A Complete Guide to Tachycardia

Tachycardia is a fast-resting heart rate of usually at least 100 beats per minute. This can be a dangerous condition, depending on its underlying cause and how hard the heart has to work.

 

Normally, the adult resting heart, beats between 60-100 beats per minute. However, when an individual has tachycardia, the upper and/or lower chambers of the heart beat a lot faster. Our heart rates are controlled by electrical signals that are sent across the heart’s tissues. When the heart starts producing rapid electrical signals, tachycardia occurs.
 
When the heart is beating too fast, it cannot pump efficiently, and blood flow to the rest of the body, including the heart, reduces. Since the heart is beating quicker, the myocardium (muscles of the heart) need more oxygen – if they become oxygen-starved, they will start to die off, leading to a heart attack.

Some patients with this condition show no symptoms or complications. However, tachycardia significantly increases the possibility of a stroke, sudden cardiac arrest, and death.

 

Symptoms of Tachycardia

• Accelerated heart rate (fast pulse)
• Chest pain
• Confusion
• Dizziness
• Hypotension
• Panting
• Sudden weakness
• Lightheadedness
• Palpitations – an uncomfortable racing feeling in the chest

Treatments for Tachycardia
Treatment options for this condition vary, depending on what has caused the condition, and the patient’s age and general health. The aim of the treatment is to tackle the cause of the tachycardia. When clinically applicable, the doctor may attempt to slow the rate, prevent subsequent episodes of tachycardia, and reduce risk complications. However, when no underlying cause is found, the doctors will have to try out different therapies.

Ways to Slow Down a Fast Heartbeat
Vagal Maneuvers
The vagal nerve helps to regulate our heartbeat. Maneuvers that affect this nerve include coughing, heaving, and placing an ice pack on your face.

Medication
Antiarrhythmic drugs that help to restore and control a normal heartbeat can be taken orally or by injection. Sometimes a patient might have to take more than one kind of antiarrhythmic drug.

Cardioversion
Paddles or patches are used to deliver electric shocks to the heart. This affects the electrical impulses in the heart and helps to restore a normal rhythm. This is done in a hospital.

Prevention of Episodes of Tachycardia

Radiofrequency Catheter Ablation
Catheters enter the heart via blood vessels. Then, electrodes at the ends of the catheters are heated to ablate (damage) the sections of the heart that are responsible for the abnormal heart rate.
Medications
When taken regularly, antiarrhythmic medications can help prevent tachycardia. However, patients may be required to take other medications as well, such as channel blockers, or example diltiazem (Cardizem) and verapamil (Calan), or beta-blockers, for example, propranolol (Inderal), and esmolol (Brevibloc).

Implantable Cardioverter Defibrillator (ICD)
This device, which constantly monitors the patient’s heartbeat, is surgically implanted into the chest. The ICD detects any heart abnormalities and delivers shocks to keep the heart rate normal.
Surgery
Sometimes, surgery is needed to remove a section of tissue. This procedure is only carried out when other therapies have been ineffective, or if the patient has another heart disorder.
Warfarin
This makes it harder for the blood to clot and it’s given to patients with a high or moderate risk of having a stroke or heart attack. Although this drug increases the risk of bleeding, it is prescribed to those whose risk of a stroke or heart attack far outweighs the risk of bleeding.

Causes of Tachycardia

• A reaction to certain medications
• Congenital (present at birth) electrical pathway abnormalities in the heart
• Consuming too much alcohol
• Consumption of cocaine and other recreational drugs
• Electrolyte imbalance
• Heart disease which has resulted in poor blood supply and damage to heart tissue, including heart valve disease, coronary artery disease, heart failure, heart muscle disease, infections, or tumors.
• Hypertension
• Hyperthyroidism (overactive thyroid gland)
• Smoking
• Certain lung diseases

Types of Tachycardia
Atrial Fibrillation
Sometimes, electrical activity can arise from the left atrium instead of the sinus node. This causes the chambers to contract at a high and irregular rate; this is atrial fibrillation. An episode of atrial fibrillation can last from a few hours to several days, and sometimes it may not go away until treated.

