What is Heart Rhythm Disorder?

What is Heart Rhythm Disorder?

The condition in which the heart beats in a rhythm different from what it normally should be is called heart rhythm disorder, or arrhythmia.

The only rhythm not included in the rhythm disorder class is sinus rhythm. In sinus rhythm, the electrical impulse from the sino atrial node at the top of the heart slowly progresses downwards.

Afterwards, the left and right branches of the neural transmission separate and stimulate the heart muscle. This allows blood to be pumped.

If a problem occurs at one stage of this transmission system, a heart rhythm disorder occurs.
There are many types of arrhythmia, or heart rhythm disorder.

What are The Causes of Heart Rhythm Disorders?

There can be many causes of heart rhythm disorder:

• Coronary Artery Disease:

Narrowing or blockage of the heart vessels.

• Heart Failure:

The heart’s inability to pump enough blood to meet the body’s needs.

• Heart Valve Diseases:

Narrowing or insufficiency of the heart valves.

• High Blood Pressure:

Constantly high blood pressure.

• Diabetes:

High blood sugar levels.

• Thyroid Diseases:

High or low thyroid hormone levels.

• Electrolyte Imbalances:

Imbalance of electrolytes such as potassium, magnesium and calcium in the body.

• Sleep Apnea:

Stopping or shallow breathing during sleep.

• Smoking:

Smoking increases the risk of heart disease.

• Excessive Alcohol or Caffeine Consumption:

Excessive alcohol or caffeine consumption can trigger heart rhythm disorders.

• Some Medications:

Some medications (such as cold medications, asthma medications) can cause heart rhythm disorders.

• Stress and Anxiety:

Stress and anxiety can trigger heart rhythm disorders.

• Genetic Factors:

Some heart rhythm disorders can be inherited.

What are The Symptoms of Heart Rhythm Disorder?

A heart arrhythmia can manifest itself with many different symptoms. These symptoms can be mild and temporary, or they can be serious and life-threatening. Noticing these symptoms and intervening in a timely manner is critical to living a healthy life.

• Palpitations: Heart Beating Fast or Slow

Heart palpitations are one of the most common symptoms of arrhythmia. When you feel your heart beating faster or slower than normal, it could be a sign that something is wrong.
Palpitations usually start suddenly and can last for a few seconds or minutes.
This feeling can be alarming. However, in mild cases, it is usually not a serious health problem. However, recurring palpitations should be evaluated by a specialist.

• Dizziness and Fainting: Common Symptoms of Arrhythmia

Dizziness is one of the common symptoms of heart arrhythmia. An irregular heartbeat can cause the brain to not receive enough oxygenated blood. This can lead to dizziness and fainting.

If you experience frequent fainting spells, this could be a sign of a serious heart condition and requires immediate medical attention.

• Shortness of Breath: When Your Heart Is Not Working Regularly

Shortness of breath is a frequent symptom of heart arrhythmia. When the heart functions improperly, it may fail to pump sufficient oxygen throughout the body, leading to this issue. It can occur abruptly, whether during physical activity or while at rest. In some cases, shortness of breath may indicate a more severe condition, such as heart failure.

• Chest Pain and Discomfort: Symptoms Similar to a Heart Attack

Chest pain is one of the most serious symptoms of heart rhythm disorders. This pain often resembles a heart attack and is often felt on the left side of the chest. Chest pain occurs when not enough blood is getting to the heart muscle and may indicate a serious medical condition. It is vital to seek immediate medical attention if you experience this type of pain.

What Are The Risk Factors for Heart Rhythm Disorders?

Heart rhythm disorders (arrhythmias) usually occur as a result of disorders in the heart’s electrical conduction system. Certain factors can increase the risk of developing these disorders.

Important risk factors for heart rhythm disorders are listed below:

1. Age:

The risk of heart rhythm disorders increases with age. Heart diseases and rhythm disorders are more common, especially in individuals aged 60 and over.

2. Coronary Artery Disease (Cardiovascular Diseases):

Narrowing or blockage of the vessels that feed the heart (coronary artery disease) can cause rhythm disorders by making it difficult for the heart to receive oxygen. This also increases the risk of heart attack and heart failure.

