Overview
Cardiac arrhythmia refers to a large group of conditions resulting from abnormalities in the electrical activity of the heart. It is the abnormality of the heart rhythm wherein the heart beats too slowly, rapidly, irregularly or with extra beats (premature atrial or ventricular beat).
There are several ways of classifying cardiac arrhythmias. A common way is to divide them into arrhythmias originating in the upper two cardiac chambers (an atrial arrhythmia) and those arising in the ventricles.
Arrhythmias that arise in the atria are:
- Paroxysmal Supraventricular Tachycardia
- Atrial Flutter
- Atrial Fibrillation
- Ectopic Atrial Tachycardia
- Ventricular Tachycardia
- Ventricular Fibrillation
During an episode of arrhythmia, a patient may usually exhibit one or more of the following symptoms:
- Palpitations
- Lightheadedness
- Loss of consciousness
- Chest pain
- Shortness of breath especially in patients with structural heart disease
Arrhythmia can also occur when the patient is already suffering from a Coronary Artery Disease, Hypertension induced heart disease, heart disease consequent to Diabetes, Congenital Heart Disease, Rheumatic Heart Disease, and forms of Valvular Heart Disease and Primary Heart Muscle Diseases called Cardiomyopathies. The incidence of arrhythmia increases in all the above cases as the cardiac muscle starts getting weak.
There are many electrical disorders in the heart, with complex causes and mechanisms, including genetic abnormalities. Due to such complexities, cardiac arrhythmia has now become a major subspecialty in Cardiology and is managed by cardiologists who are called electrophysiologists. At Max Institute of Heart and Vascular Sciences (MIHVS), we have a team of expert cardiologists who specialize in treating arrhythmia with Antiarrhythmic agents, Automated External Defibrillator, CCBs, Cardioversion, Catheter Ablation and other amenities.
Cardiac arrhythmia needs a coordinated multidisciplinary approach involving several specialities, especially imaging. At Max Institute of Heart and Vascular Sciences, we have the Department of Electrophysiology - a separate, special unit led by internationally acclaimed electrophysiologists. Today, MIHVS is one of the highest volume Electrophysiology centres in the country. Very complex arrhythmias are routinely treated here. The latest treatments like Leadless Pacemaker Implant, Alternate Site Right Ventricular Pacing, His Bundle Pacing and Left Bundle Pacing are routinely done here.
Investigations are individualized to a specific arrhythmia and the clinical aspects of the disease. These include:
- ECG, Echocardiography
- Holter Monitoring, ELR (Extended Loop Record) and Implantable Loop Recorder (these are rhythm monitoring devices with a capability to record cardiac rhythm on an outpatient basis while the patient does all his activities)
- Cardiac Catheterization and Coronary Angiography
- Cardiac CT Scan
- Cardiac MRI
- Electrophysiology Study
At Max Institute of Heart and Vascular Sciences(MIHVS), treatment of complex arrhythmia includes using a sophisticated 3-dimensional electroanatomical mapping system to enhance success rates and reduce X-ray exposure to a patient. We offer the following treatment options for arrhythmia:
A) Medication
- For heartbeat-related disorders: Antiarrhythmics are used to treat heartbeat related disorders. Antiarrhythmics work in a variety of ways to slow the electrical impulses in the heart so that the heart can regain a regular rhythm.
- For Structural Heart Disease: When structural heart disease progresses to a stage of heart failure, cardiac arrhythmia accounts for almost 50 % of deaths. In patients with structural heart disease, optimal guideline-based medical treatment with drugs is mandatory as it provides for cardiac electric stability, e.g. treatment of Ischemia in coronary artery disease and heart failure management.
C) Calcium Channel Blockers: CCBs are effective medicines that have been shown to lower blood pressure and help prevent and treat the symptoms of Angina (chest pain).
D) Cardioversion: It is a procedure followed to restore fast or irregular heart rhythm to a normal rhythm.
E) Catheter Ablation: It is a safe medical procedure to treat some types of arrhythmia and involves the use of radiofrequency (RF) energy. Specific treatment for cardiac arrhythmia is usually interventional and includes Radiofrequency Catheter Ablation, implanting devices like Permanent Pacemakers, ICD (Implantable Cardioverter Defibrillator) and very rarely requires surgery. Radiofrequency Ablation Therapy is applicable for the treatment of many arrhythmias, and many, it is a cure (PSVT, WPW Syndrome Tachycardia, Atrial Flutter, Atrial Fibrillation, some Ventricular Tachycardia in a normal heart. In such patients, the success rates are very high, and the recurrence rate is only 1-2%.
F) Pacemaker Insertion: Cardiac arrhythmias where the heart beats very slow, are called bradyarrhythmia. In a given person resting heart rates of even 50/min may be normal, especially in physically active persons. Bradyarrhythmias caused by disease of the electrical conduction system is a serious condition which can lead to loss of consciousness. In such cases, it usually needs implantable pacemakers as treatment.
Other Conditions & Treatments
- Angina
- Cholesterol
- Congenital Heart Disease
- Diabetes
- Heart Attack
- Heart Failure
- Heart Transplant
- Hypertension
- Rheumatic Heart Disease
- Valvular Heart Disease
- Vascular Surgery