Atrial Flutter
The atria beat rapidly, but regularly. This condition is caused by a circuit problem within the right atrium. The contractions of the atria are weak because of the rapid heartbeat. An atrial flutter episode can last a few hours or a few days. It may also not go away until treatment is received. This is often caused by some form of heart disease.

Supraventricular Tachycardias (SVTs)
This refers to any tachycardic (accelerated) heart rhythm that originates above the ventricular tissue. The abnormal circuitry in the heart is usually congenital (present a birth) and creates a loop of overlapping electrical signals. An SVT episode can last from anywhere between a few seconds to a few hours.

 

Ventricular Tachycardia
Abnormal electrical signals in the ventricles result in a rapid heart rate. The speed of the heartbeat does not allow the ventricles to contract and fill properly, leading to poor blood supply to the body. This type of tachycardia is life-threatening and is usually treated as a medical emergency.

Ventricular Fibrillation
This occurs when the ventricles quiver in an ineffective way, resulting in poor blood supply to the body. If a normal heartbeat is not restored rapidly, blood circulation will cease, and the patient will die. Those with an underlying heart condition, or those who have been hit by lightning, may experience ventricular fibrillation.

Risk Factors for Tachycardia

• Age – people aged 60 and above have a much higher chance of experiencing tachycardia
• Anxiety
• Consuming large quantities of alcohol regularly
• Consuming large quantities of caffeine
• Genetics – people who have close relatives with tachycardia or other heart rhythm disorders have a higher chance of developing the condition
• Heart disease
• Hypertension (high blood pressure)
• Mental stress
• Smoking
• Using recreational drugs

Diagnosis of Tachycardia
A doctor can usually diagnose tachycardia by asking the patient some questions about their symptoms, carrying out a physical exam, and ordering some tests to be done. These may include:
Electrocardiogram
Electrodes are attached to the patient’s body to measure the electrical pulses that are given off by the heart. This test is also able to show any previous heart disease that may have contributed to the tachycardia.
Echocardiogram
This is a type of ultrasound investigation. By bouncing sounds of the structures in the body and registering the echoes, a moving image of the heart can be produced. This can help show structural or congenital abnormalities that might be playing a role in tachycardia.
Holter Monitor
The patient wears a portable device that records their heartbeat. It’s worn under the clothing and records information about the electrical activity of the heart while the person goes about their daily activities.

Blood Tests
This will help determine whether thyroid problems or other substances may be contributing to the patient’s tachycardia.

 

Tilt-Table Test
If the patient is experiencing fainting spells, lightheadedness, or dizziness, and neither the ECG or the Holter revealed any arrhythmias, a tilt-table test will be performed. This monitors the patient’s blood pressure, heart rhythm, and heart rate while they are moved from a lying to an upright position.
Chest X-Ray
This helps the doctor to check the state of the individual’s heart and lungs. Other conditions that could be causing the tachycardia might also be detected.
Possible Complications of Tachycardia
• Blood clots – these significantly increase the risk of a heart attack or stroke
• Heart failure – if the condition isn’t controlled, the heart is likely to get weaker. Heart failure is when the heart does not pump blood around the body efficiently or properly. The patients left, right, or even both sides can be affected.
• Fainting spells
• Sudden death – generally only linked to ventricular tachycardia or ventricular fibrillation.                                                                 
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Various tests for heart attack and what procedures can be done

Your doctor may recommend:

• EKG (electrocardiogram): It reads your heart's electrical activity.
• Echocardiography: It shows your heart’s size, shape, and how well it works. 
• Cardiac MRI (magnetic resonance imaging): This makes detailed pictures of your heart at work.
• MUGA (multiple gated acquisition): You get a little radioactive material injected into your bloodstream to help special cameras take pictures of your heart.  

Cardiac Catheterization

Your doctor may put a soft, thin tube called a catheter into a blood vessel in your neck, arm, or upper thigh and guide it to your heart. The Dr. may send a special dye that’s visible on X-rays into the tube to check for narrowed or blocked arteries. The Dr. can also test your heart’s response to certain drugs or electrical signals.Dr. may even use the tube to do angioplasty, a procedure to open blocked arteries.  

