(Arrhythmia) In severe cases, it can even lead to cardiac arrest… When is it absolutely necessary to receive treatment?

Arrhythmia, in severe cases, can lead to cardiac arrest, requiring accurate diagnosis and management. If there's an abnormality in the heart's electrical signal generation and transmission, the heartbeat can become irregular, either accelerating or slowing down. This is called arrhythmia.

 

Arrhythmias are broadly categorized as "tachycardia" and "bradycardia." Tachycardia-type arrhythmias include "atrial fibrillation," which manifests as an irregular heartbeat, and "premature beats," which are felt as if the heart is suddenly slowing down. Paroxysmal supraventricular tachycardia, characterized by a rapid heartbeat, can cause sudden cardiac arrest.

Conversely, bradycardia means that the pulse is very slow, less than 60 beats per minute. A typical bradycardia is sinus bradycardia, which occurs when the sinus, which generates electrical impulses, is weakened. When bradycardia occurs due to a blockage in the conduction pathway that helps the pulse spread throughout the heart and contract evenly, it is diagnosed as a conduction disorder. Patients with bradycardia experience dizziness, weakness, and shortness of breath even with the slightest movement. Professor Choi Eui-geun of the Department of Cardiology at Seoul National University Hospital stated, “There are various causes of arrhythmia,” he said. “Not only congenital and acquired heart disease, but also lifestyle habits such as smoking, alcohol, and caffeine, concomitant diseases such as high blood pressure, diabetes, and thyroid disease, obesity, old age, and hereditary arrhythmia can also have an effect.”

 

In hospitals, electrocardiograms (ECGs) are used to identify electrical abnormalities in the heart and diagnose arrhythmias. The test involves attaching multiple electrodes to the body and lasting approximately 10 seconds. If a definitive diagnosis cannot be made within 10 seconds, an "ambulatory ECG" test, which involves wearing the device 24 hours a day, may be performed.

 

Lifestyle modifications are crucial for arrhythmias. Patients with tachyarrhythmias, such as atrial fibrillation, must especially assess their lifestyle habits for potential problems, such as overwork, excessive drinking, overeating, and stress. Continuing with other treatments without addressing lifestyle risk factors will result in limited results.

 

If lifestyle changes aren't feasible, medications are often used. Antiarrhythmic drugs are a common treatment option. They are used to treat tachycardia, a rapid heartbeat. While taking these medications, you may experience palpitations, dizziness, or weakness, indicating a change from tachycardia to bradycardia. In this case, it's recommended to consult a specialist for a diagnosis. Patients with atrial fibrillation may also take anticoagulants, which inhibit blood clotting to prevent blood clots.

There are also ways to treat arrhythmias through procedures.

Patients with bradycardia can undergo a procedure to implant an artificial pacemaker, and patients who survive a cardiac arrest and receive CPR may have an implantable cardioverter-defibrillator implanted to prevent recurrence. The goal for tachyarrhythmia is to find and treat the cause, and radiofrequency ablation can be used to locally detect and block the area where the arrhythmia is occurring. Professor Choi Eui-geun said, “If drug treatment is ineffective and blood pressure continues to drop, causing the patient to lose consciousness, we may perform an ‘electrical sinus conversion’ procedure, which delivers an electrical shock to the heart to convert it to normal sinus rhythm.”

 

If your arrhythmia is stable or has fully recovered after treatment, appropriate exercise is recommended. The World Health Organization recommends at least 150 minutes of walking or 70 minutes of running per week. Even if you don't have arrhythmia, regular aerobic exercise can help prevent it.

 

However, exercise is dangerous for patients with tachycardia (arrhythmia with a pulse rate exceeding 120 beats per minute). Patients with bradycardia and a pacemaker implanted should avoid contact with water for one to two weeks. Because the pacemaker is connected to the heart, they should also avoid strenuous activities, such as moving their arms or lifting heavy objects.

 

Professor Choi “If your arrhythmia is well-controlled and stable, it is okay to have one or two cups of coffee, but you should avoid energy drinks that contain too much caffeine,” he said. “If you have vague anxiety about arrhythmia, Rather than feeling it, I hope you will receive an accurate diagnosis and treatment through expert consultation.”