Beware of Heart Rhythm Disorders: Understanding Arrhythmia and How to Treat It

Have you ever felt your heart suddenly pounding for no apparent reason, feeling like it's skipped a beat, or having an irregular rhythm? Medically, this condition is known as arrhythmia, a disorder of the heart's electrical system that can cause it to beat too fast (tachycardia), too slow (bradycardia), or irregularly. Although often ignored, arrhythmia can be a sign of a serious problem that can lead to dangerous complications such as stroke, heart failure, or sudden cardiac arrest.

Arrhythmia: Disorder of Regular Heartbeat

Our heart has a natural electrical system. This system generates and transmits electrical impulses (electrical signals) that act as "commands" to trigger each heartbeat at a regular rate. Arrhythmias occur when the formation or transmission of these electrical impulses is disrupted, such as by a short circuit or an inappropriate "detour." This disruption causes an abnormal heart rhythm:

  • Tachycardia: Resting heart rate exceeding 100 beats per minute.
  • Bradycardia: Resting heart rate below 60 beats per minute.
  • Irregular Rhythm: Such as atrial fibrillation or extrasystoles, where the heartbeat feels inconsistent and chaotic.

Triggering Factors for Arrhythmia

Some conditions that can trigger arrhythmia include:

  • Structural Heart Damage: For example, previous heart attack, heart failure, or cardiomyopathy.
  • Hypertension: High blood pressure puts extra strain on the heart.
  • Thyroid Disorders: Either an overactive (hyperthyroid) or underactive (hypothyroid) thyroid gland.
  • Electrolyte Imbalance: Abnormal levels of potassium, sodium, calcium, or magnesium.
  • Lifestyle: Excessive alcohol consumption, smoking habits, stress, and lack of sleep.
  • Other Factors: Consumption of certain medications and family history.

Symptoms to Watch Out For

Not all arrhythmias cause complaints, but act immediately if you experience:

Emergency Symptoms (Need Immediate Treatment)

  • Severe chest pain or a feeling of pressure in the chest.
  • Severe shortness of breath.
  • Fainting or near fainting.
  • Very fast (>150/minute) or very slow (<40/minute) heart rate accompanied by severe dizziness.

Symptoms That Require a Doctor's Evaluation

  • Heart palpitations accompanied by a sensation of "stopping" or "racing".
  • Extreme fatigue without any apparent cause.
  • Light dizziness or feeling of floating.
  • Shortness of breath during light activity.

Initial tests such as an EKG (electrocardiogram) can detect any rhythm abnormalities. For symptoms that come and go, your doctor may recommend monitoring with a Holter Monitor or Event Recorder.

Treatment Options for Arrhythmia

Treatment for arrhythmia depends on the type, severity, and health condition of the patient. Some available options are:

1. Lifestyle Modification

  • Controlling comorbidities such as hypertension and diabetes.
  • Limit or stop alcohol and cigarette consumption.
  • Manage stress, get enough sleep (7–9 hours per day), and maintain ideal body weight.

2. Drug Therapy

  • Rhythm Stabilizers
  • Heart Rate Control Medications
  • Medicine used primarily in atrial fibrillation to prevent stroke

3. Medical Procedures and Device Installation

  • Cardioversion: A procedure to restore normal sinus rhythm with an electric shock.
  • Catheter Ablation: A procedure to neutralize the source of electrical "short circuits" in the heart.
  • Pacemaker: A device implanted to stimulate the heartbeat in cases of severe bradycardia.
  • ICD (Implantable Cardioverter Defibrillator): A device that can detect and stop dangerous arrhythmias automatically.

Arrhythmia can affect anyone, not just those with a history of heart disease. Early detection is crucial to prevent serious complications. If you notice any irregularities in your heart rhythm, don't delay seeing a cardiologist. Accurate diagnosis and prompt treatment are key to maintaining long-term heart health.

Article written by Dr. Kadek Satrya K. Suratna, Sp.JP, FIHA (Heart and Blood Vessel Specialist at EMC Pekayon & Cibitung Hospital).