What is cardiac arrhythmia?
Cardiac arrhythmia is a pathological disorder of the cardiac rhythm and is manifested from time to time, or a patient may have it constantly.
The cardiac muscle is contracted about 110 thousand times a day. The electric impulse precedes every heart contraction. The cells of the heart, cardio myocytes, are able to generate the impulses but there is the chief driver of the rhythm, a sinoatrial node which a new electric impulse starts from. The sinus rhythm is characterized by the regularity of the pace, and the frequency of the cardiac beats should be within 60-90 beats per minute.
The blood is transferred from atrium to ventricles during the contraction of the cardiac muscle. Then the ventricles contract during the relaxation and push the blood to the blood vessels, and it circulates through the whole body. In case of the disorder of the heart rate, a change of the blood pressure happens in the blood vessels and the pathologies are gradually developed.
There are two essential types of the arrhythmia:
- When the number of the heart beats is more than 90 beats per minutes at rest;
- When the number of the heart beats is less than 60 beats per minutes.
A load on the myocardium grows during the rapid heartbeat, and it contracts more often, the blood pressure grows in the blood vessels. In case of the low heartbeat, the blood pressure is weak, and a patient experiences fatigue and other symptoms.
Cardiac arrhythmia symptoms
Dr. Arvind Mahadevan, MD: The cardiac muscle is characterized by one general symptoms – a disorder of the heartbeat. If a patient experiences that the heart beats are more often than usually, or the heart beat is irregular or disruptive, this is the first sign that you should see a cardiologist.
General symptoms for all types of the arrhythmia:
- The common heart rhythm is changed all of a sudden.
- Discomfort or pain in the chest appears and is accompanied by tightness in the chest and a change of the pulse.
- The heart beat becomes more rapid and slows down in some period.
- It may seem that the heart beats as it wants, and the body does not control this process.
Patients often experience the following symptoms during the outbreak of the arrhythmia:
- Lack of energy;
- Sudden hand tremor;
- Shortness of breath and lack of oxygen;
But a danger of the heart arrhythmia is that a disease may be asymptomatic. A human may have discomfort in the heart only after the complications. It often happens with people who are doing professional sports.
Cardiac arrhythmia causes
Having analyzed all known causes of the heart arrhythmia, they may be classified into groups. There are 5 main groups:
- Cardiac (diseases of the cardiovascular system: ischemic heart disease, heart failure, heart defect, myocarditis, etc.);
- Endocrine (diseases of the thyroid gland, abrupt change of the androgenic hormones);
- Pharmaceutical (diuretics, cardiac glycosides, sympathomimetic, tranquilizers, and other medications may change the heart beat);
- Bad habits (alcohol, tobacco smoking, drug abuse quickly cause arrhythmia and increase a risk of the heart attack);
- Psychogenic (chronic stress, depression, anxious disorder, panic, and other psychological factors).
Every human has own clinical presentation when one or another causes occurs. So, there is no one whole mechanism of the treatment of the cardiac arrhythmia. For instance, a healthy person (as it may seem at the first sight) may suffer from the disorder of the water-electrolyte metabolism. Deficit of potassium and magnesium in the body can cause a harm to your heart as well as affect the heartbeat.
Cardiac arrhythmia treatment guidelines
The treatment of the cardiac arrhythmia is determined by certain type of the pathology and causes of its development. The medical measures are started from the following schemes in standard situations:
- A prescription of anti-arrhythmic drugs;
- When the abovementioned products are ineffective, ACE inhibitors or medications with narrow action (depending on a cause of the pathology) are prescribed;
- Patients are prescribed a radiofrequency ablation during the frequent relapses with complications.
The therapy of the cardiac arrhythmia is aimed at the recovery of the cardiac rhythm. Restoring the heartbeat, the blood pressure and other functions of the cardiovascular system can be controlled.
If the pharmaceutical therapy is ineffective, patients are provided with a cardiac pacemaker. This device regularly tracks the heart rate of a patient and is activated filling the pause or makes its own beat during the stimulation. The program is individual and is dosed making the heart work within the maximum natural rhythm. The cardiac pacemaker is often implanted patients with bradycardia (during low cardiac contraction).
The arrhythmia treatment comes down to not only the use of the medications but also to a change of the lifestyle. An important stage in the treatment of arrhythmia is based on the improvement of the cardiac muscle by means of the cardio. Moreover, the loads should be moderate and short. The better the myocardium is improved, the clearer and more stable the heartbeat will be.