3. High Blood Pressure (Hypertension):

Long-term high blood pressure causes the heart muscle to strain and the heart chambers to expand. This can disrupt the heart rhythm and increase the risk of arrhythmia.

4. Heart Failure:

Weakening of the heart muscle or the heart’s inability to pump enough blood can trigger heart rhythm disorders. Arrhythmias such as atrial fibrillation are more common in people with heart failure.

5. Family History of Heart Disease:

People with a family history of heart disease or heart rhythm disorders have a higher risk of developing rhythm disorders due to genetic predisposition.

6. Excessive Alcohol and Caffeine Consumption:

Alcohol and caffeine are substances that have stimulant effects on the heart. Excessive alcohol consumption can weaken the heart muscle and cause rhythm disorders. In addition, excessive caffeine consumption can cause heart palpitations.

7. Smoking:

Smoking narrows the heart vessels and negatively affects heart health. People who smoke have an increased risk of heart disease and rhythm disorders.

8. Obesity:

Obesity puts additional strain on the heart. It strains the heart muscle.

In addition,

Obesity is often associated with high blood pressure, diabetes mellitus, and other heart diseases. This can increase the risk of arrhythmias.

9. Diabetes:

Diabetes is a condition that increases the risk of cardiovascular disease. Prolonged high blood sugar levels can cause irregular heart rhythms.

10. Thyroid Diseases:

Hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can affect heart rhythm. Hyperthyroidism, in particular, can increase the heart rate and cause arrhythmias.

11. Electrolyte Imbalances:

Imbalances in the levels of electrolytes such as potassium, calcium and magnesium can disrupt the electrical conduction of the heart and lead to arrhythmias.

12. Stress and Anxiety:

Physical or emotional stress can cause the body to release stress hormones, which can increase heart rate. This can trigger arrhythmias, especially atrial fibrillation.

13. Lack of Physical Activity:

Not getting regular exercise can negatively impact heart health. A sedentary lifestyle can weaken the heart muscle and increase the risk of heart arrhythmias.

14. Sleep Apnea:

Sleep apnea causes breathing to stop or weaken during the night, causing oxygen levels to drop. This can affect heart rhythm and lead to arrhythmias.

15. Viral Infections (Especially Myocarditis):

Viral infections that affect the heart muscle (myocarditis) can damage the heart’s electrical conduction system, causing arrhythmias.

16. Medications and Drugs:

Some medications, especially those that affect the heart

For example;

• Some antihypertensive medications,
• Antidepressants

and some narcotics

For example;

• Cocaine
• And amphetamines

Can disrupt heart rhythm. In addition, drug overdose can increase the risk of arrhythmia.

17. Genetic Factors and Inherited Diseases:

Individuals with a family history of heart disease and genetic predisposition are at higher risk of developing heart rhythm disorders. Genetic conditions such as Long QT Syndrome and Wolff-Parkinson-White Syndrome can lead to rhythm disorders.

18. Pregnancy:

Pregnancy can cause the body to put extra strain on the heart. Changes in hormone levels and increased blood volume during pregnancy can trigger heart rhythm disorders in some women.

19. Older Women:

Hormonal changes after menopause can increase the risk of heart disease and rhythm disorders in women.

What are The Types of Heart Rhythm Disorders?

Rhythm disorder is the increase, decrease in the heart rate or the disruption of regular beats.

Rhythm disorders are also named according to the place where they originate in the heart:

• Arrhythmia: Deviation of Heart Rhythm from Normal

Arrhythmia means that the heart rhythm deviates from normal.
This deviation can be in the form of a faster, slower or irregular heartbeat.
Arrhythmia is a condition that is usually unnoticed, but can lead to serious health problems in the later stages.
It is caused by disorders in the electrical system of the heart.
If left untreated, it can cause serious complications such as heart failure or stroke.

• Tachycardia Rapid Heartbeat:

It means that the heartbeat is fast. It is the most common arrhythmia. And it is when the heartbeat is over 100 per minute.

• Bradycardia Slow Heartbeat:

It means that the heart beat is slower than normal and the heart rate is below 60 per minute. In people who are asleep and physically fit, the pulse can be below 60.

