Is ventricular arrhythmia serious?

Written by Wang Li Bing
Intensive Care Medicine Department
Updated on September 23, 2024
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Arrhythmias are primarily divided into sinus arrhythmias, atrial arrhythmias, and ventricular arrhythmias. Among these, ventricular arrhythmias are further categorized into ventricular premature contractions, ventricular tachycardia, ventricular flutter, and ventricular fibrillation. Ventricular flutter and ventricular fibrillation are fatal types of arrhythmias. Patients generally experience loss of consciousness, generalized convulsions, and even cessation of breathing and death. If ventricular fibrillation occurs, it is imperative to immediately perform defibrillation and cardiopulmonary resuscitation, among other emergency interventions.

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What tests are done for arrhythmia?

The examinations required for arrhythmia are as follows: First, an electrocardiogram, which is the most important non-invasive diagnostic technique for diagnosing arrhythmias. Second, a Holter monitor test should be conducted, which records the electrocardiogram continuously over 24 hours to possibly capture the occurrence of symptoms such as palpitations and fainting, and whether they are related to arrhythmias. It clarifies the relationship between arrhythmias or myocardial ischemia attacks and daily activities, as well as their diurnal distribution characteristics, and can assist in evaluating the efficacy of medications and the condition of pacemakers to some extent. Third is the exercise test; if palpitations occur during exercise, an exercise test can assist in making a diagnosis. Fourth is the esophageal electrocardiogram, which is a useful non-invasive method for diagnosing arrhythmias. Fifth is the cardiac electrophysiological study, typically involving the placement of electrode catheters on the upper and lower parts of the right atrial wall, the tip of the right ventricle, the coronary sinus, and the His bundle area, with the electrical activity at these sites being simultaneously recorded using a multi-channel physiological recorder with 8-12 channels or more.

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What department should I go to for arrhythmia?

Arrhythmia is generally treated in the department of cardiovascular medicine. What is arrhythmia? It mainly refers to abnormalities in the frequency, rhythm, origin, conduction speed, or excitation sequence of the heart's impulses. Based on the principles of arrhythmia occurrences, it can be divided into two major categories: abnormalities in impulse formation and abnormalities in impulse conduction. Abnormalities in impulse formation include sinus arrhythmias and ectopic rhythms, while abnormalities in impulse conduction include interference atrioventricular dissociation, sinoatrial conduction block, intra-atrial conduction block, atrioventricular conduction block, and bundle branch block, among others.

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Ventricular arrhythmias include the following types.

Common ventricular arrhythmias mainly include premature ventricular contractions, ventricular tachycardia, ventricular flutter, and ventricular fibrillation. Premature ventricular contractions appear on the electrocardiogram as prematurely occurring wide and abnormal QRS complexes. If asymptomatic, no treatment is needed; if symptomatic, receptor blockers can be used for treatment. Ventricular tachycardia is clearly indicated on the electrocardiogram by wide and abnormal QRS complexes, with heart rates ranging from 140 bpm to 200 bpm. The primary treatment is to remove the cause, and electrical cardioversion can be used when hemodynamics are unstable. Ventricular flutter and fibrillation, their ventricular rates are generally above 250 bpm, and treatment is crucial.

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What tests are done for arrhythmia?

Arrhythmia is also relatively common in clinical practice, and its common detection method is mainly the electrocardiogram (ECG). ECG is a simple and non-invasive operation that helps to identify the type of arrhythmia. Another method is the 24-hour Holter monitor, which can record all heart rate changes occurring within 24 hours. If an arrhythmia occurs, it is crucial to seek medical attention promptly, visiting a cardiology department. Treatment may involve antiarrhythmic medications, and if possible, a complete electrophysiological examination can be performed.

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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.