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Arrhythmia –The under-recognized but curable evil
Heart rhythm problem could prove to be a spoiler to your active life, warn Electrophysiologists at Apollo Gleneagles
Kolkata, May 18, 2018: Cardiac allignments has become a area of concern and most of the cases the initial symptoms like Palpitations, skipped beats, racing of the heart, fatigue, extreme lethargy, giddiness – these are just a few of the symptoms that warrant your immediate attention as it could be a sign of arrhythmia which can ruin your active life or even can prove to be fatal.
The term “arrhythmia” refers to any change from the normal sequence of electrical impulses. When the heart’s electrical impulses get disorganized, heartbeats can be too fast, too slow, or in an abnormal pattern. When the heart doesn’t beat properly, it can cause immense discomfort and even can cause dizziness due to the decreased blood supply to the brain. Treating cardiac arrhythmia is important to restore the quality of your life and prevent stroke or sudden death.
Apollo Gleneagles recognize that Arrhythmia has a significant prevalence in this part of our country but if often unrecognized and not treated due to lack of public awareness and absence of a dedicated heart rhythm management center. Recognizing the need, Apollo Gleneagles Hospitals decided to introduce a comprehensive Heart Rhythm Management service.
Listed below are some of the more common arrhythmias:
| Atrial arrhythmias | Ventricular arrhythmias |
|---|---|
| Sinus arrhythmia. A condition in which the heart rate varies with breathing. Sinus arrhythmia is commonly found in children; adults may often have it as well. This is a benign (not dangerous) condition. | Premature ventricular contractions (PVCs). A condition in which an electrical signal originates in the ventricles and causes the ventricles to contract before receiving the electrical signal from the atria. PVCs are not uncommon and typically do not cause symptoms or problems. However, if the frequency of the PVCs increases significantly, symptoms such as weakness, fatigue, dizziness, fainting, or palpitations may be experienced. |
| Sinus tachycardia. A condition in which the heart rate is faster than normal for the child’s age because the sinus node is sending out electrical impulses at a rate faster than usual. Most commonly, sinus tachycardia occurs as a normal response of the heart to exercise when the heart rate increases to cope with increased energy requirements. Sinus tachycardia can be completely appropriate and normal, such as when a child is exercising vigorously. However, it may cause symptoms, such as weakness, fatigue, dizziness, or palpitations if the heart rate becomes too fast to pump an adequate supply of blood to the body. Sinus tachycardia is often temporary, occurring when the body is under stress from exercise, strong emotions, fever, or dehydration, to name a few causes. Once the stress is removed, the heart rate will return to its usual rate. | Ventricular tachycardia (VT). A life-threatening condition in which an electrical signal is sent from the ventricles at a very fast but often regular rate. If the heart rate is sustained at a high rate for more than 30 seconds, symptoms such as weakness, fatigue, dizziness, fainting, or palpitations may be experienced. A person in VT may require an electric shock or medications to convert the rhythm to back normal sinus rhythm. |
| Ventricular fibrillation (VF). A condition in which many electrical signals are sent from the ventricles at a very fast and erratic rate. As a result, the ventricles are unable to fill with blood and pump. This rhythm is life-threatening because there is no pulse and complete loss of consciousness. A person in VF requires prompt defibrillation to restore the normal rhythm and function of the heart. It will result in sudden cardiac death if not treated within seconds. | |
| Premature supraventricular contractions or premature atrial contractions (PAC). A condition in which an atrial pacemaker site above the ventricles sends out an electrical signal early. The ventricles are usually able to respond to this signal, but the result is an irregular heart rhythm. PACs are common and may occur as the result of stimulants such as coffee, tea, alcohol, cigarettes, or medications. | Wolff-Parkinson-White Syndrome (WPW). A condition in which an electrical signal may arrive at the ventricle too fast due to an extra conduction pathway or a shortcut from the atria to the ventricles. Tachycardia is a common symptom. |
| Supraventricular tachycardia (SVT), paroxysmal atrial tachycardia (PAT). A condition in which the heart rate speeds up due to a series of early beats from an atrial or junctional pacemaker site above the ventricles. PAT usually begins and ends rapidly, occurring in repeated periods. This condition can cause symptoms such as weakness, fatigue, dizziness, fainting, or palpitations if the heart rate becomes too fast. This condition is the most common type of abnormal tachycardia in children, and is sometimes referred to as paroxysmal supraventricular tachycardia (PSVT). | |
| Atrial flutter. A condition in which the electrical signals come from the atria at a fast but regular rate, often causing the ventricles to contract faster and increase the heart rate. When the signals from the atria are coming at a faster rate than the ventricles can respond to, the ECG pattern develops a signature “sawtooth” pattern, showing two or more flutter waves between each QRS complex. The number of waves between each QRS complex is expressed as a ratio, i.e., a two-to-one atrial flutter means that two waves are occurring between each QRS. | |
| Atrial fibrillation. A condition in which the electrical signals come from the atria at a very fast and erratic rate. The ventricles contract in an irregular manner because of the erratic signals coming from the atria. |
The symptoms of various arrhythmias may resemble other medical conditions or heart problems. Always consult your child’s doctor for a diagnosis.
