Cardiac Arrhythmias

Abstract

Cardiac arrhythmias are disturbances in the rhythm of the heart manifested by irregularity or by abnormally fast (tachycardias or tachyarrhythmias) or abnormally slow (bradycardias or bradyarrhymias) rates. Some produce no symptoms, whereas others can endanger the patient's life. Among the most benign are premature beats that interrupt the normal rhythm of the heart. Tachyarrhythmias include atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, ventricular tachycardia and ventricular fibrillation. Bradycardias include heart (atrioventricular) block and sick sinus syndrome. Antiarrhythmic drugs, cardiac pacing, ablation and implantable defibrillators can control most arrhythmias that need treatment.

Key Concepts:

  • Cardiac arrhythmias are disturbances in the rhythm of the heart in which the heart beats are irregular, too fast, or too slow.

  • Cardiac arrhythmias range in severity from asymptomatic to life‐threatening.

  • Most arrhythmias that require treatment can be controlled by antiarrhythmic drugs, cardiac pacing, ablation and implantable defibrillators.

  • Some arrhythmias can be treated with ablation in which the physician locates the source of the arrhythmia and, using electrode‐catheters, destroys it.

  • Premature beats are among the most common cardiac arrhythmias. Specific treatment is seldom required if the patient can be assured that they are benign, which is usually the case.

  • Atrial fibrillation is the most common sustained cardiac arrhythmia.

  • Atrial flutter is a rapid rhythm that is best treated with ablation.

  • In heart block, the electrical signals from the atria cannot reach the ventricles. Symptoms develop when the heart rate slows excessively. Treatment with pacemakers usually relieves the symptoms.

  • When patients have ventricular tachycardia, the rapid heart rate can produce syncope (fainting). This is a dangerous condition, and electrophysiological treatment is usually required.

  • Ventricular fibrillation is the arrhythmia that most frequently causes cardiac arrest.

Keywords: arrhythmias; premature beats; fibrillation; flutter; Wolff–Parkinson–White syndrome; torsades de pointes

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Further Reading

Josephson ME (2008) Clinical Cardiac Electrophysiology: Techniques and Interpretations, 4th edn. Philadelphia: Lippincott Williams & Wilkins.

Kastor JA (2000) Arrhythmias, 2nd edn. Philadelphia: WB Saunders.

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Kastor, John A, and Saba, Magdi M(Dec 2009) Cardiac Arrhythmias. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0002112.pub2]