ARRYTHMIA

CARDIAC ARRYTHMIA A common outline
ARRYTHMIA
Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or
dysrhythmias, are irregularities in the heartbeat, including when it is too fast
or too slow. A resting heart rate that is too fast – above 100 beats per minute
in adults – is called tachycardia, and a resting heart rate that is too slow –
below 60 beats per minute – is called bradycardia. Some types of arrhythmias
have no symptoms. Symptoms, when present, may include palpitations or
feeling a pause between heartbeats. In more serious cases, there may be
lightheadedness, passing out, shortness of breath, chest pain, or decreased
level of consciousness. While most cases of arrhythmia are not serious, some
predispose a person to complications such as stroke or heart failure. Others
may result in sudden death.
Arrhythmias are often categorized into four groups: extra beats, supraventricular
tachycardias, ventricular arrhythmias and bradyarrhythmias. Extra beats include
premature atrial contractions, premature ventricular contractions and premature
junctional contractions. Supraventricular tachycardias include atrial fibrillation, atrial
flutter and paroxysmal supraventricular tachycardia. Ventricular arrhythmias include
ventricular fibrillation and ventricular tachycardia. Bradyarrhythmias are due to sinus
node dysfunction or atrioventricular conduction disturbances. Arrhythmias are due to
problems with the electrical conduction system of the heart. A number of tests can help
with diagnosis, including an electrocardiogram (ECG) and Holter monitor.
Many arrhythmias can be effectively treated. Treatments may include medications,
medical procedures such as inserting a pacemaker, and surgery. Medications for a fast
heart rate may include beta blockers, or antiarrhythmic agents such as procainamide,
which attempt to restore a normal heart rhythm. This latter group may have more
significant side effects, especially if taken for a long period of time. Pacemakers are
often used for slow heart rates. Those with an irregular heartbeat are often treated with
blood thinners to reduce the risk of complications. Those who have severe symptoms
from an arrhythmia or are medically unstable may receive urgent treatment with a
controlled electric shock in the form of cardioversion or defibrillation.
CLASSIFICATION
Arrhythmia may be classified by rate
(tachycardia, bradycardia),
mechanism (automaticity, re-entry,
triggered) or duration (isolated
premature beats; couplets; runs, that is
3 or more beats; non-sustained = less
than 30 seconds or sustained= over 30
seconds).
Junctional arrhythmia
oAV nodal reentrant tachycardia
oJunctional rhythm
oJunctional tachycardia Ventricular arrhythmia
oPremature junctional contraction o Premature ventricular contractions (PVCs),
o ventricular bigeminy
o non-sustained ventricular tachycardia (NSVT);
Atrial arrhythmia o sustained ventricular tachycardia
o Sinus bradycardia o Accelerated idioventricular rhythm
o Sinus arrhythmia o Monomorphic ventricular tachycardia
o Sinus tachycardia o Polymorphic ventricular tachycardia
o Premature atrial contractions (PACs) o Ventricular fibrillation
o Wandering atrial pacemaker o Torsades de pointes
o Atrial tachycardia o Arrhythmogenic right ventricular dysplasia
o Multifocal atrial tachycardia o Re-entry ventricular arrhythmia
o Supraventricular tachycardia (SVT)
o Atrial flutter
o Atrial fibrillation (Afib)
o AV nodal reentrant tachycardia
Heart blocks
These are also known as AV blocks, because the vast majority of them arise from
pathology at the atrioventricular node. They are the most common causes of
bradycardia:
1. First-degree heart block, which manifests as PR prolongation
2. Second-degree heart block
•Type 1 Second degree heart block, also known as Mobitz I or Wenckebach
•Type 2 Second degree heart block, also known as Mobitz II
3. Third-degree heart block, also known as complete heart block
Sudden arrhythmic death syndrome (SADS), is a term used as part of sudden

unexpected death syndrome to describe sudden death because of cardiac arrest
occasioned by an arrhythmia in the presence or absence of any structural heart disease
on autopsy.
SIGNS AND SYMPTOMS
The term cardiac arrhythmia covers a very large number of very different conditions. The most common
symptom of arrhythmia is an awareness of an abnormal heartbeat, called palpitations. These may be
infrequent, frequent, or continuous. Some of these arrhythmias are harmless (though distracting for
patients) but some of them predispose to adverse outcomes. Arrhythmias also cause chest pain and
shortness of breath.
Some arrhythmias do not cause symptoms and are not associated with increased mortality. However, some
asymptomatic arrhythmias are associated with adverse events. Examples include a higher risk of blood
clotting within the heart and a higher risk of insufficient blood being transported to the heart because of a
weak heartbeat. Other increased risks are of embolization and stroke, heart failure, and sudden cardiac death.
If an arrhythmia results in a heartbeat that is too fast, too slow, or too weak to supply the body's needs, this
manifests as lower blood pressure and may cause lightheadedness, dizziness, syncope, loss of consciousness,
coma, persistent vegetative state, or brain death due to insufficient supply of blood and oxygen to the brain.
Some types of arrhythmia result in cardiac arrest, or sudden death.
Medical assessment of the abnormality using an electrocardiogram is one way to diagnose and assess the
risk of any given arrhythmia.
THANK YOU Vijayasekar Vishwant Vijeth
LD1-S21i

ARRYTHMIA

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CARDIAC ARRYTHMIA A common outline

Sudden arrhythmic death syndrome (SADS), is a term used as part of sudden

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