Bayındır İçerenköy Hospital, a subsidiary of Türkiye İş Bankası, Cardiology Specialist Assoc. Dr. Mutlu Güngör gave the following information about rhythm disorders in the heart and regular checks:
– The heart’s conduction system is like the electrical installation of a house. This system consists of a generator (sinoatrial node) that generates electrical activity and pathways that take this electrical activity to the heart muscle. Rhythm disturbances can be seen in the diseases of the generator or its conduction pathways, and sometimes in systemic diseases that may affect them. Organic rhythm disorders in the heart are distributed over a wide spectrum.
Take care of low heart rate
It may decrease due to malnutrition, some storage diseases, thyroid dysfunctions or many systemic diseases. In this case, the impulse output rate, which is normally between 60-100, decreases. The patient’s heart rate is below 60/min. This causes malnutrition in the body. The patient complains of dizziness, weakness, shortness of breath even with minimal effort, or fainting.
The patient’s pulse is determined to be low by ECGs taken or by 24-hour rhythm holter examination for rhythm monitoring. In this case, the treatment is permanent pacemaker applications that can provide the electrical activity of the heart. Pacemakers are 3×5 cm devices placed under the chest muscle.
Listen to your heart problems with controls
– Normally there is a mains cable that transmits to the heart muscle connected to the generator of the heart. Some people may have a second cable congenitally. This is called the ‘accessory pathway’. In cases where this accessory pathway is activated, palpitations occur, which can increase the heart rate up to 150-200/min, start abruptly and end abruptly, causing a feeling of uneasiness in the chest. It is not possible to predict when these palpitations will begin and how long they will last.
– If the duration of palpitation is long, the diagnosis can be made by the ECG taken when the patient applies to the emergency department or by the 24-hour rhythm holter test if it repeats frequently. These palpitations are not bad rhythm disturbances that cause heart attack or heart failure. However, a very high heart rate can cause serious discomfort in the patient. The treatment of these disorders is called EPS (electrophysiological study) and ablation. These treatments are procedures performed in angiography laboratories and applied by entering the inguinal vein. It is based on locating the accessory pathway and eliminating it by radiofrequency (burning) or cryoablation (freezing).
Palpitations may not be just because of the heart Normally, our heart works continuously for life, but we do not feel it working in our chest. These palpitations can sometimes be irregular misfires, and sometimes the heart rate can reach 200/min.
– It should be investigated whether there is a systemic disease in patients with palpitation description. In many cases such as anemia, thyroid diseases, fluid losses, febrile illnesses, anxiety, panic, heavy exercise, chronic systemic diseases, and deconditioning, the heart rate increases, and the person may feel palpitations.
– Actually, the situation here is that the heart increases its speed to compensate for the existing disease, rather than heart disease, that is, it is a physiological condition. Treatment should be based on the cause. In other words, anemia, infection or thyroid functions should be treated, and regular exercise should be started if there is deconditioning.
Follow your family health history well
– Rhythm disorders seen in patients with structural disorders in the heart are clinically very important. In patients who have had a heart attack, undergone procedures such as bypass, stent, or have an enlarged heart, or in some congenital anomalies (such as hypertrophic cardiomyopathy, arrhythmigenic right ventricular dysplasia, ebstein anomaly) or in genetically inherited diseases with some rhythm disturbances (brugada syndrome, long QT syndrome, short QT rhythm disorders (such as ventricular tachycardia or ventricular fibrillation) may cause sudden cardiac arrest, that is, fainting or death.
– Therefore, all patients with cardiovascular disease should have routine cardiology checks. In these examinations, if echocardiographic examinations are required, rhythm holter examinations should be performed. Cardiology examinations, ECG and echocardiographic evaluations of patients or athletes with a family history of unexplained premature death must be performed. ICD (implantable cardiac defibrillator) shock devices should be fitted to patients who are at risk of sudden death during examinations or tests. These shock devices are devices that are placed under the chest muscle similar to pacemakers, slightly larger than batteries, approximately 5×7 cm in size. These devices are devices that continuously monitor the rhythm of the heart and make the heart work again by giving a shock when a fatal rhythm disorder is observed.
Athletes and heart patients should not neglect regular check-ups ( heart palsy) or it may be so significant that it results in death. Therefore, it is recommended that everyone undergo a detailed cardiology examination, ECG and echocardiographic examinations once a year. On the other hand, it is important to perform tests such as exercise ECG, thallium test, coronary angiography, if necessary, in order to evaluate patients in the risk group in terms of coronary artery disease.
– ECG and rhythm holter follow-ups for cardiovascular disease or rhythm disorders are neglected by people with premature death in the family, athletes, patients followed up with heart failure, or patients with complaints such as dizziness, weakness, fainting. should not be done.
Continuous arrhythmia: Atrial Fibrillation Known as rhythm disorder, which is the most frequently ongoing rhythm disorder, it is a disease that should be dealt with separately. Its incidence increases especially in advanced age, in the presence of valvular disease, hypertension, and heart failure. It is a rhythm disorder in which the atria cannot contract and only vibrate. Due to this feature, the blood in the atrium may coagulate due to inactivity. Embolization of these clots can lead to attacks of paralysis. The most common cause of strokes seen in advanced age is AF. Detection of AF necessarily requires the use of anticoagulant therapy. Because anticoagulant treatments protect against clots and strokes, they also increase bleeding tendency
