arrhythmias
ARRHYTHMIAS
Arrhythmia is a disorder in which the heart beats irregularly. It may be too slow or too fast.
Bradycardia is having a heart rate of <50 beats/minute that may not affect the hemodynamic status of some patients.
Clinically significant bradycardia is having a heart rate that is inadequate for the patient's current condition and may not be able to support life.
Tachycardia is having serious signs and symptoms that are often demonstrated at ventricular rates of >150 beats/minute.
Signs and symptoms related to rapid heart rate are altered sensorium, angina, shortness of breath, myocardial infarction, hypotension and other signs of shock (eg cold clammy skin, low urine output), heart failure or pulmonary congestion.

Introduction

  • Arrhythmias are disturbances in the heart rhythm
  • May either be slower heart rate (bradycardia) or faster heart rate (tachycardia)

Definition

Bradycardia

  • HR <50 beats/min (bpm)
  • May not affect hemodynamic status of some patients

Clinically Significant Bradycardia

  • HR is inadequate for the patient’s current condition & may be unable to support life

Contributing factors that should be identified & treated:

  • Hypovolemia
  • Hypoxia
  • Acidosis
  • Electrolyte imbalance
  • Hypoglycemia
  • Hypothermia
  • Toxins
  • Cardiac tamponade
  • Tension pneumothorax
  • Coronary/pulmonary thrombosis
  • Increased intracranial pressure (eg in trauma)

Serious signs & symptoms are often demonstrated at ventricular rates >150 bpm
Signs & symptoms related to rapid HR:

  • Altered sensorium
  • Angina
  • Hypotension
  • Shortness of breath (SOB)
  • MI
  • Other signs of shock (eg cold clammy skin, low urine output), heart failure (HF) or pulmonary congestion
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Cardiology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
4 days ago
The appropriate cutoff value in predicting combined cardiovascular outcomes in patients with type 2 diabetes (T2D) is 125 mm Hg for home morning systolic blood pressure (MSBP), suggests a new study.
Pearl Toh, 3 days ago
Whether the 2017 ACC/AHA* blood pressure (BP) guidelines should be adopted in Asian countries was the topic of a much-anticipated discussion here at the Asian Pacific Society of Cardiology (APSC) Congress 2018 in Taiwan last week.
Jairia Dela Cruz, 5 days ago
Rheumatoid arthritis patients who use low-dose aspirin in primary prevention of cardiovascular (CV) disease have similar risks of major toxicity and CV events as those who are not exposed to aspirin, according to a secondary analysis of the PRECISION* trial.
15 May 2018

A study by researchers at Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) found that, even at levels currently considered normal, low-density lipoprotein cholesterol (LDL-C) is a prime predictor of the presence of atherosclerotic plaques in arteries. [J Am Coll Cardiol 2017;70:2979–2991]