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Arrhythmia

Cardiac rhythm disturbances are a common reason for ER visits, hospitalizations, and long-term cardiovascular morbidity. These disorders range from relatively benign to life-threatening, capable of causing sudden cardiac death. Advances in electrophysiology, imaging, and risk managment have substantially refined how doctors evaluate these conditions and select appropriate therapies, including pharmacologic treatment, catheter ablation, and device based treatment.

A heart arrythmia is an irregular heartbeat. This happens when the electrical signals that tell the heart to beat don't work as they should. The heart may beat too fast or too slow. Or the pattern of the heartbeat may be inconsistent.

AF, Atrial Fibrillation is significantly higher in men than in women in all age groups, and appears to be more common in Caucasians than in African Americans. Herein, there is an irregular pulse and tachycardia, with heart rates typically in the range of 100 to 150 beats/min.

 The arrhythmia generally originates from a single, well-defined focus (eg, the ventricular outflow tracts, papillary muscles, or valve annuli), and advanced imaging or electrophysiologic studies typically do not reveal a myocardial scar.

ICDs are primarily used to prevent sudden cardiac death in patients with structural heart disease or high-risk ventricular arrhythmias. These do not eliminate the arrhythmia itself, unlike catheter ablation which directly targets the arrhythmogenic focus and is used to reduce recurrence in some patients.

Left atrial enlargement is predictive of AF after atrial flutter ablation

Carotid sinus massage can stimulate vagal activity to terminate tachycardia, it is generally less effective than Valsalva-based techniques and carries additional precautions, such as the risk for embolization in patients with carotid artery disease.

Recognizing When to Go to the ER:

1. Chest Pain or Discomfort

2. Shortness of Breath

3. Irregular Heartbeat

4. Severe Fatigue or Weakness

5. Loss of Consciousness

6. Swelling in legs, ankles & abdomen and Sudden Weight Gain

7. Severe or Unexplained Nausea and Sweating

 

Author
Paddy Kalish OD, JD and B.Arch Author and Blogger

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