Heart Rhythm Disorders (Arrhythmias)

A heart rhythm disorder, or arrhythmia, is any abnormality in the rate or regularity of the heartbeat caused by a fault in the heart's electrical system. The heart may beat too fast (tachycardia), too slowly (bradycardia) or irregularly.

Many arrhythmias, such as occasional extra beats, are harmless. Others matter because of their consequences: atrial fibrillation raises stroke risk about fivefold, heart block causes blackouts, and ventricular arrhythmias can cause cardiac arrest. Sorting out which kind you have depends on recording the rhythm during symptoms.

Symptome

• Palpitations: fluttering, pounding, racing or skipped beats
• An irregular pulse
• Dizziness or light-headedness
• Fainting or near-fainting
• Breathlessness or reduced exercise capacity
• Chest discomfort during fast rhythms
• Unexplained tiredness
• No symptoms, with the arrhythmia found on a routine ECG or smartwatch alert

Ursachen und Risikofaktoren

Atrial fibrillation is linked to age, high blood pressure, obesity, sleep apnoea, alcohol, valve disease, heart failure and an overactive thyroid. Supraventricular tachycardias arise from an extra electrical pathway or circuit present from birth. Slow rhythms come from age-related wear of the sinus node or conduction system, medicines such as beta blockers, or after valve procedures. Ventricular arrhythmias are associated with scar from heart attacks, cardiomyopathies and inherited conditions such as long QT and Brugada syndromes. Stimulants, low potassium or magnesium, and some prescription drugs can trigger rhythm problems.

Wie es diagnostiziert wird

• 12-lead ECG: The essential test, ideally captured during symptoms.
• Holter and patch monitors: Continuous recording for 24 hours to 14 days for frequent symptoms.
• Event recorders and wearables: Patient-activated devices and smartwatch ECGs for infrequent episodes; traces should be confirmed by a doctor.
• Implantable loop recorder: A tiny device under the skin that monitors for up to 3 years when fainting is unexplained.
• Echocardiography and blood tests: Look for structural heart disease, thyroid and electrolyte problems.
• Exercise test and cardiac MRI: For exertional arrhythmias and suspected cardiomyopathy.
• Electrophysiology study: Invasive mapping, usually combined with ablation.

Behandlungsmöglichkeiten

• Reassurance and trigger management: For benign extra beats: less caffeine and alcohol, better sleep, treating sleep apnoea and weight loss.
• Stroke prevention in atrial fibrillation: Anticoagulants such as apixaban, rivaroxaban, edoxaban, dabigatran or warfarin according to your risk score; left atrial appendage closure if anticoagulation is impossible.
• Rate and rhythm medicines: Beta blockers, calcium channel blockers, flecainide, propafenone, sotalol and amiodarone.
• Electrical cardioversion: A brief controlled shock under sedation to restore normal rhythm.
• Catheter ablation: Curative for most SVT and flutter; effective symptom control in atrial fibrillation and selected ventricular arrhythmias.
• Pacemaker: For symptomatic slow rhythms and heart block.
• Implantable defibrillator: For people at risk of life-threatening ventricular arrhythmias.

Wenn es dringend ist

Call your local emergency number for palpitations with chest pain, severe breathlessness, fainting or near-collapse, for a racing heart that does not settle within 20 to 30 minutes, or for any blackout without warning. Sudden weakness, facial droop or speech difficulty in someone with atrial fibrillation is a stroke emergency. These are not situations for travel.

Reisen nach Türkiye zur Behandlung

A stable, documented arrhythmia is well suited to planned treatment abroad: ablation or device implantation with a stay of 5 to 7 days. Bring your ECG recordings. Long-term matters, including anticoagulant monitoring, device checks and drug adjustments, need a home cardiologist, so set that up before you go.

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