• Supraventricular Arrhythmias:

Rapid and irregular heartbeats originating from the upper chambers of the heart. These types of arrhythmias usually occur as a result of electrical abnormalities occurring in the atria.

• Ventricular Arrhythmias:

Ventricular arrhythmias refer to rhythm disorders occurring in the lower part of the heart called the ventricular region. This type can cause the heartbeats to become irregular or accelerate differently than normal.

• Bradyarrhythmia:

It refers to a condition in which the heart rhythm is slower than normal. Bradyarrhythmia usually occurs when the heart rate drops below 60 beats per minute.

Supraventricular arrhythmia is a type of arrhythmia that starts in the atria.

1. Tachycardia (Rapid Heartbeat):

• Paroxysmal Supraventricular Tachycardia (PSVT):

A heart rhythm disorder originating in the atria but not irregular. This type of arrhythmia has a sudden onset and ends suddenly.

• Accessory Pathway Tachycardias:

It is a rapid heart rhythm disorder that occurs due to an abnormal conduction path through which electrical signals are transmitted or an abnormal connection between the atria and the ventricles.
Abnormal signals travel very quickly through the heart.
And cause unusually fast heart beats.
One of the known examples is Wolff Parkinson White Syndrome.

• AV Node Reentrant Tachycardia (AVNRT):

A condition characterized by more than one electrical signal transmission path exiting the atrioventricular node. The heart rate is also high in this rhythm disorder.

• Atrial Tachycardia:

It is a form of tachycardia caused by abnormal foci or damaged cells within the atria.

It can be seen in normal hearts or in patients who have had heart surgery;

• Valve surgery,
• Bypass,
• Congenital heart disease,

Due to surgeries.

• Atrial Fibrillation: Heart Chamber Vibration

Atrial fibrillation is a condition in which the upper chambers of the heart (atria) beat irregularly and rapidly.
This prevents blood from moving smoothly between the chambers of the heart. And it can lead to blood clots.
Atrial fibrillation is a serious arrhythmia that significantly increases the risk of stroke. It is most common in older people and those with a history of heart disease.

• Atrial Flutter:

Irregular but usually rapid beating of the atria. This is similar to atrial fibrillation. But it has a more regular rhythm.

What are The Arrhythmias Originating from the Ventricles?

• Premature Ventricular Contractions (PVCs):

A common type of arrhythmia characterized by premature heartbeats originating from the ventricles.

• Ventricular Tachycardia:

Very rapid heartbeats that start in the ventricles. This rhythm prevents the heart from filling with blood and reduces the amount of blood pumped into the body. Ventricular tachycardia can be serious. And usually causes more severe symptoms.

• Ventricular Fibrillation: Life-threatening Arrhythmia:

Ventricular fibrillation is a condition in which the lower chambers of the heart (ventricles) quiver irregularly and cannot pump blood effectively. This condition is a sudden and life-threatening medical emergency, similar to a heart attack. Ventricular fibrillation can result in death within minutes if not treated immediately.

• Long QT Syndrome:

A disorder in the heart’s electrical system, similar to an arrhythmia. It is an abnormality that delays the recharging process of heart cells after they are released by the heart’s electrical system.

It causes rapid, chaotic heartbeats.

In Long QT Syndrome, it takes a very long time for the ventricles (the lower chambers of the heart) to relax and contract. The name of this condition comes from the letters associated with the waveforms that the heart’s electrical signals create when recorded by the heart.

• Brugada Syndrome:

It is a genetic, inherited disease that has the potential to cause fainting, cardiac arrest and sudden death. It is diagnosed by an abnormal image on the ECG.

Risk assessment is performed. An ICD (Shock pacemaker) should be inserted in high-risk patients. Ablation therapy may be applied in the presence of recurrent shocks. Other family members should also be screened for the disease.

2. Bradycardia (Slow Heartbeat):

• Sinus Bradycardia:

It is the slower functioning of the sinus node than normal, reducing the heart rate to less than 60 beats per minute. It can usually be seen in healthy individuals, especially athletes.

• AV Block (Atrioventricular Block):

There is an obstacle to the transmission of electrical signals from the atria to the ventricles. This can cause the heart to beat very slowly.

