Palpitations and Rhythm Disorders

The irregular working of the heart as a result of a malfunction in the heart electrical system is called arrhythmia or dysrhythmia. Arrhythmias may occur as bradycardia (slow heart work) as a result of the slowing of the electrical signals of the heart, tachycardia (fast work of the heart) with the acceleration of the electrical signals, and rhythm irregularity as a result of irregular signals. A pulse rate of less than 60 per minute at rest is called bradycardia, and over 100 is called tachycardia. Rhythm disturbances may cause dizziness, weakness, palpitations, sweating, shortness of breath, chest pain, falling and rarely fainting.

Rhythm disorders that manifest as slowing of the heart are called bradycardia. It is formed as a result of the cells in the center (sinus node), which generate electrical signals in the heart, or disorders in the conduction pathways. It can manifest itself in the form of intermittent pauses or excessive slowing of the heart. The pulse may not be taken intermittently or it may drop to 25-30s per minute. As a result, symptoms such as fainting attacks, dizziness, weakness or fatigue are observed in the patient. This may be caused by the deterioration of the conduction system due to aging, infections involving the heart muscle, coronary artery diseases, heart attack, certain drugs, hypothyroidism (goiter), and electrolyte disturbances in the blood. Although many can be corrected with treatment, a pacemaker is the only mandatory option in the treatment of a significant proportion of bradycardia.

Tachycardias is a resting heart rate above 100 per minute. It manifests itself in the form of palpitations in the patient. They often start abruptly and end abruptly. Fatigue, insomnia, stress, sudden excitement can cause palpitations to begin. Sometimes palpitations may occur for no apparent reason. You never know when the palpitation will start or how long it will last. Again, during palpitation, sweating, dizziness, shortness of breath, darkening of the eyes and even fainting can be seen.

When tachycardias originate in the atria of the heart, they are called supreventricular tachycardias. Supraventricular tachycardias are usually benign arrhythmias, which start abruptly in the form of palpitations and continue for a while, then abruptly terminate spontaneously or are terminated by various intravenous drugs in emergency services. Dizziness, blackout, numbness may occur during palpitation. After palpitations, fatigue and exhaustion can be seen.

Tachycardias originating from the ventricles of the heart are called ventricular tachycardias. Ventricular tachycardias are more dangerous than supraventricular tachycardias. Types of ventricular tachycardia, called ventricular fibrillation, which causes sudden death within a few minutes, can be observed in those who have had a heart attack and have heart failure, those with heart muscle disease (cardiomyopathy) and those with congenital genetic ion channel disorders. Sudden cardiac death may develop in those with congenital genetic ion channel disorders and cardiac muscle hypertrophy without any prior clinical symptoms.

In addition, another rhythm disorder that originates from the atria and causes irregular heartbeats can cause clot formation in the heart, clotting in the body, and as a result, severe complications such as paralysis. To prevent this, patients should receive anticoagulant therapy.

There are two options for the treatment of rhythm disorders. The first of these is rhythm-regulating drugs. The frequency of palpitations can be reduced or completely suppressed by drug therapy. However, palpitations reappear when the drug is discontinued. In some patients, the drug may not have any effect or may not be able to use the drug due to drug-related side effects. In such cases, radiofrequency ablation therapy, which is the second and definitive treatment option, should be applied. Radiofrequency ablation treatment; Without anesthetizing the patient, the focus or mechanism causing arrhythmia in the heart is detected by anesthetizing the inguinal region and entering with a single needle, through the catheters placed into the heart. Then, arrhythmia is eliminated by applying radiofrequency energy to this determined focus (popularly known as burning therapy). After the treatment, patients can return to work one day later.

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