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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Cardiology
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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.

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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.

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Geriatrics
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How to treat arrhythmia?

The treatment of arrhythmias should be based on the symptoms of the patients with arrhythmias, the type of arrhythmias, and their impact on hemodynamics. Control of arrhythmias during episodes involves removing the cause and focus of the disease and preventing recurrence, which can be divided into non-pharmacological and pharmacological treatments. Non-pharmacological treatments include methods such as eyeball compression, carotid sinus massage, pinching the nose to exhale forcefully and hold breath to reflexively excite the vagus nerve, along with electrical treatments like electrical cardioversion, defibrillation, pacemaker implantation, and ablation surgery. There are mainly four types of drugs used: sodium channel blockers; beta-adrenergic blockers; drugs selectively prolonging the repolarization process, such as amiodarone; and calcium channel blockers. However, long-term use of these antiarrhythmic drugs can have varying degrees of side effects, and severe cases can cause ventricular arrhythmias or cardiac conduction block which can be fatal. Therefore, in clinical application, it is essential to strictly control the indications, monitor for adverse reactions, and rigorously follow the doctor's orders.

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Symptoms of Sinus Arrhythmia

Symptoms of sinus arrhythmia vary according to different causes, including sinus bradycardia, sinus tachycardia, sinus arrhythmia, sinus arrest, and sick sinus syndrome. Mild cases of sinus bradycardia, sinus tachycardia, and arrhythmia generally do not present noticeable clinical symptoms. However, severe cases can experience symptoms such as palpitations, fatigue, and shortness of breath. Sinus arrest and sick sinus syndrome often present more severe clinical symptoms, including not only shortness of breath but also dizziness, blackouts, fainting, and acute cerebral ischemia and hypoxia.

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Is sinus arrhythmia serious?

Sinus arrhythmia is a relatively common type of arrhythmia in clinical practice. It is typically identified through electrocardiogram testing. If no other specific symptoms are present other than sinus arrhythmia, sinus bradycardia, or sinus tachycardia, and if there is no structural heart disease, generally, there are no serious concerns. Often, these kinds of arrhythmias are caused by autonomic nervous system dysfunction, leading to an imbalance between the sympathetic and parasympathetic nerves. To address this irregular heartbeat, it is advisable to rest adequately in daily life and to include some aerobic exercise. Exercise can enhance cardiac contractility and strengthen regular heart function, which can help correct the arrhythmia.