Today is Vascular Health Day. The purpose of establishing Vascular Health Day is to call on people to pay attention to vascular health, because abnormal blood vessels can cause circulation problems, and poor circulation may affect people’s overall health. “But we’re not talking about blood vessels here, but about a heart problem that can be affected by abnormal blood circulation: arrhythmia.

What is an arrhythmia? What causes an irregular heartbeat?

Usually the heart beats regularly. The normal heart rate is 60 to 100 beats per minute. As long as it exceeds this range, whether it is too fast, too slow or irregular, it is called arrhythmia.

The rhythm of the normal heart is called sinus rhythm, which is a common situation when ordinary people do ECG, but sometimes there are rhythm points that appear from other parts, which is also arrhythmia. If there are problems with the internal structure of the atrium, or blood circulation problems (such as abnormal blood vessels, vascular blockage, etc.), drugs, electrolytes, etc., it may cause atrial arrhythmia, which is usually manifested as fast heartbeat or early contraction. But in addition to the atria, the ventricles can have similar arrhythmias. Even at the atrioventricular junction between the atrium and the ventricle, conduction problems can occur, such as tachycardia; if transmission from the atrium to the ventricle is blocked, the heartbeat will be too slow, etc.

Arrhythmias can be caused by, in addition to age, structural problems, or circulation problems (such as abnormal coronary arteries), or electrolyte imbalances, or even drug use (such as cardiovascular drugs, some colds Drugs or sympathetic drugs, etc.), and some are caused by infection and inflammation, such as myocarditis.

Can arrhythmia be self-detected? What tests or diagnoses are needed?

Most patients can self-aware that their heartbeat is too fast or too slow. This kind of discomfort is called palpitations, but it is not necessarily arrhythmia. Similarly, sometimes they may feel that there is nothing abnormal, but it may also be arrhythmia.

A common symptom of an arrhythmia is palpitations , but sometimes sudden dizziness and fainting can occur if the heartbeat is too fast or too slow, resulting in insufficient cardiac output. In addition, wheezing can occur if the heart is already weak (heart failure). When a blood vessel is blocked, patients experience chest pain. Therefore, when there are these uncomfortable symptoms, further examination is necessary. Cardiovascular problems are no trivial matter, so don’t delay.

The most basic clinical objective evaluation and diagnosis basis is the electrocardiogram.

From the electrocardiogram, the wave patterns of the atria and ventricles can be seen to determine the cause of the irregular heartbeat. However, the patient’s arrhythmia sometimes occurs only occasionally. This situation will not be revealed by the ECG alone. At this time, the recording time must be extended (called Holter ECG or 24-hour ECG recording), which means that it needs to be carried for 24 hours. The instrument is monitored, so that abnormality can generally be found.

But for a slightly severe arrhythmia, some people may be in normal condition, but very uncomfortable once they have an attack, and they may not even have an attack within 24 hours. At this time, it can be recorded for a longer time (such as 1-2 weeks). ) or to record only the ECG at the time of the attack, sometimes an exercise ECG can also be used to check for exercise-related arrhythmias.

Sometimes, if a severe ventricular arrhythmia is suspected, a magnetic resonance imaging (MRI) of the heart is considered to see if there was any inflammation of the left ventricle or scar tissue from a myocardial infarction, as this can affect follow-up treatment. In addition, if the 24-hour ECG shows that the early ventricular contraction (VPC) exceeds 20% of the number of heartbeats in 24 hours, electrophysiological examination should be considered to decide whether to adopt special treatment methods to avoid the occurrence of danger.

What kind of arrhythmia is dangerous? Under what circumstances do I need immediate medical attention?

Severe arrhythmias can cause sudden cardiac arrest and even death, which is called sudden death.

Most of the causes of sudden death are ventricular fibrillation, but before the occurrence of ventricular fibrillation, there are often ventricular frequency pulses, which can cause syncope and may be a precursor to sudden cardiac death. Therefore, if syncope occurs frequently, seek medical attention immediately to determine whether there is a heart problem.

As for atrial fibrillation, which is common in older adults, it’s not immediately fatal, but if severe, it can also increase the risk of stroke. Therefore, people over the age of 70 should seek medical attention immediately if they have a fast and irregular heartbeat.

Of course, if the patient’s self-perceived discomfort increases, it also needs to be paid attention to. It may be that abnormal blood vessel problems are accumulating, such as severe blockage. If treatment is delayed, it may also lead to myocardial infarction.

How is arrhythmia treated?

Whether the heart is beating too fast or too slowly, drug therapy is the first choice.

Generally speaking, when the heart rate is slow, less than 40 beats per minute, and symptoms are present, and the drug control is not good, the use of a cardiac rhythm regulator will be considered. If it is tachycardia, in principle, drugs will be used first, but if there is a so-called convoluted tachycardia, or if it is atrioventricular tachycardia or atrial fibrillation, special treatment methods can be considered; ventricular fibrillation is An internal defibrillator (ICD) is required.

Basically, the treatment of arrhythmia is very safe and has a high success rate. As long as it is a paroxysmal heartbeat or arrhythmia at the junction of the atrium and ventricle, professional surgical treatment methods can be used, and the success rate can be as high as 99%, with few comorbidities and low recurrence rate. In the case of atrial fibrillation, drug control is usually the first priority, and anticoagulants are also important therapeutic drugs. However, after the drug is used, the seizures still occur frequently, and other surgical treatment methods can also be tried. The method is mainly to isolate the starting point (the first occurrence point) in the left atrium. The success rate can also reach 80%, but the recurrence rate is about 20% higher. %.

What are some ways in everyday life that can prevent or improve arrhythmia?

If you want to prevent arrhythmia, you must first know the cause, and control and treat it. In addition to age is an uncontrollable factor, if it is ventricular fibrillation caused by acute myocardial infarction, it is necessary to start from the prevention of myocardial infarction.

It is generally recommended that people with high risk of coronary artery should control the three highs, exercise properly and regularly, quit smoking, control alcohol consumption, and not be too stressful or anxious in life, etc., all of which can reduce the risk of attack.

As for the general arrhythmia, no matter what type it is, it is not recommended to drink alcohol, especially those with obvious irregular ventricular beats. In addition, excessive coffee drinking, emotional and life tension will have an impact on early contraction, and special attention should be paid to it.