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A Patient's Guide to Heart Surgery

What is an Arrhythmia?

Heart failure impairs both the heart muscle and the heart's electrical system. Disturbances of the heart's normal rhythm - known as arrhythmias - result from problems with the electrical system. Because of heart muscle damage, patients with heart failure commonly have arrhythmias, especially from the lower chambers of the heart (the ventricles) consisting of slow, fast, or irregular heart beats.

A normal heartbeat is triggered by an electrical impulse which starts in the Sinoatrial (SA) Node. The impulse then travels across the Atrioventricular (AV) Node and triggers the ventricles to contract.

Management of arrhythmias in heart failure patients is a specialized field and requires the collaboration between arrhythmia and heart failure specialists. Some of the drugs made to suppress these rhythm disturbances can also decrease the heart's pumping ability, which could worsen heart failure and in turn cause more arrhythmias. The goal of therapy is to treat the arrhythmia and the heart failure together.

Extra or rapid heart beats, called palpitations, are sometimes felt as "fluttering sensations" in the chest. Some people faint or feel dizzy or short of breath. Still others may feel chest pain or nothing at all when they have an arrhythmia. Generally, but not always, the longer the arrhythmia lasts, the more severe the symptoms.

Arrhythmias are divided into two main types:

Both can be especially dangerous to someone with heart failure and a weakened heart muscle (cardiomyopathy). When the heart beats too slowly, too little blood is pumped out to the rest of the body. When the heart beats too quickly, it cannot fill completely so the body does not receive the blood volume it needs to function properly.

Arrhythmias are often diagnosed by cardiac exam, electrocardiogram (ECG), Holter monitor, event recorder, or an invasive examination of the heart called electrophysiology study. After thoroughly examining you and determining that you do have an arrhythmia or are at high risk to develop one, the doctor may order one or more tests to determine the type of arrhythmia present, what may have caused it, and how to treat it.

Related link: Atrial Fibrillation

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