Arrhythmia is caused by what?

Written by Chen Ya
Geriatrics
Updated on September 16, 2024
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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.

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Written by Chen Tian Hua
Cardiology
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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.

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Written by Xie Zhi Hong
Cardiology
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Is atrial fibrillation a serious arrhythmia?

Atrial fibrillation is a type of cardiac arrhythmia, primarily feared for its potential to form blood clots within the heart. These clots can travel to other organs via the bloodstream, most commonly to the brain. Additionally, pieces of these clots can also travel to coronary arteries causing myocardial infarction, leading to organ embolism wherever they lodge. Generally, if no blood clots are formed, many individuals with atrial fibrillation may not experience symptoms. However, if combined with other cardiac conditions such as heart failure or coronary artery disease, atrial fibrillation can exacerbate the risk of developing these heart diseases. Thus, atrial fibrillation on its own is not severe but becomes concerning when associated with other cardiac conditions, increasing the risk of other heart diseases. If atrial fibrillation occurs with left or right accessory pathways, it may also lead to ventricular fibrillation, resulting in sudden death of the patient. Moreover, if the atrial fibrillation has no apparent cause, and the heart structure is normal with no symptoms, then such isolated atrial fibrillation does not typically form blood clots and is considered relatively mild.

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Written by Wang Li Bing
Intensive Care Medicine Department
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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.

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Written by Chen Ya
Geriatrics
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What medicine is used for arrhythmia?

There is still no consensus on the drugs commonly used for arrhythmia. The main classes used clinically are as follows: The first class is sodium channel blockers, which include three subclasses: moderate, mild, and significant sodium channel blockers, respectively comprising quinidine, lidocaine, and propafenone. The second class mainly consists of adrenergic receptor blockers, with propranolol being a representative drug. The third class of drugs selectively prolongs the repolarization process, among which amiodarone is commonly used clinically. The fourth class is calcium channel blockers, which mainly block calcium channels and inhibit the inflow of calcium, with verapamil being the main representative drug. Long-term use of anti-arrhythmia drugs can cause varying degrees of side effects, with severe cases possibly leading to ventricular arrhythmia or fatal cardiac conduction block. Therefore, when using these drugs clinically, it is essential to strictly control the indications, monitor adverse reactions, and strictly follow the doctor's prescription for rational medication.

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Written by Chen Ya
Geriatrics
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Can people with arrhythmia eat ginseng?

Arrhythmia falls under the categories of palpitations and throbbing in traditional Chinese medicine. The common differential diagnoses are as follows: For Blood Stasis Obstruction type, the treatment focuses on activating blood circulation and resolving stasis, and regulating qi to unblock the collaterals. For Blood Deficiency type, the treatment is to nourish qi and calm the spirit, and to nourish the heart and supplement blood. For Yang Deficiency type, the treatment aims to warm and supplement heart yang, and calm the spirit and stabilize the will. For Heart Deficiency and Timid Gallbladder type, the treatment is to nourish the heart and calm the spirit, and to stabilize fright and fix the will. For Yin Deficiency and Exuberant Fire type, the treatment focuses on nourishing the heart and calming the spirit, and nourishing yin to clear the fire. For Water Dampness Overwhelming the Heart type, the treatment aims to invigorate heart yang and transform qi to promote water movement. For Qi and Blood Deficiency type, the treatment is to supplement both qi and blood simultaneously. Ginseng's main therapeutic effect is to greatly supplement the primal qi, secure and stop prolapse, generate fluids, and calm the spirit. Therefore, ginseng can be used when arrhythmia differentiation indicates qi deficiency, but it is recommended to use it under the guidance of a traditional Chinese medicine practitioner.