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Thursday, March 20, 2008

Arrhythmia

Cardiac arrhythmia (also dysrhythmia) is a term for any of a large and heterogenous group of conditions in which there is abnormal electrical activity in the heart. The heart beat may be too fast or too slow, and may be regular or irregular.
Some arrhythmias are life-threatening medical emergencies that can result in cardiac arrest and sudden death. Others cause aggravating symptoms such as an abnormal awareness of heart beat, and may be merely annoying. Others may not be associated with any symptoms at all, but pre-dispose toward potentially life threatening stroke or embolus.
Some arrhythmias are very minor and can be regarded as variants of normal. In fact, most people will sometimes feel their heart skip a beat, or give an occasional extra strong beat - neither of which are usually a cause for alarm.
The term sinus arrhythmia refers to a normal phenomenon of mild acceleration and slowing of the heart rate that occurs with breathing in and out. It is usually quite pronounced in children, and steadily lessens with age.

Causes:
Many times, there is no recognizable cause of an arrhythmia. Heart disease may cause arrhythmias. Other causes include: stress, caffeine, tobacco, alcohol, diet pills, and cough and cold medicines.

Treatment:
Because arrhythmias are such a heterogenous group of conditions, treatment needs to be carefully selected by a patient with their physician. Some arrhythmias require no treatment at all. Others require immediate emergency treatment if death is to be avoided.
Treatments include physical maneuvers, antiarrhythmic drugs, other drugs, electricity, and electro or cryo cautery.
Physical maneuvers-A number of physical acts can increase parasympathetic nervous supply to the heart, resulting in blocking of electrical conduction through the AV node. This can slow down or stop a number of arrhytmias that originate above or at the AV node. Parasympathetic nervous supply to the heart is via the vagus nerve, and these maneuvers are collectively known as vagal maneuvers.
Antiarrhythmic drugs-There are many classes of antiarrhythmic medications, with different mechanisms of action and many different individual drugs within these classes. Although the goal of drug therapy is to prevent arrhythmia, nearly every antiarrhythmic drug has the potential to act as a pro-arrhythmic, and so must be carefully selected and used under medical supervision.
Electricity-Cardioversion is the application of a shock synchronised to the underlying heartbeat. It is used for treatment of supraventricular tachycardias. In elective cardioversion, the recipient is usually sedated or lightly anesthetized for the procedure.
Defibrillation or cardioversion may be accomplished by an implantable cardioverter-defibrillator (ICD).

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