Classification of Arrhythmias

Introduction

Arrhythmia is a broad term referring to any irregular heartbeat. It can manifest as bradycardia (slow heart rate), tachycardia (fast heart rate), or irregular rhythms. Understanding the classification of arrhythmias is crucial for proper diagnosis and treatment.

Main Types of Arrhythmias

1. Bradyarrhythmias (Slow Heart Rhythms)

These are characterized by a heart rate of fewer than 60 beats per minute (bpm). Causes may include: - Sinus node dysfunction (e.g., sick sinus syndrome) - Atrioventricular (AV) block (first-degree, second-degree, or third-degree)

2. Tachyarrhythmias (Fast Heart Rhythms)

These occur when the heart beats too fast (above 100 bpm). They are divided into: - Supraventricular Tachycardias (SVT) (arising above the ventricles): - Atrial fibrillation (AF) - Atrial flutter - AV nodal reentrant tachycardia (AVNRT) - Wolff-Parkinson-White (WPW) syndrome - Ventricular Tachyarrhythmias (arising in the ventricles): - Ventricular tachycardia (VT) - Ventricular fibrillation (VF)

3. Ectopic Beats and Extrasystoles

Premature contractions originate from abnormal sites in the heart, leading to extra or missed beats: - Premature atrial contractions (PACs) - Premature ventricular contractions (PVCs)

Clinical Presentation

Symptoms of arrhythmias may include: - Palpitations - Dizziness or fainting - Shortness of breath - Chest pain - Sudden cardiac arrest (in severe cases)

Diagnosis

Arrhythmias are typically diagnosed using: - Electrocardiogram (ECG) – A crucial test for identifying abnormal rhythms. - Holter Monitoring – A 24-hour ECG recording. - Electrophysiological Study (EPS) – An invasive test to further define arrhythmia mechanisms.

Treatment Approaches

  • Lifestyle Modifications: Avoiding caffeine, alcohol, and stress.
  • Medications: Beta-blockers, antiarrhythmic drugs, or anticoagulants (for AF patients).
  • Medical Procedures:
    • Pacemaker implantation (for bradyarrhythmias)
    • Catheter ablation
    • Implantable cardioverter-defibrillator (ICD) (for life-threatening ventricular arrhythmias)

Conclusion

Understanding the classification of arrhythmias is essential for accurate diagnosis and management. If you experience symptoms, consult a cardiologist for proper evaluation.

Source recommendations

1. American College of Cardiology/American Heart Association Guidelines for the Management of Patients With Arrhythmias

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
  2. https://pubmed.ncbi.nlm.nih.gov/14563598/
  3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
  4. https://pubmed.ncbi.nlm.nih.gov/16949478/
  5. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2020/12/16/21/58/2020-ACC-AHA-VHD-GL-Pt-1-GL-VHD

2. European Society of Cardiology Guidelines on Cardiac Arrhythmias

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
  2. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
  3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Supraventricular-Tachycardia
  4. https://pubmed.ncbi.nlm.nih.gov/36017572/
  5. https://www.ahajournals.org/doi/10.1161/01.cir.0000091380.04100.84

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