If You Need an ICD

This device is a small automated defibrillator that a surgeon can implant under your skin to send an electric shock to your heart if he finds certain irregular heartbeats. Your doctor may suggest that you get one if you have severe heart disease or have already had cardiac arrest. A surgeon places the ICD under your skin. Some devices include a pacemaker as well as an ICD to keep your heart rhythm regular.
 

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                                                                                                                                                                                      PS- THOSE INTERESTED IN RECIPES ARE FREE TO VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/   

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Costlier Heart Device May/May Not Be Worth It ?

Patients prone to dangerously fast heart rhythms may get just as much help and have fewer complications with less-expensive implanted defibrillators that run one wire to the heart instead of two, a new study shows.

Implantable cardioverter defibrillators, or ICDs, are like having an emergency "crash cart" in the chest. The devices can sense runaway heart rhythms and deliver powerful shocks to jolt the heart back to a normal, steady pace.

Studies have shown that the devices cut deaths in patients at risk for sudden cardiac arrest because their heart muscles are too weak to effectively pump blood throughout the body, a condition called cardiomyopathy.

But little evidence exists to help doctors decide when it's better to choose a single-chambered ICD for patients or the more complex dual-chambered model.

The study, compared the fates of more than 32,000  patients who received ICDs, from 2006 through 2009. None of the patients also needed a pacemaker, a device that speeds up a slow heartbeat.

"There is evidence for greater risk of complications. Not clear evidence of benefit. That risk-benefit ratio really doesn't support the routine use of dual-chamber devices for primary prevention," said study co-author.

About one-third of patients received a single-chamber ICD, in which an electrical lead is attached to the heart's lower right pumping chamber. The other two-thirds got dual-chamber devices, in which wires are attached to the upper and lower chambers of the heart's right side.

After a year, patients who got single-chamber ICDs were no more likely to die or be hospitalized than patients who got the more expensive dual-chamber models. They were, however, slightly less likely to face serious complications, including fluid build-up around the heart or lungs and mechanical problems with the device that required a second surgery to fix.

That was true even after researchers adjusted their results to control for any differences between patients who got single- and dual-chamber devices.

Overall, close to 4 percent of patients with single-chamber ICDs had complications with their devices compared to about 5 percent of patients with dual-chamber models, the investigators found.

The study was observational, which means researchers couldn't prove that the type of ICD was the only reason patients fared the way they did. Though they tried to carefully control their data for important differences between the two groups, other factors they couldn't measure, such as medications people were taking, may have influenced the results.

An expert who was not involved in the research praised the study, but said its findings come with an important caveat. The study wasn't able to measure so-called "inappropriate" shocks, instances when the devices misfire after sensing an irregular, but harmless, heartbeat.

Patients describe the powerful jolt as feeling like they're being kicked or hit with a baseball bat. Inappropriate shocks can be a major quality-of-life issue for patients who get them frequently.

Dr.  said the dual-chamber defibrillator may have an advantage in that regard.

"A dual-chamber ICD device, along with its extra atrial lead, is frequently chosen in the belief that it will better discriminate fast heart rates originating in the upper versus lower chambers of the heart and thereby reduce the risk of inappropriate shocks from the device," said a Dr.

A Dr. agreed that not being able to study inappropriate shocks to patients was a limitation of the study. However, she said, "data that has looked at that doesn't demonstrate that there's a benefit of dual-chamber devices in decreasing inappropriate shocks."

Another question they weren't able to address in the study was cost. Single-chamber devices are initially less expensive than dual-chamber models.

A study published said it costs roughly $34,000 for a single-chamber device and about $38,000 for a dual-chamber model.

But that study also found that the cost savings of single-chamber devices can be wiped out if patients need to upgrade to the dual-chamber model because their condition gets worse, a situation that occurs in about 5 to 6 percent of patients in clinical trials.