What exactly is an arrhythmia and why does it occur?
Arrhythmia is a very generic term and one that has transcended purely medical usage to enter everyday language. In the medical sense, an arrhythmia is any alteration of the heart rhythm: the heart beats with a regular cadence, subject to changes in frequency, what we commonly call pulsations or heart rate. When there is a loss of that regularity, or when the heart rate is significantly higher or lower than what would correspond to the person’s situation, we may be dealing with a cardiac arrhythmia.
Not all situations of elevated or reduced frequency are pathological, as there is great variability between subjects. Nowadays there is concern about “pulsations” when in reality the important thing is to relate them to the activity performed, the characteristics of the subject, his or her circumstances, etc.
Arrhythmias include a large number of entities, from very high life-threatening diseases, such as ventricular tachycardia, to physiological situations such as sporadic extrasystoles or the usual respiratory arrhythmia in children and young people.
How can we detect that we are suffering an arrhythmia and at what times can it occur?
The typical symptomatology of arrhythmia is the perception of palpitations: noticing the heartbeat at an inappropriate frequency, usually rapid. It is a very variable symptom: there are people who notice their heartbeat on a regular basis (which would be normal) and there are people who only notice it sporadically during exercise, in stressful situations…
Other possible symptoms are intense dizziness or loss of consciousness, which may be associated with intense bradycardia (very low heart rate) or some types of tachycardia: this is a symptom that requires ruling out a potentially serious arrhythmic problem. Other more atypical symptoms are chest discomfort, general malaise, choking sensation, or short-lasting loss of strength.
Situations of increased cardiac work such as physical exercise and situations of anxiety can act as a “trigger” for some types of arrhythmia. For this reason, when faced with potentially arrhythmic symptoms such as rapid palpitations not justified by the level of effort, or above all loss of consciousness or dizziness during exercise, it is highly advisable to undergo a cardiological check-up.
It is noteworthy that the symptomatology of many arrhythmias (rapid palpitations, discomfort or choking) is very similar to that of psychological disorders such as anxiety crises. It is far from uncommon to find that people treated for an anxiety disorder for years actually have arrhythmic crises that are perfectly treatable cardiologically.
Has the pandemic affected the diagnosis and treatment of patients with arrhythmias?
As with other pathologies, we have seen a decrease in the number of consultations and a certain delay in the onset of symptoms.
Why is this? Is it due to the fact that these are not priority pathologies?
These are pathologies with symptoms that are usually transitory and once they have passed, they can be minimized. However, it should be borne in mind that the most reliable way to diagnose an arrhythmia is to perform an electrocardiogram during the symptoms of the arrhythmia. That is why it is essential to consult as soon as possible, and if possible when the discomfort appears.
What can happen if these patients do not receive adequate treatment, and what does it usually consist of?
In the case of benign arrhythmias, which fortunately are more frequent, the delay in treatment mainly results in the persistence and recurrence of symptoms, which are often bothersome.
This delay is much more worrying in the case of serious arrhythmias that can lead to dangerous situations such as heart failure, loss of consciousness, and truly dramatic events such as sudden death.
As for treatment, it depends on the type of arrhythmia: some only require some advice regarding physical activity, changes in posture, diet, etc. In other cases it is necessary to resort to antiarrhythmic drugs. Catheter ablation may also be indicated, which can definitively resolve some disorders. Finally, there are arrhythmias that require the use of implantable devices such as pacemakers and defibrillators.
For more information about arrhythmias, contact a Cardiology specialist.