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Arrhythmias - Overview

Alternative Names

Dysrhythmias; Abnormal heart rhythms; Bradycardia; Tachycardia

Definition of Arrhythmias:

An arrhythmia is a disorder of the heart rate (pulse) or heart rhythm, such as beating too fast (tachycardia), too slow (bradycardia), or irregularly.


Arrhythmias

Causes, incidence, and risk factors:

Normally, your heart is able to pump blood out to your body without working any harder than is needed.

To help this happen, your heart has an electrical system that makes sure it contracts (squeezes) in an orderly way.

The electrical impulse that signals your heart to contract begins in the sinoatrial node (also called the sinus node or SA node). This is your heart's natural pacemaker.

  • The signal leaves the SA node and travels through the two upper chambers (atria).
  • Then the signal passes through another node (the AV node). Finally, it passes through the lower chambers (ventricles).
  • Different nerve messages signal your heart to beat slower or faster.

Cardiac conduction system

Arrhythmias are caused by problems with the heart's electrical conduction system. Other areas of the electrical system may also send out signals. Other times, electrical signals are not able to move as easily or at all.

When an arrhythmia is present, your heartbeat may be:

  • Too slow (bradycardia)
  • Too quick (tachycardia)
  • Irregular

Problems can occur anywhere along this conduction system, causing various arrhythmias. Examples include:

The risk of getting a tachycardia or bradycardia varies greatly, depending on:

  • Blood chemistry imbalances, such as abnormal potassium levels
  • Cardiomyopathy -- a weakening of the heart muscle or a change in the heart muscle
  • Heart failure
  • Overactive thyroid gland
  • Past heart attack

Arrhythmias may also be caused by some substances or drugs, including:

  • Amphetamines
  • Caffeine
  • Cocaine
  • Beta blockers
  • Psychotropics
  • Sympathomimetics

Sometimes anti-arrhythmic medications -- prescribed to treat one type of arrhythmia -- can actually cause another type of arrhythmia.

  • Reviewed last on: 6/5/2010
  • Issam Mikati, MD, Associate Professor of Medicine, Feinberg School of Medicine, Director, Northwestern Clinic Echocardiography Lab, Northwestern University, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA 3rd, Freedman RA, Gettes LS, et al. ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation. 2008;117:e350-e408.

Hayes DL, Zipes DP. Cardiac pacemakers and cardioverter-defibrillators. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 34.

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