Description arrhythmia

The cardiac muscle cells are groups which have a different role than all of cardiac muscle cells.Formed in them repeatedly impulses that spreads to other cells to spread throughout the heart and thus leads to repeated contractions of the heart. These cells form the cardiac conduction system.Heart rhythm disorders causing faulty formation impulses, or error in their dissemination throughout the heart muscle (disorder of the cardiac conduction system, scars in the heart muscle, etc.).

Disorder in addition to impaired heart muscle can also cause change in the levels of minerals (low blood potassium, hypokalemia). Also there is a change in hormone levels (thyroid disorders, thyrotoxicosis), during alcohol intoxication after ingestion of drugs and other addictive substances.

According to the frequency of cardiac events can be divided arrhythmia events with lower frequency (bradyarrhythmia, below 60 beats per minute) and higher frequency (tachyarrhythmias above 100 beats / min).


sinus bradycardia

Heart rate below 60 beats / min. Physiologically occurs in trained individuals (athletes). May occur during hypothermia in the treatment of β-blockers in intracranial hypertension.

Sick sinus syndrome

It is a combination of sinus bradycardia and certain other arrhythmia, most supraventricular tachycardia. It occurs in the elderly, the cause is often unclear. It is most likely microscopic damage to the sinoatrial node (SA node conduction system of the heart).

Carotid sinus syndrome

Excessive response to stimulation of the carotid sinus. After his irritation comes bradyarrhythmias.

Malignant vasovagal syncope

The fault is on the level in venous return to the heart when upright. Now is the sudden syncope with bradycardia.

AV blockade

Fault conduction from the atrium to the chamber (corrupt AV node, the atrioventricular node, part of the conduction system of the heart). There are several types (Wenckebach AV block, Mobitz AV block). Individual types differ according to the proportion of converted and unconverted impulses.The most clear-cut form is AV block third type, where the impulse from the atria to the ventricles does not convert at all and halls and chambers are pulling their own mutually different frequencies.


The term refers to premature contractions, which derives from deposits outside the SA node, which should begin any cardiac activity. Depending on where the resource is located pathological activity can be used to divide atrial extrasystoles, junctional extrasystoles (source in junction, or transition between the atrium and ventricle) and ventricular premature. Individual extrasystols can be distinguished by their appearance on the ECG (electrocardiography, examination that shows the electrical activity of the heart, the record of this investigation is a typical course where you can identify any abnormal heart rhythm).

supraventricular tachyarrhythmias

atrial fibrillation

One of the most common types of arrhythmias. The basis is called. Reentry phenomenon(pathological impulse after circling the heart muscle). Atrium only shake but do not. It is a very highrisk of embolism (venous blood clots and subsequent stroke).

atrial flutter

Also, due to reentry phenomenon. The atrial rate is about 300 beats per minute. Converting high frequencies from the atria to the ventricles is not physiologically possible frequency chambers is around half of the atrial rate. If there is any fault (additional track, or certain medications affected cardiac conduction system) between the atrium and ventricle, can be converted to the frequency of atrial chamber and then goes on a life-threatening condition. This is called. Deprotected flutter.Often may occur together with another type of arrhythmia. There is also a high risk of embolic complications.

atrial tachycardia

Frequent occurrence after heart operations. There are several types. Focal atrial tachycardia in cardiac or pulmonary disease. Atrial tachycardia with blockade 2: 1 at nadužití digitalis. Multifocal atrial tachycardia in acute shortage of oxygen (hypoxia).

AV junctional tachycardia

There are two types. AV nodal reentry tachycardia is paroxysmal well treatable arrhythmia occurs in adolescence and productive age. Neparoxyzmální junctional tachycardia is caused by digitalis, acute myocardial infarction or postoperative complications.

AV reentry tachycardia

There are an additional coupling between the atria and ventricles, through which impulses may circle. There is an increased risk of ventricular fibrillation.

Tachyarrhythmia – Ventricular tachyarrhythmias

ventricular tachycardia

Pathological activity arises here in the chambers. According to the shape of the ECG waveform (ie. QRS describing the electrical activity of the ventricles), this arrhythmia divided into monomorphic(where the QRS complex remains the same) and polymorphic (QRS complexes are different).

The causes of monomorphic ventricular tachycardia, coronary heart disease, arrhythmogenic right ventricular cardiomyopathy, hypertrophic cardiomyopathy, dilated cardiomyopathy, tetralogy of Fallot, idiopathic ventricular tachycardia.

Causes of polymorphic ventricular tachycardia, coronary heart disease, Brugadových syndrome (a disorder of intracellular transport of sodium, damage to the heart muscle) syndrome, torsades de pointes (a disorder of ion transportů- most potassium and magnesium).

ventricular fibrillation

Muscle chambers quivers but does not download and comes stasis. It is the leading cause of death in acute myocardial infarction. Untreated atrial leads within a few minutes to death. If the patient survives fibrillation is a major risk of recurrence.

