Sometimes, the hartbeats increase to 150-300 or even more per minute. These beats are not formed from SA node. This may be a risky situation. The patient experiences beats in the chest. Some patients may feel shortness of breath, heaviness in the chest, choking of throat, heavy head, giddiness or blurred vision. Uncommonly, one may become unconscious for a while or longer duration.
In many cases the diagnosis can be achieved by getting a cardiogram during the episode. Few patients may need additional investigations.
- SupraVentricular Tachycardia (SVT) :
There is an extra wire beside the normal conduction system. When the cardiac impulse gets on to this wire, the heartbeats increase suddenly.After some time this extra wire becomes silent as before, either by itself or by giving medicines.
Who can be the victim ? : Any one, those who have this extra wire right from birth
Medicines : Verapamil, Diltiazem, Beta-Blockers, Adenosine
Electric shock : If not controlled by medicines, the heartbeats can be regularized again by giving electric shock to the patient.
Permanent remedy : Radiofrequency (RF) ablation
2. Atrial Fibrillation (AF) :
In such cases, heartbeats become fast and irregular abruptly.
Who can be the victim ? : People having valvular heart disease. People having one or more risk factors like, old age, diabetes, high blood pressure, weak heart, blockage in the coronary artery, etc.
Medicines : Beta-Blockers, Digitalis, Amioderon, Verapamil, Diltiazem.
Electric Shock : If the heartbeats are not regularized by medicines, an electric shock is given.
Anticoagulant medicines : Warfarin, Debigatran, Rivaroxaban, Apixaban, Aspirin.
In patients with AF, there is a risk of blood clot formation in the heart. This blood clot formed in the left auricle can get dislodged and embolize to some important organs of the body and damage it. If this happens to brain artery, it causes paralysis. It is compulsory to give one of the above-mentioned medicines to such patients as per the advice of the Doctor.
Permanent remedy : RF Ablation-in some selected cases only.
- Ventricular Tachycardia (VT) / Ventricular Fibrillation (VF) / Cardiac Arrest (CA) : Heartbeats increase suddenly and rapidly. The efficiency of heart starts declining very fast. In many such cases, if timely treatment is not given, a patient can die within moments due to heart failure.
Who can be the victim ? : Patients with a weak heart / heart failure or a heart attack in the past or critical blockage in the coronary arteries have a high risk of cardiac arrest. During a major heart attack, there is a high risk of this serious arrhythmia. Even side effect of some medicines, kidney failure, acute stroke, severe respiratory failure, etc. can cause cardiac arrest.
Medicines : Intravenous Amioderon, Xylocaine, Beta-Blockers, Magnesium
Electric Shock : It becomes necessary to give an electric shock in most of such cases. If the blood pressure of the patient has dropped severely, there is no option left except to give an urgent electric shock.
Permanent remedy : It is quite essential to eliminate the root cause. Moreover, the above mentioned remedied are also useful in certain cases. Many patients would require to continue beta-blockers and amiodarone like medicines for long term.
- Automatic Implantable Cardioverter Defibrillator (AICD) Implantation : This device, similar to a pacemaker, is placed in the upper part of the chest, beneath the skin through an incision of 2 inches under local anaesthesia. Its size is equal to one-third the size of an apple mobile phone. This device constantly monitors the heart rhythm of the patient. Whenever the heartbeats increase due to VT, it makes them normal as before by giving an internal shock. Its battery lasts for 3 to 7 years. During periodic checking, complete information can be obtained from it with the help of a computer and parameters can be readjusted as per the need.
RF Ablation : In few selected cases, this treatment reduces the possibility of recurrence of VT in the future. Overall, this form of treatment is more effective for SVT.