Is it time to see a heart rhythm specialist?
Ventricular arrhythmias (ven-TRI-kyuh-lar uh-RITH-mee-uhs) are problems with the electrical signals in your heart. These conditions make your heart beat too fast or cause the heart’s rhythm to become out of sync. Arrhythmia means a change in the heart’s rhythm or force.
A healthy heart at rest beats at a steady rhythm of 60 to 100 times per minute. Ventricular arrhythmias cause problems with the heart’s electrical system, leading it to beat too fast, or sometimes, chaotically.
Your heart has four rooms, or chambers. The lower two chambers are called ventricles (VEN-tri-kulls). When an arrhythmia occurs in the ventricles, the heart has a hard time pumping enough blood to the body.
Left untreated, some types of ventricular arrhythmias may lead to fainting, dizziness, lightheadedness, a loss of consciousness and sudden cardiac arrest or death.
There are several types of ventricular arrhythmias, including:
Arrhythmias are caused when the electrical signals in the heart don’t fire as they should. If the heart does not squeeze and release in a certain way at a certain time, blood can’t move through the body. This can cause symptoms such as lightheadedness, dizziness, shortness of breath and fatigue. There are different types of arrhythmias, depending on where the arrhythmia starts from and how the muscles move. Ventricular arrhythmias only affect the lower two chambers of your heart.
Premature ventricular contractions
Premature ventricular contractions (PVC) are extra heartbeats that start in the ventricles. It may feel as if your heart has skipped a beat and then beats very hard for one or two beats. This feeling is caused by an electrical impulse sent too soon to the heart’s ventricles, so that extra beat occurs before a normal heartbeat would.
After a PVC, blood begins to fill the ventricle. The additional amount of blood in the heart gives the next beat extra force, making it feel stronger. Symptoms include heart palpitations that feel like a fluttering or flip-flopping in the chest.
This arrhythmia is not dangerous in healthy people because it usually doesn’t affect the heart. But in people with heart problems, such as a heart valve disease, or those who have had a heart attack, PVC can trigger more dangerous arrhythmias. These can include ventricular tachycardia or ventricular fibrillation.
Premature ventricular contractions can be caused by:
Ventricular tachycardia (VT) is when your heart beats very fast – more than 100 beats per minute. A healthy heart rate is about 60 to 100 beats a minute while you are at rest.
During VT, the chambers can’t fill up with enough blood. When the heart muscle squeezes and pushes out what little blood there is. This means the body isn’t getting enough oxygen, which leads to very serious problems. VT requires immediate medical attention.
Causes of ventricular tachycardia:
Symptoms of ventricular tachycardia:
Treatment for ventricular tachycardia
Some types of VT require an implantable cardioverter-defibrillator, which checks your heart rhythms and sends an electrical signal to bring your heart back into a normal rhythm as needed.
Your health care provider may recommend you have a ventricular catheter ablation. This is a minimally invasive procedure that uses hot or cold energy to scar the part of the heart that causes the misfiring.
There are also some medications that might help correct your arrhythmia.
Ventricular fibrillation is a life-threatening condition. The heart’s electrical signals become irregular. The ventricles then quiver, rather than squeezing and releasing. Blood gets trapped in the heart and cannot circulate to the body. Left untreated, VT can lead to sudden cardiac arrest, and in severe cases, death.
A heart attack is the most common cause of VT. Other causes of ventricular tachycardia include:
Symptoms of ventricular tachycardia include:
Survival is possible with immediate treatment, using either an automated external defibrillator (AED) found in public places or a defibrillator in an emergency department.
Besides some of the causes listed above, ventricular arrhythmias can also be caused or affected by:
If you have symptoms of ventricular tachycardia, your health care provider will start with a physical examination and ask questions about your symptoms, your family and personal medical history, and your lifestyle habits such as diet and exercise.
If you have signs or symptoms of tachycardia, tests can be done to evaluate the heart and help confirm the diagnosis. Tests can also help determine if another health problem is contributing to ventricular tachycardia. There are many types of test your physician may order.
An electrocardiogram (e-LEK-troh-CAR-dee-oh-gram) is the most common test used to diagnose tachycardia. This painless exam detects and records the heart’s electrical activity using small sensors on to the chest and arms.
An EKG records the timing and strength of electrical signals as they travel through the heart. Patterns in the signals help physicians see where the problem might be coming from.
There are also many types of portable heart rhythm machines you can use at home to get more information about your heart rate. These devices include:
Heart (cardiac) imaging
Like many other things in life, ventricular fibrillation will affect you differently than it affects someone else. It’s important that you see your own health care team to get a personalized treatment plan.
There are many kinds of treatment for ventricular arrythmia.
Ventricular fibrillation that lasts longer than 30 seconds usually requires urgent medical treatment, as this condition may sometimes lead to sudden cardiac death. If you or a loved one is experiencing an abnormal heartbeat for longer than 30 seconds, seek immediate care.
Since VT is a condition based on abnormal heartbeats, the goal of treatment is to slow a fast heartbeat and to stop episodes from happening. This can be done with medications, lifestyle modifications and surgical procedures. Or it may be done by figuring out if there is an underlying condition causing the arrhythmia.
VT can be treated with medication, but there are some reasons why a ventricular ablation is right for you. You will talk to an electrophysiologist (eh-LEK-troh-fi-zee-AHLL-uh-just), who has an expertise in understanding your heart’s electrical signals. Before recommending ablation, the physician will check:
Your physician will also take into consideration your age.
If you have a device that sends electrical signals to your heart to get it to beat correctly, called an implantable cardioverter-defibrillator, ablation can reduce the number of times this device needs to send signals to your heart to get it to beat correctly.
The ablation procedure typically has a higher success rate than medication alone, which means there is less risk of symptoms returning. There is a low risk of complications with this procedure, as well as a quick recovery time.
Treatment for ventricular tachycardia involves managing any diseases that causes the condition, as well as the symptoms of VT. Common treatments for ventricular tachycardia include:
Medications: These can slow heart rate and may help your heart to maintain a safe rhythm. Your health care provider can help you understand the pros and cons of medications. Sometimes medicines called anti-arrhythmics can help with irregular abnormal heart rates. Your physician may also prescribe calcium channel blockers or beta blockers. These improve your heart’s ability to relax, pump blood and maintain a normal heart rate. Examples of beta blockers are carvedilol (Coreg) and metoprolol succinate (Toprol-XL).
This medical procedure is generally used when emergency care is needed for a rapid heart rate, such as that seen with sustained ventricular tachycardia. Cardioversion sends electrical signals to the heart through sensors (electrodes) placed on the chest. This affects the heart’s electrical signals and restores a regular heartbeat. It’s also possible to do cardioversion with medications.
When appropriate, a shock can also be delivered to the heart using an automated external defibrillator (AED).
As we know, everyone is affected differently by their ventricular arrhythmia. Most of the time, the best thing you can do is take your medication as instructed and see your provider regularly. You should also pay attention to your symptoms and report any changes to your provider, especially if symptoms suddenly change or get worse.
There are a few lifestyle habits that can help reduce the number and severity of an episode, including:
The outlook is good for people who get an early diagnosis and prompt treatment, and who follow the health care provider’s recommendations. You should also:
Follow your treatment plan, ask your provider when you have questions and make the lifestyle changes you need to stay healthy. Tell your family and friends about your treatment plan. Often, people with ventricular arrythmias don’t look sick, and others can assume you’re healthy. Educate them on your condition and ask for support. The experts at the Norton Healthcare Heart Rhythm Center can help you do all this and more.
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