1. 1st Degree AV Block:

There is a delay in electrical conduction, but all signals pass.

2. 2nd Degree AV Block:

Some electrical signals are not transmitted.

3. 3rd Degree AV Block (Complete AV Block):

Not all electrical signals are transmitted, which slows the heart rate very much.

• Sinus Node Dysfunction:

When the sinus node does not function properly, it can cause the heart to beat slower than normal.

How is Heart Rhythm Disorder Diagnosed?

A heart rhythm disorder (arrhythmia) is usually diagnosed based on a person’s complaints, physical examination findings, and various medical tests. Arrhythmia symptoms usually manifest themselves with symptoms such as heart palpitations, irregular heartbeat, dizziness, or fainting. A cardiologist evaluates these symptoms and makes a correct diagnosis.

1. Physical Examination and Medical History:

• Medical History:

The doctor asks about the patient’s medical history. Factors such as family history of heart disease, previous heart conditions, medications used, and lifestyle are important.

• Physical Examination:

The doctor checks the regularity and speed of the heartbeat by listening to the pulse. Other vital signs such as blood pressure, body temperature, and breathing patterns are also checked.

2. Electrocardiogram (ECG):

ECG (ECG or Electrocardiogram) is a test that measures the electrical activity of the heart. The electrical conduction of the heart shows abnormalities in the heart rhythm and rate.

A short ECG (usually 10 seconds long) is usually sufficient to detect momentary arrhythmias. However, arrhythmias can be temporary, so longer monitoring may be required.

3. Holter Monitoring:

A Holter monitor monitors the heart rhythm continuously, usually for 24-48 hours. This device records the heart rhythm during daily activities and is used to detect temporary or intermittent arrhythmias.

This method is especially useful when arrhythmia attacks are short-lived.

4. Stress Test:

A stress test monitors the heart rate and rhythm during exercise. This test is performed to determine if arrhythmias are caused by conditions such as a heart attack or coronary artery disease. It can also detect arrhythmias that occur during physical activity.

5. Echocardiography:

Echocardiography creates an image of the heart using sound waves. The heart chambers, valves, and heart muscle are examined. It can show structural changes caused by arrhythmias (such as an enlarged heart or valve problems).

Echocardiography is also used to evaluate whether heart failure or other heart disease is causing the arrhythmia.

6. Electrophysiological Study (EP Study):

An EP Study is an invasive test that looks at the electrical conduction in the heart in detail. It is usually done to find the cause of a heart rhythm disorder or to determine the appropriate treatment.

During this test, thin electrodes are placed on the heart. And the heart’s electrical activity is mapped.
It is used to determine the type and source of the arrhythmia.

7. Blood Tests:

Blood tests are used to look for electrolyte imbalances, thyroid function, kidney disease, diabetes, and other diseases. These tests can help identify metabolic or systemic problems that may be causing the arrhythmia.

8. MRI or Computed Tomography (CT):

In certain instances, magnetic resonance imaging (MRI) or computed tomography (CT) scans may be employed to examine the heart’s structural abnormalities more thoroughly. These advanced imaging techniques provide a detailed view of potential issues, such as blockages in the coronary arteries.

9. Tilt Table Test:

This test is typically performed on patients experiencing dizziness or episodes of fainting. During the procedure, the patient is swiftly moved from a lying to a standing position, while their heart rate is closely monitored. It helps identify whether these symptoms are linked to irregularities in heart rhythm.

10. Event Recorder:

It is a compact device designed to monitor heart rhythms and document any irregularities in heart activity. This is particularly beneficial for patients with temporary or sporadic arrhythmias that may not be captured during standard testing procedures.

The event recorder records the patient’s heart rhythm only when a specific event occurs, such as;

• Palpitations,
• Fainting,
• Dizziness.

In this way, heart rhythm disturbances related to the symptoms felt by the patient can be detected more easily.

What are The Treatment Methods for Heart Rhythm Disorder?

Heart rhythm disorder (arrhythmia) treatment methods vary depending on the type of disorder, its severity, the patient’s general health status, and the factors that trigger the arrhythmia.