An instruction for the patients with arrhythmia includes:
- Refusal of alcohol, opium analgesics, medications that may influence on the heart beat;
- A full or partial quitting smoking;
- Increase of the physical activity in order to improve the cardiac muscle. Sport is not prohibited during the arrhythmia. You should give your body a moderate load, and only after the estimation of your clinical pattern by cardiologist.
Cardiac arrhythmia drugs
A pharmaceutical therapy is based on several categories of medications:
- Medicines blocking calcium channels;
- Medicines reducing coming sodium ions in the heart cells;
- Statins (during ventricle arrhythmia);
- ACE inhibitors (during ventricle and ciliary arrhythmia);
- Beta-blockers (during any types of arrhythmia).
Dr. Arvind Mahadevan, MD: The most universal medical group is beta-blockers. The most prominent representative of this group Propranolol reduces the symptoms of arrhythmia and controls the functions of the cardiovascular system during the prolonged disorder of the cardiac rhythm.
There are such drugs as Verapamil, Diltiazem, and others helps to reduce the heart beat only, and Propranolol helps to reduce a load on the myocardium, restore the blood pressure in the blood vessels and prevent the development of the congestive heart failure. Therefore, medicines in this group of the beta-adrenoceptors are often used in cardiology.
Cardiac arrhythmia treatment with Propranolol (Inderal). Dosage
The treatment of the cardiac arrhythmia with Propranolol comes down to the use of tablets within 2-4 months. If a stable result is achieved within this period, a patient is prescribed a medicine in a lower dosing to maintain the therapy, or the treatment is terminated.
The mechanism of the action of Propranolol consists in blocking the sympathetic impulsion coming in the heart. Due to the reduced stimulation of these receptors in the heart, the frequency and strength of the cardiac contraction is reduced.
A therapeutic effect from the use of a dose of Propranolol is kept for not less than 6 hours. The effect is usually kept within 12 hours.
- The initial dosage of Propranolol is 20 mg 3 times a day during arrhythmia.
- If the needed result is not achieved within a month, and a patient has the attacks of arrhythmia, the dose of Inderal is increased up to 40 mg 3 times a day.
- The dose may be increased every 3-4 weeks by 40-80 mg depending on the severity of the arrhythmia symptoms.
The maximum dosage of Propranolol is 320 mg a day (2 tablets Inderal 40 mg 4 times a day) in the treatment of arrhythmia.
A cardiologist should be visited at least once in 6-8 weeks at the stage of the active treatment. It will help to estimate the disease course and adjust the dosing, as needed.
What is supraventricular arrhythmia?
Supraventricular arrhythmia is a common type of the pathology met in 60% of cases. The main peculiarity of this type of arrhythmia is a sudden increase of the frequency of the cardiac beats and keeping a pathological rhythm within a prolonged period. A source of spreading of the extra contractions is placed in atrium, above ventricles, and so it has such name.
Supraventricular arrhythmia is characterized by the increased number of the heart beats. A site of the increased activity appears in the heart and it sends extra impulses to the cardiac muscle. There may be many impulses, so that many patients do not feel the heart beat disorder. But the disease can quickly progress, so that the number of the heart beats may be more than 100 beats per minute at rest.
Supraventricular arrhythmia treatment
A development of the supraventricular arrhythmia symptoms tells about the excessive stimulation of the cardiac muscle, as a result of which a pathological rhythm disorder occurs. The first thing doctors recommend to do is to get rid of the triggers that can stimulate the additional sites with the impulses.
Patients are recommended to avoid coffee and any drinks containing caffeine, refuse from alcohol, cigarettes, and adjust sleeping and eating. At first, a patient may think that a pharmaceutical therapy is needed during supraventricular arrhythmia. But according to the statistics, in 18% of cases, a change of the sleep, healthy eating, and giving up bad habits lowers the symptoms of this type of the arrhythmia.
If the non-pharmaceutical methods are ineffective, the heart rate is adjusted pharmaceutically.
In case of the frequent attacks of tachycardia, it is recommended to take beta-blockers, the action of which is aimed at a reduction to the frequency of the cardiac contractions. A non-selective action of Propranolol (Inderal) will better do for this type of the arrhythmia because besides the cardiac symptoms, the drug controls other mechanisms influencing on the development of tachycardia, for instance, the attack of anxiety.
If the frequent attacks of Supraventricular arrhythmia cause a psychological discomfort, without harming the cardiovascular system, doctors recommend tranquilizers or light sedative products. They will help to remove a concern and reduce the frequency of the cardiac beats by means of the relaxing effect.
If a patient does not have concomitant diseases such as ischemic heart disease, or heart failure, a pharmaceutical therapy is not really advisable. This type of the arrhythmia is well adjusted by means of the changed lifestyle and a reduction of triggers for the excessive impulsion in the heart.