In cardiac arrhythmias, the normal heartbeat sequence is disturbed by organic or external factors. Patients often experience heart stumbling, palpitations, palpitations, extra beats or pauses in the heartbeat. The ECG is crucial for the diagnosis of cardiac arrhythmia. Depending on the cause, type and severity of the disorder, treatment is conservative, either with medication or surgery.
Here you will find all the important information and recommended specialists for cardiac arrhythmias.
Cardiac arrhythmias are abnormally altered heartbeat sequences. It is a disturbance in the generation or propagation of excitation in the heart. Cardiac arrhythmias are also referred to as arrhythmias.
In cardiac arrhythmias, the heartbeat may be too slow compared to normal
be.
Disorders of excitation formation are also referred to as sick sinus syndrome or sick sinus node syndrome.
Cardiac arrhythmias can originate from different areas of the heart:
Cardiac arrhythmias can originate in different areas of the heart © designua | AdobeStock
Some forms of cardiac arrhythmia can be dangerous, such as
However, other forms are relatively harmless.
If conduction within the heart is blocked, the following conditions can occur:
The distinction between the individual arrhythmias, such as terms like flutter and fibrillation, can be somewhat confusing. The following is therefore a brief overview of some important arrhythmias.
Sinus tachycardia: Heartbeat that is too fast and originates from the sinus node. The causes can be varied, but are often external to the heart, for example stress or thyroid disease.
Sinus bradycardia: A heartbeat that is too slow and originates from the sinus node. Sinus bradycardia is normal in well-trained athletes ("athlete's heart") or during sleep. However, it can also be caused by various underlying diseases, such as
Atrial flutter: The atrium is excited up to 300 times per minute. However, not all excitations are transmitted to the ventricles, so that the ventricles normally beat more slowly. The symptom is felt as a rapid heartbeat.
Atrial fibrillation: The atrium is excited over 300 times per minute. The ventricles then beat up to 180 times per minute (up to 200 times in children), which is perceived as uncomfortable.
Atrial fibrillation is one of the most common cardiac arrhythmias in Germany. Although it relatively rarely leads to a medical emergency, it is associated with an increased risk of, among other things
Ectopic atrial tachycardia: In addition to the sinus node, there are other excitation centers in the atrium that trigger excitation. This leads to palpitations.
AV node reentry tachycardia (AVNRT): In the AV node, there are two pathways that can "short-circuit" instead of just one. This is also perceived as palpitations. AVNRT is the most common congenital heart disease and mainly affects females.
Wolff-Parkinson-White syndrome (WPW syndrome): Due to an additional conduction bundle between the atrium and ventricles, a circular excitation occurs. This is manifested by paroxysmal palpitations.
Ventricular tachycardia (VT, ventricular tachycardia): The cause of the increased heart rate is in the ventricles. This is a life-threatening cardiac arrhythmia.
Ventricular flutter and ventricular fibrillation: The heart beats so fast that the blood can no longer be pumped sufficiently into the body. This is a medical emergency! In ventricular flutter, the heart beats 200 to 350 times per minute, in ventricular fibrillation over 320 times. The transition between the two forms is fluid.
Cardiac arrhythmias can be caused by
can occur. Congenital diseases that can trigger cardiac arrhythmias include
Acquired diseases such as
can be responsible for an arrhythmia.
External causes include
Some patients have no symptoms. Others perceive the altered heartbeat sequence as
heartbeat.
Possible symptoms of a slow heartbeat are
Possible symptoms of a rapid heartbeat are
In the worst case, an arrhythmia can also lead to
lead to heart failure.
The diagnosis is made on the basis of a physical examination. The doctor feels the pulse and listens to the heart.
An electrocardiogram (ECG) is also carried out. By recording the electrical currents of the heart in the ECG, an arrhythmia and its type can often be recognized immediately.
In the case of rare or irregular arrhythmias, a long-term ECG device is used. It records the heart rhythm over 24 hours or more. An event recorder can be used as an alternative or supplement to the long-term ECG. The patient starts it when they notice a disturbance in the heartbeat.
If necessary, further examinations are carried out to find the cause of the arrhythmia.
An electrocardiogram can be used to differentiate between the different forms of cardiac arrhythmia © mattbadal | AdobeStock
The therapy depends on the type and cause of the disorder as well as the severity of the symptoms. If the cause is organic, this must also be treated.
Drugs used to treat cardiac arrhythmias are known as antiarrhythmic drugs. These drugs can influence the formation and transmission of electrical excitation and thus the heart rate in different ways.
A pacemaker is usually implanted if the heartbeat is too slow. It uses electrical impulses to regulate the heart rate.
A defibrillator is implanted if dangerous arrhythmias occur repeatedly. It recognizes dangerous disturbances and stops them with electrical impulses.
Cardiac catheter ablation is used to obliterate the diseased areas in the heart (e.g. in the case of atrial fibrillation). This stops the impaired conduction.
Through heart surgery (e.g. bypass surgery), doctors can eliminate the conditions that lead to reduced blood flow and thus indirectly to arrhythmia.
Specialists in cardiac arrhythmias are cardiologists.
Depending on the cause of the disorder, other specialists such as
may be consulted.
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