The treatment process is usually determined by a cardiologist and one or more of the following methods can be used:

1. Drug Treatment:

• Anti-Arrhythmic Drugs:

These drugs control rhythm disorders by regulating the electrical activity of the heart.

Different drugs can be used depending on the type of arrhythmia.

• Beta Blockers:

Slows down the heart rate and allows the heart to work more efficiently.

• Calcium Channel Blockers:

Slows down the electrical conduction of the heart, regulates accelerated heartbeats.

• Digoxin:

Can help slow down the heart rate, especially used in cases such as atrial fibrillation.

• Sodium Channel Blockers:

Can correct rhythm disorders by preventing the stimulation of heart muscle cells.

• Anticoagulant Drugs:

Blood thinners are used because the risk of clot formation increases in arrhythmias such as atrial fibrillation. These drugs can help reduce the risk of stroke.

2. Electroshock (Cardioversion):

• Definition:

A procedure in which the rhythm is tried to be corrected by applying an electrical shock. It aims to re-arrange the heartbeats in a synchronized manner.

• Application in Emergency Situations:

Cardioversion can be applied urgently in cases where the heart rate cannot be controlled. The shock resets the electrical system of the heart and allows it to return to normal rhythm.

3. Catheter Ablation: Destroying Arrhythmic Areas

• Definition:

Catheter ablation is a medical procedure designed to eliminate abnormal electrical pathways in the heart.
It involves inserting thin catheters into the heart to target specific problem areas.
These areas are then treated by applying heat through radio waves to ablate the irregular tissue.
This approach can provide long-term relief for certain arrhythmias. And it can also help reduce reliance on medication.

• In Which Cases Is It Used?:

It is effective in supraventricular tachycardia, atrial fibrillation, atrial flutter and some types of ventricular tachycardia.

• Advantage:

A successful catheter ablation can eliminate the use of medication and prevent the recurrence of arrhythmias.

4. Pacemaker:

• Definition:

A pacemaker continuously monitors the heartbeat. It regulates the heart rate by sending electrical impulses when necessary. This device is used especially for patients who experience bradycardia (slow heartbeat).

• Function:

A pacemaker constantly monitors the heartbeat and regulates the heart rate by sending electrical stimulation when necessary. This device is used especially for patients experiencing bradycardia (slow heartbeat).

5. Implantable Cardioverter Defibrillator (ICD):

• Definition:

An ICD automatically delivers an electrical shock when the heart starts beating abnormally fast, such as during ventricular tachycardia or ventricular fibrillation, helping to restore a normal heart rhythm..

• In Which Cases Is It Used?:

It is used in serious arrhythmia cases such as ventricular fibrillation and recurrent ventricular tachycardia.

• Function:

It detects abnormal rhythms that may lead to cardiac arrest and prevents life-threatening situations by giving a shock.

What are The Dangerous Situations of Heart Rhythm Disorder?

In certain cases of heart arrhythmia, it is vital to seek medical help quickly.

Dangerous Situations of Heart Arrhythmia:

• Very Fast or Slow Heartbeats:

• Shortness of Breath:

A sudden feeling of shortness of breath can be a serious symptom of heart arrhythmia. If you have difficulty breathing, especially during exertion or while resting, you should immediately seek medical attention.

• Weakness and Dizziness:

Severe weakness, dizziness, and even fainting can be symptoms of a heart arrhythmia. These conditions can be serious and may require specialist advice.

• Chest Pain or Feeling of Pressure:

Chest pain can indicate many problems related to heart health. If you experience chest pain or a feeling of pressure, especially during a heart arrhythmia, you should seek medical attention immediately.

• Loss of Balance:

Sudden loss of balance, dizziness, and fainting can be serious consequences of an arrhythmia. Such symptoms may require immediate medical attention.

• Ventricular Fibrillation:

In this type of arrhythmia, the heart stops beating irregularly and effectively. The person may not be able to breathe and may lose their pulse. This condition requires immediate medical attention. 112 should be called and cardiac massage should be started immediately.

• Fainting:

Sudden fainting can be a serious consequence of an arrhythmia. In the event of fainting, medical attention should definitely be sought.