Easy Guide To: Palpitations And Irregular Heartbeats In Women

Palpitations in Women


Irregular Heartbeat


What Are Arrhythmias?
What Causes Them?
What Are The Symptoms?
What Are The Risk Factors?
What Types Are There?
How Are Arrhythmias Diagnosed?
How Are They Treated?
Can Arrhythmias Be Prevented?


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Overview Of Arrhythmias

Arrhythmia Risk Factors
Heart Palpitations

Type Of Arrhythmias

Summary Of Types
Atrial Fibrillation
Ventricular Fibrillation

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What Are Arrhythmias?

Any abnormality in the rhythm or rate of your heartbeat is called an arrhythmia. They occur when the electrical impulses that regulate the timing of heartbeats (or contractions of the heart), do not work properly. They can range in severity from the incidental harmless skipped heart beat to life-threatening emergencies. During an arrhythmia, the heart can beat too slow, too fast or in an irregular manner. A heartbeat that is too slow is known as bradycardia and one that is too fast is tachycardia (both also come under the general term palpitations, although not all palpitations are caused by arrhythmias). If palpitations are noted and are not easily attributed to drinking too much coffee, emotional stress or strenuous exercise, a doctor should be consulted to rule out any possible underlying medical cause. While some arrhythmias may be a cause for worry, fortunately advances in treatment means that the prognosis is good in most cases. Millions of American's have arrhythmias but they are particularly common in older people with heart disease. About 2.2 million Americans have atrial fibrillation, the most common type of arrhythmia. Statistically, of all the types of arrhythmia, ventricular fibrillation is the most likely to cause sudden cardiac death (an estimated 335,000 every year, US). See Heart disease stats (America) and UK heart disease statistics, as well as what a regular heart beat looks like).

Heartbeat, Heart rate and Pulse. What's The Difference?

Your heartbeat is when the heart expands and contracts and blood is pumped through it's chambers. The average heart beats about 100,000 times in a day. If you place your hand over your heart you can feel your heartbeat. Your heart rate is how many times your heart beats in a minute. You can measure this by taking your pulse. Your pulse is a measurement tool for checking your heart rate.

What Causes Them?

Causes of arrhythmias: Every second an electrical impulse starts in the right atrium of the heart (picture of heart) and travels through the heart, triggering one single heartbeat or contraction of the heart that pumps blood through the body. An arrhythmia occurs when this electrical signal is either blocked or delayed. The signal starts in the 'pacemaker' area of the heart (technically called the sino-atrial node, S-A node). The S-A node sends out an electrical signal prompting other cells in the heart to contract so that blood is pushed into ventricles. Another node, the atrio-ventricular or A-V node is prompted to stop the flow of blood, allowing the ventricles to fill with blood so that it can then be pumped out to the body. An arrhythmia occurs when these signals are interrupted. The most common causes for signals to fail include:
1. Heart failure can cause the heart tissue to be stretched, causing arrhythmias.
2. When electrolytes in the blood, such as potassium, become imbalanced.
3. When excitement or stress raises the epinephrine (adrenaline) levels in the blood. Read about the dangers of stress.
4. Some substances such as caffeine, alcohol and cocaine can cause temporary palpitations.

What Are The Symptoms?

The following are typical symptoms of arrhythmia:
1. Palpitations: Awareness of your own heartbeat.
2. An irregular heart beat.
3. A slow heartbeat.
4. A feeling of skipping a heartbeat.
More serious symptoms include:
5. Pounding or racing heart.
6. Chest pain.
7. Anxiousness or sweating.
8. Dizziness, weakness or fainting.
9. Shortness of breath.

What Are The Risk Factors?

People with:

1. Underlying heart disease, in particular coronary heart disease (CHD).
2. An enlarged heart.
3. Pregnant women have increased risk (heart disease in pregnancy).
4. Hyperthyroidism increases the risk.
5. An underlying heart defect, such as Wolff-Parkinson-White syndrome can cause arrhythmias.
6. Arrhythmias are also common in women with severe anorexia nervosa and can prove fatal.
7. Stress, smoking, excessive alcohol or too much exercise can also cause arrhythmias. See, risk factors for heart disease.
8. Some people find caffeine or the use of prescription or certain OTC medications can trigger an attack.

What Types Are There?

There are quite a few different types of arrhythmias but they tend to fall into 4 main categories: (1) premature contractions, (2) supraventricular arrhythmias (fast heart rates), (3) ventricular arrhythmias and (4) bradyarrhythmias (slow heart rates):

(1) Premature (Extra) Contractions

One of the most common types of arrhythmia, premature contractions, are usually quite harmless. Very often they do not cause symptoms, but if they do it may feel like a fluttering or sometimes a thump in the chest. They occur when the heart's chambers contract sooner than normal, breaking the regular heartbeat. Premature contractions do not require treatment and can be bought on by too much caffeine, exercise, stress or smoking.

