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 04/26/2024

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Ventricular Arrhythmias
 
Basic Facts
An arrhythmia is an abnormality or disturbance in the rate or rhythm of the heartbeat.
Arrhythmias are caused by problems with the heart's electrical system, which causes a heartbeat to begin and sends electrical impulses through the heart.
Because the ventricles are primarily responsible for moving blood through the body, ventricular arrhythmias are often more serious than atrial arrhythmias.
An arrhythmia is a change in the heart's normal rate or rhythm. Typically, the heart beats with a regular rhythm at a rate between 60 and 100 beats per minute. Problems with the heart's electrical system or the heart's response to the electrical signal can interrupt the heart's coordination and cause arrhythmias. Ventricular arrhythmias are abnormalities that affect these ventricles, or lower chambers of the heart.

Ventricular arrhythmias include:

An electrocardiogram of an episode of sustained ventricular tachycardia.
An electrocardiogram of an episode of sustained ventricular tachycardia.
  • Premature ventricular complexes (PVCs), which are premature heartbeats;
  • Ventricular tachycardia, an abnormally fast heartbeat; and
  • Ventricular fibrillation, in which the heart quivers rather than contracts.
Ventricular fibrillation is a medical emergency that requires immediate attention.

WHAT ARE THE SYMPTOMS?

An electrocardiogram reflecting the irregular, pulseless electrical activity of ventricular fibrillation.
An electrocardiogram reflecting the irregular, pulseless electrical activity of ventricular fibrillation.
Some ventricular arrhythmias have no symptoms. When symptoms do occur, they include:

  • Diminished or irregular pulse;
  • Fatigue;
  • Shortness of breath;
  • Fainting (syncope);
  • Palpitations (awareness of one's own heartbeat);
  • Low blood pressure;
  • Chest pain; and
  • Cardiac arrest.
CAUSES AND RISK FACTORS

The causes of ventricular arrhythmias include:
  • Coronary heart disease (CHD);
  • Congestive heart failure;
  • Left ventricular dysfunction;
  • Hypertension (high blood pressure);
  • Cardiomyopathy (dilated or hypertrophic);
  • Congenital (inherited) heart disease; and
  • Valve disease (aortic or mitral).
DIAGNOSIS

The physician will take a detailed medical history and perform a physical examination, during which he or she may hear irregular heartbeats with a stethoscope. The physician may also order tests, including an electrocardiogram (ECG), either resting or ambulatory (using a portable machine called a Holter monitor or a loop recorder). The physician may also order electrophysiology testing.

TREATMENT APPROACH

Many cases of arrhythmias may not require treatment. Other arrhythmias can be treated by treating any underlying heart disease. Treatments for ventricular arrhythmia includes:
  • Defibrillation;
  • Medication (beta-blockers and antiarrhythmic agents);
  • Radiofrequency catheter ablation;
  • Angioplasty; and
  • Pacemaker implantation.
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