Under the inspiration of Dr P.C Mondal, HOD & Senior Consultant, Cardiology, Apollo Gleneagles Hospitals, the arrhythmia clinic is being headed by Dr Aftab Khan, Senior Consultant Interventional Cardiologist & Head – Electrophysiologist Services, Apollo Gleneagles Hospitals, Kolkata and Dr Suchit Majumder, Consultant Interventional Cardiologist & Electrophysiologist, Apollo Gleneagles Hospitals, Kolkata.
Dr. Aftab Khan said, “About a quarter of heart rhythm problems can be classified as ‘complex arrhythmias’ which largely occur in patients who have an abnormal heart, an enlarged heart (cardiomyopathy) or in those who have had a heart attack previously or are suffering from Atrial Fibrillation. Here the conventional method of RFA has a low success rate but thanks to advancements in science, we have access to the latest 3D RFA machine. This machine creates a three dimensional geometry of the heart and identifies the short circuit with high precision, making it easier for us to target and destroy the abnormal tissue.”
Dr P.C Mondal while speaking on this said, “We have launched Heart Rhythm Management services at Apollo Gleneagles Hospital with the sole objective of improving the quality of life of patients of all age group suffering from arrhythmia. ICD’s have a role in preventing cardiac arrest in high-risk patients who haven’t had, but are at risk for, life-threatening ventricular arrhythmia. In cases of too slow heart rhythm, permanent pacing relieves symptoms and improves quality of life and therefore a pacemaker is an appropriate device.”
Palpitations or anxiety can last from a few minutes to few hours. ECG is one of the best ways to identify the cause of palpitations when they occur for longer durations. An EP study is required to characterize arrhythmia in some cases. Here the doctors try to mimic the palpitation by creating stimulation in the heart and the test is performed by inserting catheters and wire electrodes, which measure electrical activity. After pinpointing the cause of the palpitations which could be due to a short circuit or abnormal tissue, doctors may decide to go for RFA (radiofrequency ablation) i.e. destroying the abnormal tissue through heat produced by radiofrequency energy. This procedure has a high success rate and provides a permanent solution, so the person can lead an active life without the need of lifelong medication.
There have been instances of people fainting and losing consciousness and the reason is either passed off as a heat stroke or low blood sugar, but the actual cause could be cardiac arrhythmia which can even pose as life-threatening in certain cases.
Dr. Suchit Majumdar added, “Unlike coronary artery disease which affects the typically older patients, arrhythmia symptoms are often seen in younger patients which can adversely impact their productive life. EP study and highly sophisticated 3D mapping technology have seen a high success rate in curing people. Some of these unique facilities are available in very few centers across India. Apollo Gleneagles Hospital in Kolkata has the latest model of 3D mapping system called Ensuite Velocity SYSTEM which is the only such system in Eastern India.”
Photo: Sutithi Munshi
