Causes of sinus arrhythmia

Written by Zhang Yue Mei
Cardiology
Updated on September 05, 2024
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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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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.

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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.

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Is ventricular arrhythmia serious?

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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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.