Tachyarrhythmia – Accelerated ideoventricular rhythm

It occurs when an artery patency in the therapy of acute myocardial infarction and its presence indicates that the therapy has been successful. In this case, called reperfusion arrhythmia.


Caused by the simultaneous occurrence of impulses in two places. There is so typical. Coalesced contraction. Arrhythmias accompanies heart muscle damage and does not require therapy.

Risk factors for arrhythmia

Most are at risk of arrhythmia, people with damaged heart muscle. It can be damaged on the basis of congenital disorders, undergoing surgery or trauma. Frequently, however, the consequences of inadequate oxygenation of the heart muscle (myocardial infarction) caused by atherosclerosis.Other risk factors are primarily a shortage (excess) of some ions or hormones (caused by the composition of the diet, taking certain medications, unrecognized or inadequately treated diseases).The most important risk factor is the poor lifestyle leading to atherosclerosis and subsequently to heart attacks and arrhythmias (lack of exercise, dietary composition, uncontrolled high blood pressure).

prevention of arrhythmia

The easiest prevention is lifestyle change toward prevention of atherosclerosis, obesity and high blood pressure, which can make patients themselves. It is also important to avoid stressful situations and devote enough attention to psychological difficulties. Prevention rather the consequences of arrhythmias are regular check ups and early detection of health deterioration.

symptoms of arrhythmias

Symptoms of disease vary depending on the types of arrhythmias, according to cause arrhythmia and compensatory ability of the circulatory and respiratory system (the ability to change the performance of the system even his fault).

Bradyarrhythmia have symptoms caused by reduced heart rate. It is present in muscle weakness, fatigue, dizziness to vertigo, dyspnoea (rest and stress) and sudden fainting (syncope, Stokes-Adams syndrome).

Tachyarrhythmias have symptoms of increased heart rate. It is present tightness in heart beat (palpitations), shortness of breath, chest pain and fainting.
Some arrhythmias can feel the change already palpable pulse.

treatment of arrhythmias

Treatment is well as the symptoms depend on the type of arrhythmia and impaired cardiac kind presence of other diseases.

Pharmacological treatment of bradyarrhythmias is usually atropine or isoprenaline. For tachyarrhythmias are administered medicines that are anti-arrhythmic agents. There are multiple groups, and selection of drug is by type of arrhythmia.

Electrical cardioversion defibrillation-used if drug treatment is not sufficient and the risk of cardiac arrest. It introduced cardioverter defiblirátor, which monitors the heart activity and if there is a life-threatening arrhythmias, changes the electrical discharge towards heart rhythm to normal.

For electrical pacing the heart rhythm ostensible pacemaker. May only be temporary (short-term), which is used for the therapy of acute onset of arrhythmia. In this case the pacemaker outside the body. For permanent pacing stimulator implanted into the body (the area below the collarbone).

Very used method, however, suitable only for some arrhythmias, is the destruction of pathological sources of arrhythmia in the heart. When surgery (surgical ablation) is removed pathological (often cryogenic route, local sudden freezing). When exercising catheterization (catheter ablation) is a pathological destroyed by radiofrequency discharge.

How can I help myself

The patient can best help themselves if they reduce strain on the heart. Valid find everything that is useful in the prevention of cardiovascular diseases (cardiovascular diseases) in general. Therefore it is appropriate to change the lifestyle and changing dietary habits. Patients should limit the amount of consumed salt and fluids. You must be limited to completely eliminate alcohol and smoking. It is suitable for obese patients reduce weight.

It is important to consistently taking prescribed medications for regular checkups and do not underestimate any signs of deterioration of health.

complications arrhythmias

In heart failure and other cardiovascular disorders presence of cardiac arrhythmias greatly worsens the prognosis of the underlying disease. Cause early decompensation and increase the risk of death.Most arrhythmias can also cause heart failure itself. For most arrhythmias, originating in the atria, often blood clots (thrombi) on the walls of the hall. There is an increased risk of embolism (thrombus carried off). Embolization blocked artery causing a heart attack in tissue hypoperfusion.One of the most frequent and serious complication is embolization of cerebral arteries, followed by cerebrovascular accident (CVA). Some arrhythmias are maintained without sufficient treatment in a short time to death.

Other names: Cardiac rhythm disorders, cardiac disorders automaticity Bradyarrhythmia, Sinus bradycardia, sick sinus syndrome, carotid sinus syndrome, malignant vasovagal syncope, Wenckebach AV block, Mobitz AV block, Atrial extrasystoles, junctional extrasystoles Ventricular extrasystoles

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