Arrhythmia refers to abnormal electrical activity in the heart that causes an irregular heartbeat. Common causes include coronary artery disease, changes in heart muscle, and congenital conditions. Types of arrhythmias include premature atrial contractions, atrial fibrillation, ventricular tachycardia, and heart block. Symptoms vary depending on whether the heart rate is too fast or too slow. Diagnosis involves electrocardiograms, Holter monitors, and electrophysiology studies. Treatment options include lifestyle changes, medications, procedures like ablation or pacemakers, and sometimes surgery.

2. The heart beat may be too fast or too slow, and may be regular or irregular.

4. TYPES OF ARRHYTHMIAS Premature atrial contractions - Due to premature discharge of an electrical impulse in the atrium - These are early extra beats that originate in the atria 2. Premature ventricular contractions - cause by stress, heart disease or too much exercise

5. 3. Atrialfibrillation - common irregular heart rhythm that causes the atria, the upper chambers of the heart to contract abnormally 4. Paroxysmal supraventricular tachycardia - there are 2 types: a) AV nodal reentrant tachycardia - due to more than one pathway through the AV node - can cause heart palpitations, fainting or heart failure

6. b) Accessory pathway tachycardias - due to an extra abnormal pathway between the atria and the ventricles. 5. Atrial flutter - caused by one or more rapid circuits in the atrium - occurs most often in people with heart disease in the first week after heart surgery. - often converts to atrialfibrillation

7. Ventricular tachycardia - originating from the lower chambers (or ventricles) - rapid rate prevents the heart from filling adequately with blood cause less blood is able to pump through the body 7. Ventricular fibrillation - disorganized firing of impulses from the ventricles - The ventricles quiver and are unable to contract or pump blood

8. 8. Sinus node dysfunction - due to an abnormal SA (sinus) node 9. Heart block - A delay or complete block of the electrical impulse as it travels from the sinus node to the ventricles - heart may beat irregularly and, often, more slowly

9. SYMPTOMS OF ARRHYTHMIAS Most common symptoms: palpitations or rapid thumping in your chest feeling tired or light-headed loosing consciousness shortness of breath chest pain.

10. Symptoms that lead to fast heart rate: heartbeat might feel like a strong pulse in neck a fluttering, racing beat in chest feelings of discomfort Weakness shortness breath faint sweaty dizzy

11. Symptoms that lead to slow heart rate: feeling tired short of breath dizziness

12. How are arrhythmias diagnosed? 1. Electrocardiogram - Small patches called electrodes are placed on our chest, arms and legs, and are connected by wires to the ECG machine. - Our heart's electrical impulses are translated into a wavy line on a strip of moving paper - enabling doctors to determine the pattern of electrical current flow

13. 2. Holtermonitor - a small, portable machine that we wear for 24 hours - enables continuous recording of our ECG 3. Tilt Table Test - used to diagnose fainting or black-out spells (vasovagal syncope) by trying to reproduce the black-out episodes - You will be tilted upright to about 60 degrees on a special table for a period of time

14. 4. Electrophysiology study (EPS) - Special catheters are threaded through veins into the heart. - electrical impulse generated by the heart shows up on a computer screen. - Electrical impulses are utilized to evaluate for arrhythmias 5. Stress Test - enables physicians to record our heart's electrical activity which may not occur at rest.

15. 6. Magnetic Source Imaging - used as an overlay to magnetic resonance imaging - The device senses weak magnetic fields generated by heart muscle tissue - localizes the arrhythmia non-invasively to save time during the invasive study. 7. Event Recorder - small portable transtelephonic monitor that may be worn for several weeks. - The monitor "loops" a two-minute recording into its memory that is continually overwritten

16. TREATMENT OF ARRHYTHMIAS 1. Lifestyle Changes - avoid activity that lead to irregular heart rhythm - stop smoking - stop drink alcohol - Limit or stop using caffeine - Stay away from stimulants used in cough and cold medications

17. 2. Medications - Antiarrhythmicdrugs (control heart-rate) - Anticoagulant or antiplatelettherapy (reduce the risk of blood bloodclots) 3. Surgical Procedures a) electrical cardioversion - After administration of a short-acting anesthesia, an electrical shock is delivered to our chest wall that synchronizes the heart and allows the normal rhythm to restart.

18. b) pacemaker - a device that sends small electrical impulses to the heart muscle to maintain a suitable heart rate - primarily prevent the heart from beating too slowly. - has a pulse generator (which houses the battery and a tiny computer) and leads (wires) that send impulses from the pulse generator to the heart muscle.

19. 4. implantable cardioverter-defibrillator (ICD) - to treat ventricular tachycardia and ventricular fibrillation, two life-threatening heart rhythms - When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again

20. 5. catheter ablation - high-frequency electrical energy is delivered through a catheter to a small area of tissue inside the heart that causes the abnormal heart rhythm - This energy "disconnects" the pathway of the abnormal rhythm. 6. heart surgery - needed to correct heart disease that may be causing the arrhythmia - During this procedure, a series (or "maze") of incisions are made in the right and left atria to confine the electrical impulses to defined pathways