Arrhythmia patients in clinical studies

Arrhythmia is a severe disturbance of the heart rhythm. The word comes from Greek and means “loss of rhythm.” In arrhythmia, the heart can beat too fast or too slow, and premature contractions may occur. It can occur due to organic damage to the heart muscle such as valve disease, myocardial infarction, dysfunction of the autonomic nervous system, imbalances in electrolytes and fluids, or intoxication.

Arrhythmia can also occur in healthy individuals as a result of fatigue, colds, strong emotions, or excessive alcohol consumption. The normal range for heart rate is typically considered to be between 65 and 100 beats per minute. Arrhythmias can occur with both normal and reduced cardiac activity.



When heartbeats fall below 60 beats per minute, the condition is called bradycardia. When heart rate increases above 90-100 beats per minute, it is referred to as tachycardia. Disorders in the heart rhythm reduce the amount of blood ejected by the heart. If cardiac output falls below a critical value, it can lead to decreased cerebral blood flow and result in loss of consciousness.

This can occur at very high or very low heart rates. Life-threatening conditions are those with heart rates below 30-35 beats per minute or above 200 beats per minute.

Types of arrhythmias: they are divided into:

  • Benign arrhythmias, which are relatively safe, and
  • Malignant arrhythmias, which are immediately life-threatening and the most common cause of sudden death. Most dangerous arrhythmias originate in the muscular part of the heart’s chambers, disrupting its pumping function and causing it to stop contracting and ejecting blood. When this happens, normal blood supply to the brain is compromised, leading to loss of consciousness. There is a real risk of death if cardiac activity is not restored within a few minutes. These are called ventricular arrhythmias.

The causes of malignant arrhythmias vary with age. In young individuals up to 30 years old, they are often a result of congenital structural heart diseases, known as cardiomyopathies.



Thickening of the heart wall, known as hypertrophic cardiomyopathy. This is the most common cause of death in professional athletes.

Enlargement of the heart and impairment of its pumping function.

Anomalies in the coronary arteries that supply blood to the heart.

Electrical diseases, resulting from abnormalities in the electrical system of the heart that generate and conduct impulses for the heart muscle’s function.

In older individuals, arrhythmias are most commonly due to ischemic heart disease.

How to recognize it:

Malignant arrhythmia occurs suddenly, and the patient simply collapses unconscious. In such cases, it relies on someone nearby to provide first aid.

How to recognize arrhythmia

First aid in arrhythmia:

It has been proven that starting timely cardiopulmonary resuscitation (CPR) while waiting for the arrival of an ambulance with a defibrillator saves many lives. The unconscious individual should not be slapped or given water, as they may choke. Clear airways and perform CPR on the collapsed person.

Quick and appropriate response is critical in many cases, so it is the best thing a person can do for someone who has collapsed unconscious.

First aid in arrhythmia

Wait for the ambulance without doing anything, the chances of the victim surviving are about 40 to 60%. If CPR is performed, the chances increase to 90%. In some individuals, cardiac function may spontaneously recover, which is one of the reasons for syncope (fainting).

Benign arrhythmias are primarily supraventricular and very rarely result in death.


Their occurrence is due to the presence of foci outside the electrical system through which the impulses for the heart’s function are normally conducted. These foci generate their own impulses towards the heart, thereby disrupting its rhythm.

How to recognize it:

Benign arrhythmias

With benign arrhythmias, one may feel skipped heartbeats, palpitations, and/or experience a fast, irregular, or sometimes regular pulse.

First Aid in case of arrhythmia

There are several techniques that can help temporarily control a large percentage of them.

When a person experiences an arrhythmia accompanied by dizziness due to a drop in blood pressure, they should ideally lie down or at least sit down and start coughing forcefully, with more exertion. Coughing initially helps maintain blood pressure for a certain period of time by increasing intrathoracic pressure, and secondly, it may interrupt some of the arrhythmias.

This is advised by a cardiologist.

When the arrhythmia is accompanied by a rapid pulse. It can be interrupted by activating a nerve called the “vagus” nerve. This can be done primarily in three ways:

  • A person can induce vomiting by stimulating their throat.
  • By applying pressure to the closed eyes with two fingers (in the case of healthy eyes).
  • A person can take a deep breath and, after closing their mouth and nose, they should strain their abdominal wall as if they were trying to have a bowel movement.

This is effective in 50% of cases.

Atrial Flutter and Fibrillation

These are two important, generally benign arrhythmias that can occur in both individuals with heart disease and those with healthy hearts. They themselves are not directly life-threatening but pose a risk factor for the formation of blood clots in a small chamber of the heart. These clots often travel through the bloodstream to the brain and can cause severe strokes.

Therefore, special anti-clotting medications are required to prevent clot formation if the arrhythmia itself cannot be eliminated. Atrial flutter presents with symptoms such as palpitations, shortness of breath, dizziness, fatigue, and can occur more frequently in older individuals, as well as those with a genetic predisposition.

It is often associated with other heart conditions. Such as ischemic heart disease, congenital and acquired valve diseases, and certain endocrine disorders.

Risk Factors

Genetic predisposition is among the main factors, while others include conditions such as arterial hypertension, diabetes mellitus, obesity, and metabolic syndrome. Lifestyle factors also play a role, including stress, depression, unhealthy eating habits, and frequent alcohol consumption, all of which can contribute to deviations in cardiac rhythm.

Seek immediate medical attention if you experience the following complaints:

  • Palpitations
  • Rapid heartbeat/high pulse rate (tachycardia)
  • Slow heartbeat/low pulse rate (bradycardia)
  • Chest pain and pressure
  • Shortness of breath
  • Dizziness or nausea
  • Sweating
  • Feeling of fainting or loss of consciousness.


When a person experiences problems with their heart rhythm, they should consult a cardiologist who will first ask them to describe their symptoms and then perform the necessary examinations. Among these, the electrocardiogram (ECG) is the first test, followed by the placement of 24-hour ECG monitoring devices known as Holter monitors. The recording obtained from such a device can provide a diagnosis, as there are other rhythm disorders that can present with similar complaints.

Treatment of Arrhythmia

The approach to treatment depends on the underlying cause. In all cases, the underlying condition is treated. And for some malignant arrhythmias, patients may be fitted with implantable cardioverter-defibrillators in combination with medication. These are small devices implanted under the skin, similar to pacemakers. They have special electrodes that go into the heart. They “detect” the arrhythmia and deliver electric shocks to reset the heart. Treatment of arrhythmias associated with ischemic heart disease is usually focused on treating the underlying disease itself.

In a large percentage of cases, this resolves the arrhythmias. If not, additional medications are prescribed. There are also modern invasive methods, known as electrophysiological procedures, which aim to identify and eliminate the sources that produce abnormal electrical impulses.

This is called ablation and is the most effective method for treating certain benign arrhythmias that occur in structurally normal hearts. During this procedure, the most common approach is to enter through the veins in the legs and use electrodes to reach the targeted sources.

They are then eliminated using high-frequency radio waves, cold energy, and other methods. Medications are primarily used to manage arrhythmias with the help of antiarrhythmic drugs. A group of medications that aim to prevent subsequent episodes or make them shorter and more tolerable.

Some medications help maintain a normal heart rate in patients, thus achieving controlled arrhythmia. Arrhythmia is a manageable condition.

Arrhythmia is a manageable condition


If the problem with the heart rhythm is neglected or improperly treated, complications can occur, such as the formation of blood clots. Therefore, the most common complications are cerebral embolism (known as a stroke) and other embolisms in the body, such as blockages in the arteries of the legs, arms, or internal organs.