Irregular heartbeat also is known as arrhythmia, dysrhythmia or palpitation occurs when the heart rate is not regular. The heart beats at a normal range between 60 -100 beats per minute. When the heartbeat falls below 60 beats per minute, it is known as bradyarrhythmia. If it exceeds 100bpm, it is referred to as tachyarrhythmia. Irregular heartbeat is benign in healthy people (such as in trained athletes) or can signal a more serious heart condition.
Some people are more aware of their irregular heartbeat than others and is often accompanied with symptoms such as excessive sweating (hyperhidrosis), difficulty with breathing, weakness, feeling of tightness or pressure in the chest, dizziness, light-headedness, and pain that spreads through your arms, neck, jaw or upper back.
It is a well-established fact that stress and negative emotions can trigger irregular heartbeat in healthy people even without an underlying heart condition.
What is Stress?
Stress is a physiological response of the body to harmful situations or threat, whether they are real or perceived.
The autonomic nervous system and the hormonal system play a vital role in regulating the neuro-hormonal-cardiac axis and determines how we respond to stress. During stress, our body responds by releasing cortisol alongside glucagon and catecholamines (adrenaline). These hormones cause changes in cellular ionic and electrolytes concentration, disrupting the normal electrical activity of the heart and
What is the Cause of Irregular Heartbeat?
An intrinsic system in the heart is responsible for generating and maintaining a regular heartbeat. This system known as the conducting system of the heart consists of specialized muscle cells and conducting fibers, initiates impulses and conducts them through the heart at a rapid rate. The conducting system of the heart can be regulated or modified by hormones and the autonomic nervous system. Heart-related pathologies that damage and disrupts the conducting system or factors that influence the autonomic and hormonal system can trigger will trigger an arrhythmia.
Heart-related pathologies that can cause arrhythmias include:
• Valvular heart diseases (E.g., mitral valve prolapse)
• Cardiomyopathies (Heart muscle problems)
• Congestive heart failure.
• Coronary artery disease.
• Myocardial infarction.
Non-heart related causes include
• Intense or vigorous physical activity
• Abnormal electrolytes level (E.g., calcium, potassium, sodium)
• Low blood sugar level (hypoglycemia).
• Hormonal diseases include thyroid disease (Hyperthyroidism), pheochromocytoma,
• Fever, dehydration
• Stimulants like nicotine, amphetamines, caffeine, and cocaine
• Medications, including digitalis toxicity, diet pills, hypertensive drugs
• Cardiogenic shock.
How Do they Test for Arrhythmia?
If your doctor suspects you have an irregular heartbeat, he will conduct series of physical examination and laboratory test to confirm the diagnosis and rule out any underlying heart diseases.
• Electrocardiogram: Is a device used for measuring the electrical activity of the heart. It uses a series of sensors (electrodes), that are attached to the chest and limbs. An ECG measures and records on a paper the timing and electrical phase of your heart. Your doctor will interpret the reading to find any abnormality
• Echocardiogram: A hand-held device (transducer) placed on the chest uses reflection from sound waves to produce a pictorial image of the heart anatomical structures, size and wall motion.
• Stress test: Some irregular heartbeat is triggered or aggravated physical activity. Your physician will subject you to an exercise on a stationary bicycle or a treadmill while monitoring your heart activity via an ECG.
• Holter monitor: This is a battery-operated portable device that monitors and records your heart’s electrical activity continuously for 24 to 48hours or longer depending on your condition
• Implantable loop recorder: This device is implanted under the skin in the chest area. It detects any abnormal cardiac rhythm.
• In some cases, your doctor might perform additional test such as blood sugar test, serum electrolytes, thyroid hormones, complete blood count to rule out anemia
What is the best treatment for an irregular heartbeat?
Treatment is usually not necessary if its benign but might be considered if it is causing you significant discomfort or puts you at serious risk of complications or life-threatening arrhythmia.
• Medications: There are different kinds of medication for treating various forms of irregular heartbeat. The choice of drug depends on which type you have. Some anti-arrhythmic drugs have a narrow therapeutic window, so it is advised to adhere strictly to instruction as recommended by your physician to prevent or minimize complications due to overdose. Commonly used drugs include verapamil, amiodarone, diltiazem, sotalol, lidocaine.
• Vagal maneuvers: An irregular heartbeat can be stopped by using any particular maneuvers that include gently massaging the carotid artery on one side of the neck with the thumb, holding your breath while straining (Heimlich maneuver), coughing or dipping the face in ice water
• Relaxation therapy: As stress and negative emotions are triggers for arrhythmia, stress management, and relaxation therapies can prove beneficial. This includes meditation, massage, music, and art therapy,
• Cardioversion: This procedure helps to restore normal cardiac rhythm to people with certain types of irregular heart rhythm. A paddle or patches is placed on the chest and used to send an electric shock to the heart.
• Pacemaker: A pacemaker is an implantable electrical device used to restore a normal heartbeat. The device is implanted near the clavicle (collarbone) through a minor surgical procedure. An insulated wire extends from the pacemaker to the heart, where it is permanently fixed. This is usually reserved for people with severe forms of arrhythmia.
Besides treatment, there are lifestyle changes you can make that will help your irregular heartbeat
• Avoid caffeinated drinks,
• Quit cigarette smoking.
• Engage in regular exercise and physical activities
• Do not take alcohol, but if you chose to drink, limit it to a drink per day.
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