Heart Arrhythmia

Affecting more than 4 million Americans, heart arrhythmia is an irregularity in your heartbeat that can feel like your heart is skipping a beat or fluttering. An irregular heartbeat can take many forms and each has a different root cause, including coronary heart disease, changes in the heart muscle and an imbalance in electrolytes in the blood.

When the two upper chambers of your heart (the atria) beat irregularly or out of sync with the lower chambers (the ventricles), atrial fibrillation occurs. As a result, the heart can beat faster than normal or beat irregularly, causing poor blood flow to the body. This form of arrhythmia is fairly common, affecting more than two million Americans. Atrial fibrillation is often associated with other forms of heart disease. Symptoms can include heart palpitations, shortness of breath, fatique and weakness.
What are the symptoms of ischemic ventricular tachycardia?Syncope, or fainting spell, is a common presentation for patients with this syndrome. In some patients, sudden cardiac arrest may be the first and only symptoms of these conditions. Yet other patients, there may be no symptoms at all or there may be vague symptoms such as shortness of breath or fatigue.What causes ischemic ventricular tachycardia?A prior heart attack, caused by the acute occlusion of one of the main coronary arteries (arteries that supply blood to the heart muscle), results in scar formation in the part of the heart supplied by that particular artery.  Over time, the border between the scar and healthy tissue (transitional zone) can allow electricity to go in and out of the scar (reentry), leading to incessant rapid heart beat.Consequences of ventricular tachycardia.This is a serious form of VT with presenting symptoms ranging from fainting spells to sudden cardiac arrest. If left untreated, this tachycardia is nearly universally fatal.Treatment OptionsWith rare exceptions, all patients with ischemic VT must be treated with an implantable defibrillator (ICD). Drug therapy with antiarrhythmic medications is no longer considered the standard of care as the failure rates for medications are unacceptably high (up to 50%).While ICD is the standard of care for ischemic VT, radiofrequency ablation may be a useful adjunctive therapy, especially in those patients whose VT recurs incessantly resulting in excessive number of ICD shocks.  The strategy in the ablation of this tachycardia is to create electrical isolation of the transitional zone in the ventricle where the electrical "circuit" of the VT resides.  This type of complex ablation will require specialized 3-D mapping system.
Supraventricular tachycardia (SVT) occurs when the heart’s normally precise heart rate speeds up, sometimes as fast as 150 to 200 beats a minute. The heart can return to its normal rate (60 to 100 beats a minute) on its own or through treatment. Often, a person will not know they are having arrhythmia due to SVT. Symptoms can include palpitations, light-headedness and chest pain. In some instances there may be confusion or even a loss of consciousness.
The onset of atrial flutter may go unnoticed, particularly at first, however people with hypertension, coronary artery disease and cardiomyopathy (a weakening of the heart muscle) are most likely to experience this type of arrhythmia, though a normal heart can have episodes of atrial flutter as well. Symptoms can include palpitations, shortness of breath, chest pain and nausea.