Umair Gaines
Heart rhythm disorders, or arrhythmias, are a potentially fatal condition that affects millions of people worldwide. These disorders are caused by abnormalities or short-circuiting in the electrical system of the heart, which can lead to a rapid or slow heartbeat. In some cases, arrhythmias can be managed with medication, but in other cases, they may require more invasive treatments such as cardiac ablation, which involves destroying the tissue causing the short circuit to restore normal heart rhythm. While heart attacks are often discussed, it is important to be aware of electrical heart diseases and their symptoms, such as palpitation, fluttering, or extreme racing of the heart.
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What You'll Learn
Atrial fibrillation (AF)
AF is the most common type of irregular heartbeat, and it is estimated that people with AF are at a fivefold increased risk of stroke. It is a progressive disease, and can develop due to abnormal structural or electrical problems in the heart. AF can also be caused by another health condition or medicine, and in these cases, treating the condition or stopping the medication can help improve symptoms.
If you think you may have AF, you should see a doctor. They will refer you to a heart specialist, who will ask about your symptoms and check your heart rate. You will also have tests to check your heart rhythm and see if anything else could be causing your symptoms.
There are treatments available for AF. One such treatment is cardiac ablation, which is successful in more than 90% of patients. This procedure involves inserting small wires through a blood vessel into the heart to map the electrical paths and pulses. When the problem areas are identified, an electrical signal is sent through a catheter into the heart, creating heat that destroys the abnormal tissue.
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Wolff-Parkinson-White syndrome
An electrical short circuit in the heart, or tachycardia, is a condition where the heart rate is abnormally fast. This is caused by very fast electrical activity or short-circuiting in the electrical circuit of the heart. Wolff-Parkinson-White (WPW) syndrome is a condition that causes the heart to beat abnormally fast for periods of time. It is characterised by an extra electrical pathway in the heart, which leads to rapid heart rates. This extra pathway is caused by a strand of heart muscle that grows while the baby is developing in the womb.
Normally, electrical signals follow a certain pathway through the heart, which helps the heart beat regularly. In people with WPW syndrome, some of the electrical signals take an alternative route, causing a very rapid heart rate called supraventricular tachycardia. This can lead to symptoms such as a pounding or fluttering heartbeat (palpitations), shortness of breath, chest discomfort, and dizziness. WPW syndrome is one of the most common causes of fast heart rate problems in infants and children, although many cases are diagnosed in otherwise healthy young adults.
WPW syndrome is typically diagnosed using an electrocardiogram (ECG) or with ambulatory ECG monitoring. An ECG involves placing small discs called electrodes on the arms, legs, and chest, which are connected by wires to an ECG machine. This machine records the tiny electrical signals produced by the heart each time it beats. If WPW syndrome is present, the ECG will record an unusual pattern.
The long-term treatment for WPW syndrome is often catheter ablation, which involves inserting a tube (catheter) into a vein through a small cut near the groin, up to the heart area. Once the catheter reaches the heart, the small area causing the fast heart rate is destroyed using radiofrequency or by freezing it (cryoablation). This procedure is highly successful, with a success rate of between 85-95%.
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Atrial flutter
The underlying cause of atrial flutter is often associated with damage to the heart's electrical system. This damage can be a result of various conditions, such as inherited heart diseases or other underlying issues. In some cases, the signal that triggers the atria to beat may be blocked by damaged or scar tissue.
Treatment options for atrial flutter include medication and catheter ablation procedures. Medications, known as antiarrhythmics, are used to control the heart rhythm, although they may be less effective than catheter ablation. Catheter ablation is a minimally invasive procedure where the faulty electrical pathways are destroyed, returning the heart's rhythm to normal. The procedure is generally safe and successful, with a high success rate in patients.
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Arrhythmias
An arrhythmia is a disturbance in the rhythm of the heartbeat, whether it is beating too hard, too fast, or skipping beats. This condition can be caused by problems with the heart's electrical system. Much like faulty wiring in a home, an arrhythmia can cause the heart to race so fast that it might suddenly stop.
There are several types of arrhythmias, each with its own unique characteristics and treatment options. One type of arrhythmia is atrial fibrillation (AF), which is characterised by abnormal electrical impulses in the top chambers of the heart. People with atrial fibrillation often describe their heart as "skipping" or beating erratically. They may also experience fatigue and feel unable to perform regular activities. Atrial fibrillation can lead to palpitations, fatigue, and even heart failure in the long run.
Another type of arrhythmia is paroxysmal supraventricular tachycardia (PSVT), which occurs due to a short circuit in the upper chamber of the heart. This results in a regular but rapid heartbeat that starts and stops abruptly. Symptoms of PSVT include a racing heartbeat, shortness of breath, chest discomfort, dizziness, and lightheadedness. It is often diagnosed through a medical history review, physical examination, and electrocardiogram (ECG) or Holter monitor, a portable ECG worn continuously for up to seven days.
Atrial flutter is another arrhythmia that involves an electrical short circuit in the heart's upper chambers. This short circuit causes the left and right atria to be stimulated too rapidly, impairing their ability to pump effectively. Medications such as beta-blockers, calcium channel blockers, and digoxin can help slow the heart rate and prevent the lower chambers from being overstimulated. In some cases, a procedure called atrial flutter ablation may be performed, which involves using radiofrequency energy to destroy a critical part of the short circuit.
In summary, arrhythmias are electrical problems in the heart that can cause disturbances in the heartbeat. Different types of arrhythmias, such as atrial fibrillation, paroxysmal supraventricular tachycardia, and atrial flutter, have unique characteristics and treatment options. These may include medications, cardiac electrophysiology studies, and procedures such as ablation to correct the electrical short circuit in the heart.
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Cardiac electrophysiology
Electrophysiologists are specialists in cardiac electrophysiology who can diagnose and treat irregular heart rhythms. They review a patient's medical history, discuss symptoms, and review medications. They can perform quick tests, such as an electrocardiogram (EKG) or send the patient home with an event monitor to record heart rhythms over time. Electrophysiologists can also perform more invasive procedures, such as intracardiac catheter recording of spontaneous activity and cardiac responses to programmed electrical stimulation. These procedures can help assess complex arrhythmias, evaluate abnormal electrocardiograms, and design treatments.
One treatment option for electrical short circuits in the heart is cardiac ablation. This involves inserting small wires through a blood vessel into the heart to map the electrical paths and pulses. Once the problem area is identified, the tissue causing the short circuit is destroyed, returning the heart's rhythm to normal. Cardiac ablation is successful in more than 90% of patients and can be performed by electrophysiologists.
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Frequently asked questions
An electrical short circuit in the heart is an abnormal heart rhythm, or arrhythmia, that can cause the heart to beat too fast or too slow. This can be caused by problems with the heart's electrical system, such as faulty wiring or electrical impulses that enter an extra pathway.
Symptoms of an electrical short circuit in the heart can include palpitations, a fluttering sensation, extreme racing of the heart, lightheadedness, shortness of breath, chest discomfort, dizziness, and fatigue.
An electrical short circuit in the heart can be treated with cardiac ablation, which is a safe and minimally invasive procedure that is successful in more than 90% of patients. Cardiac ablation involves using a catheter to deliver energy to the heart and destroy the tissue causing the short circuit, returning the heart's rhythm to normal.
