical exercise, ensuring adequate sleep, and avoiding stimulating beverages or coffee, this type of heart rate can return to normal.


Can arrhythmia be cured?
There are many types of arrhythmia, some of which, like sinus tachycardia, sinus bradycardia, occasional premature atrial contractions, premature ventricular contractions, and premature junctional contractions, can also occur in healthy individuals and usually do not require treatment. Another category requires treatment, such as supraventricular tachycardia, including atrioventricular nodal reentrant tachycardia, which can be cured by radiofrequency ablation. Additionally, conditions like atrial fibrillation can be treated with radiofrequency ablation; many patients may be cured, but some may not respond to this treatment and require medication instead. There are also patients with intrinsic structural heart disease presenting various arrhythmias that can only be managed with medication, not cured.


How to alleviate arrhythmia
Arrhythmia is very common in clinical settings, and its treatment mainly includes etiological treatment and symptomatic treatment. If a patient experiences occasional premature beats without significant hemodynamic effects, special treatment may not be necessary at this time. However, if a patient repeatedly experiences supraventricular tachycardia, atrial fibrillation, and other arrhythmias, cardiac electrophysiological examination and dynamic heart rate monitoring should be conducted. Antiarrhythmic drugs or even radiofrequency ablation may be administered for symptomatic treatment, as uncontrolled arrhythmias can easily lead to sudden death in patients.