(2) Supraventricular Arrhythmias

These are where the heart beats too fast - known as tachycardias. Types of supraventricular arrhythmias include atrial fibrillation (AF), paroxysmal atrial tachycardia (PAT) and atrial flutter.

Atrial Fibrillation (AF)
This is most common type of serious arrhythmia. In atrial fibrillation (AF) the normal electrical impulses in the heart are overwhelmed and disorganized causing very fast and irregular contractions in the atria. It is usually seen in patients with CHD, but it can also occur for no apparent medical reason. It may also be associated with hypertension, and rheumatic heart disease. If blood clots develop as a result of AF and travel through the aorta it can lead to a stroke.

Paroxysmal Atrial Tachycardia (PAT)
This involves a very fast heart beat which begins and ends suddenly. It feels like a pounding heartbeat and is often accompanied by a feeling of dizziness or light-headedness. More common in young people PAT is not usually dangerous. It can usually be treated with lifestyle changes such as eliminating stimulants like caffeine and smoking or by avoiding strenuous physical activity.

Atrial Flutter
Similar to AF, but instead of electrical signals causing a fast and irregular rhythm; they cause a fast and REGULAR rhythm. Atrial flutters are far less common than AF but have similar symptoms and complications.

(3) Ventricular Arrhythmias

Ventricular Tachycardia (VT)
Like PAT, ventricular tachycardia can be characterized by attacks of rapid heartbeat, dizziness and sometimes chest pain or fainting. Patients often describe feeling a dread that 'something bad is about to happen'. VT is however more dangerous than PAT in that it can degenerate into ventricular fibrillation (VF).

Ventricular Fibrillation (VF)

Highly lethal, ventricular fibrillation (VF) occurs when disorganized electrical signals causes the ventricles in the heart to quiver rather than pump normally. Instead there is a series of twitching movements with no pumping action. After a few minutes the heart ceases to function and the person dies. The condition needs to be treated instantly with an electric shock to the heart (automated external defibrillator) in order to prevent death.

(4) Bradyarrhythmias

Bradycardia, or 'brady' are arrhythmias in which the heart beats slower than normal. A slow heart rate is strictly defined as 60 beats per minute (bpm). Medical problems do not however usually occur until heart rates fall below 40 bpm. Some people may have normally slow heart rates which are not considered dangerous, athletes in particular commonly have a bpm below 60. But in other people a slow heart rate may be due to a serious underlying condition. Certain drugs, particularly in the elderly, can cause bradycardia.

How Are Arrhythmias Diagnosed?

Arrhythmia diagnosis: If an arrhythmia is suspected the doctor’s first goal is to determine the type of arrhythmia present by ordering an ECG (also known as an electrocardiogram or EKG. An ECG is a simple and non-invasive test which records the electrical activity of the heart. As arrhythmias can come and go, it may be necessary to wear a miniaturized version of the ECG called a Holter Monitor for 24 hours. Other possible tests include an Event Monitor, echocardiogram, stress tests and electrophysicological testing. The latter involves threading tiny electrodes through the veins and into heart, a procedure which requires hospitalization and experienced cardiologists.

How Are They Treated?

Arrhythmia treatment: Most arrhythmias can be treated with medication or surgical implants.

Common arrhythmias are treated with medications which either slow down the heart rate or regulate it, depending on the type of arrhythmia present. These drugs come under the general term antiarrhythmics and include digoxin, flecainide, tocainide, amiodarone and propafenone. Beta blockers and calcium channel blockers are also used as well. Patients with AF are often treated with blood thinners (anticoagulants) to prevent the chance of blood clots occurring. Currently there are no medications which can speed up a slow heart rate.

Some arrhythmias are treated with the implantation of a pacemaker device. Permanent pacemakers can correct slow heartbeats and are implanted underneath the skin just below the collarbone. A pacemaker consists of a battery with one or 2 leads which are positioned in the right side of the heart. They can last up to 15 years before needing replacement. Patients at risk of ventricular fibrillation may be implanted with a device called an implantable cardioverter defibrillator (ICD). While pacemakers deliver mild regular electrical shocks, an ICD provides powerful bursts of electricity whenever it detects rhythms that might result in ventricular fibrillation.

Vagal Maneuvers
These are simple home techniques which can stop or slow down some types of supraventricular arrhythmias. Always discuss any treatment with your doctor first. Vagal maneuvers include:
1. Gagging.
2. Holding your breath and bearing down.
3. Coughing.
4. Immersing your face in very cold water.
5. Placing your fingers on your eyelids and pressing down gently.

Can Arrhythmias Be Prevented?

Arrhythmia prevention: The best prevention for arrhythmias is to reduce your risk of CHD (see CHD prevention). As smoking, caffeine intake and extremely low calorie intake increase the chances of developing arrhythmias in younger people (in particular), lifestyle changes in this area may also be necessary. Recent studies show that while stress and strong emotions (such as anxiety) may contribute to an episode of arrhythmia, it does not generally cause it. This can be comforting news to those diagnosed with the condition as it means that there is no need for family members or friends to walk on egg shells around them.

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