Heart Rhythm Disorders (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- How does the heart work?
- What is a heart rhythm disorder (arrhythmia)?
- What causes heart rhythm disorders?
- What are the signs and symptoms of heart rhythm disorders?
- What are the different types of heart rhythm disorders?
- Premature atrial contractions (PACs) and premature ventricular contractions (PVCs)
- Sinus tachycardia
- Sinus bradycardia
- Abnormal heart rhythms
- Ventricular fibrillation (V-fib)
- Ventricular tachycardia (V-tach)
- Paroxysmal supraventricular tachycardia (PSVT)
- Wolff-Parkinson-White (WPW) syndrome
- Atrial fibrillation (A-fib)
- Atrial flutter
- Heart blocks
- When to seek medical care
- How are heart rhythm disorders diagnosed?
- What is the treatment for heart rhythm disorders?
- What is the prognosis for heart rhythm disorders?
- Can heart rhythm disorders be prevented?
- Find a local Cardiologist in your town
Atrial flutter is similar to atrial fibrillation except that instead of having chaotic electrical firing from all points in the atrium, one point has become irritated and can fire 300 times per minute or more. Many issues that exist for atrial fibrillation apply to atrial flutter. Atrial flutter may degenerate into atrial fibrillation, and the two can often coexist.
Aside from medications that are meant to slow the heart for treatment of a variety of medical problems, bradycardia (brady = low + cardia = heart) is usually due to heart block and the aging of the electrical wiring of the heart. This is no different than the aging of your home's electrical system; but instead of being able to rewire the heart, these conditions may need to be treated with an implantable pacemaker.
Heart blocks involving the ventricle may be asymptomatic and of little consequence except to point to underlying heart or lung disease. They are diagnosed by EKG.
Heart blocks involving the atrium can be classified as first-, second-, and third-degree.
- First-degree heart block is common and usually of little significance. There is a slight delay in getting the electrical signal from the SA node to the AV node, but the heart functions normally.
- There are two types of second-degree heart block (Mobitz I and Mobitz II, with Type II being more serious than Type I.
- Third-degree heart block describes the complete loss of connection between the electrical activity of the atria and the ventricles. Second- and third-degree heart blocks are diagnosed by analyzing heart rhythm strips and EKGs.
Heart blocks are symptomatic because the heart beats so slowly that cardiac output is decreased. The symptoms may include lightheadedness or passing out (syncope), weakness, shortness of breath, and chest pain.
Diagnosis and treatment of life-threatening heart block happen at the same time. Often, the patient with bradycardia may be taking medications that can slow the heart including beta blockers and certain calcium channel blockers. If the patient is stable, time can be taken to have the medications wear off while the patient is monitored. If the bradycardia remains, a pacemaker may be needed. In certain situations, a temporary pacemaker can be placed to stabilize the patient, while decisions are made as to a permanent solution.
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