What is an arrhythmia?
We call arrhythmia any alteration of the normal rhythm of the heart. How do we classify them? We can classify them in a very simple way. First, by the place where the arrhythmia originates. We will speak of ventricular arrhythmias when the problem is in the ventricles, which are the main chambers of the heart, and supraventricular arrhythmias when the arrhythmia originates in the upper part, in the atria. We will also classify them into two types: bradyarrhythmias, which means that the heart beats slower than normal. If the heart beats between 60 and 100 beats per minute, we can imagine what happens if it beats at, for example, 30 beats per minute. And we call them tachyarrhythmias when the heart beats much faster than normal. In this simple way we can already get an idea of each arrhythmia.
What causes it? Are there risk factors?
There are two fundamental types of causes, the damage we do to our heart, willingly or unwillingly, and as an example we have arterial hypertension, which is something that overloads the heart and causes arrhythmias in the end. Other causes of arrhythmias are if you have a myocardial infarction, if you have a scar in your heart because you have had an operation; all this can produce arrhythmias. And then the other part is if someone is born with a congenital problem that affects the electricity of their heart. This is also the second important cause of arrhythmias. So there are some congenital causes and some acquired causes.
What treatments are available?
In recent years this has changed a lot and we are now able to cure many arrhythmias. What we have to see first is that there is some predisposing factor. If we have a cause, whether it is a disease, or that we smoke, or that we drink alcohol, or that we have very high blood pressure, then the first thing to do is to control these risk factors. Imagine, sometimes the heart is very slow because one takes anti-arrhythmic drugs, when the drugs are removed, this is normalized. When we are talking about rapid arrhythmias or tachycardias, we have to see what treatments can solve the problem. First we will have medication. Simply taking medication is enough. When this is not the case and with medication alone we cannot control the heart rhythm, we proceed to perform procedures that we call ablation. In these procedures, a catheter such as this one is introduced into the heart and the areas that produce the tachycardias are burned. In the upper part of the heart we are successful in practically 99% of the cases and this has been a very important advance. This is called radiofrequency ablation or ablation with other energies. But there are times when we are not able to prevent arrhythmias and arrhythmias are dangerous, those that make the heart go so fast that it is unable to expel blood and can cause death, sudden death as we call it. In these cases we sometimes use what we call implantable defibrillators. They are bigger than pacemakers, they are placed under the skin and they are capable of when the heart has one of these tachycardias they release an electrical discharge and they make it return again to the normal rhythm which is the sinus rhythm.