We offer a comprehensive treatment for arrhythmias including outpatient testing and monitoring through to interventional procedures including ablation and device therapy. A very common problem, arrhythmia may cause simple palpitations that just require reassurance, or may cause blackouts with injury and sometimes, tragically, unexpected deaths in young and apparently healthy people.
Types of Arrhythmia
The many types of arrhythmia include:
Attrial Fibrillation. Atrial fibrillation (AF) is the commonest abnormal heart rhythm. It involves very rapid, irregular activity in the atria (the top chambers of the heart). The ventricles (the bottom, main pumping chambers of the heart) try to keep up and are therefore often fast and irregular too. AF can start and stop on its own after seconds, minutes or even hours. This is known as paroxysmal AF. Persistent AF is AF that does not stop on its own but will stop if a doctor treats it; the doctor may use medicines or a small electric shock (cardioversion). Permanent AF is AF which remains even after cardioversion.
Attrial Flutter. Atrial flutter is a special type of supraventricular arrhythmia. It arises from the upper chamber on the right side of the heart, the right atrium. Electricity circulates around this chamber at a rapid rate and drives the main pumping chambers (ventricles) at a fast rate, often 100 to 150 beats per minute.
Ventricular Arrhythmia (Ventricular Tachycardia). Ventricular tachycardia (VT) describes a fast rhythm originating in either of the two main pumping chambers of the heart (the ventricles). During VT the heart doesn’t beat as efficiently as normal and as a consequence symptoms including palpitations, breathlessness, chest pain and dizziness are often present. Rapid ventricular tachycardia may lead to loss of consciousness and degenerate into ventricular fibrillation, causing cardiac arrest.
Heart Failure, this is a condition based on a deterioration in the ability of the heart to pump blood around the body. It is a progressive disorder affecting many organs and systems in the body. A syndrome, arising from the inability of the heart to maintain an output to meet the needs of an individual, at rest or at exercise. It is characterised by a limitation in exercise capacity with symptoms of breathlessness and fatigue.
SVT (Atrial Tachycardia). Atrial tachycardia arises from a small area (focus) of tissue, anywhere in the atria of the heart. This focus starts to fire and drive the heart, more rapidly than the heart's natural pacemaker. Usually, the focus fires only intermittently (this is sometimes known as paroxysmal atrial tachycardia) but occasionally it can continue for days or even persist for months at a time. In some patients (especially the elderly or those with other significant heart disease) there is more than one abnormal focus.
Wolff-Parkinson White Syndrome. The Wolff-Parkinson-White syndrome (WPW) is a condition in which patients are born with an extra electrical connection within the heart which causes palpitations.The presence of this abnormal pathway can often be detected on a routine ECG. Rarely dangerous disturbances of heart rhythm occur, and very rarely patients with this condition may die suddenly. A cauterising procedure (ablation) is highly effective in curing most patients with this condition.
Atrioventricular nodal reentry tachycardia (AVNRT). Atrio-ventricular nodal reentry tachycardia (AVNRT) is a supraventricular tachycardia (SVT); that is a fast heart rhythm originating from above the ventricles. It is the commonest regular SVT, occurring more often in women. It may occur in childhood but is more often seen in patients in their twenties and thirties. It produces a sensation of fast, regular palpitations which usually start and stop suddenly. In some people there may be a clear precipitant, such as anxiety, caffeine, alcohol etc. however this is by no means always the case. On occasion patients may also notice chest tightness, breathlessness or dizziness. After the palpitations pass off some patients may feel rather lethargic or may need to pass urine.
Dilated Cardiomyopathy (DCM). Dilated cardiomyopathy (DCM) describes a weakness of heart muscle resulting in heart failure. The heart usually enlarges and the weakened heart muscle leads to symptoms such as breathlessness, tiredness, dizziness, and in some chest pain. Some patients will be aware of palpitations due to ventricular tachycardia, a fast rhythm arising from either of the two main pumping chambers of the heart (ventricles). Dilated cardiomyopathy may be secondary to viral infection or inflammatory heart conditions, or in some will be a genetic condition and found in other family members.
Hypertrophic Cardiomyopath (HCM). Hypertrophic cardiomyopathy (HCM) describes a thickening of heart muscle, commonly resulting in obstruction to the emptying of blood from the heart. This in turn leads to dizziness, breathlessness, chest pain and on occasions fainting, particularly during or just after exercise. Some patients will also be aware of palpitations due to an accessory pathway (see Wolff Parkinson White Syndrome) or ventricular tachycardia, a fast rhythm arising from either of the two main pumping chambers of the heart (ventricles). Hypertrophic cardiomyopathy is a genetic condition, and therefore commonly found in other family members.
Ectopic Beat (or Cardiac Ectopy). Ectopic beats are early beats that are the most common disturbance of heart rhythm. They may be present without any symptoms, or as palpitations described as missed or extra beats, or occasionally cause dizziness. In patients who have suffered a heart attack previously, the presence of ectopic beats may demand more thorough investigation to assess the future risk of more dangerous heart rhythms.
Effective treatments are available for nearly all arrhythmias and we offer the most up to date facilities from a dedicated group of cardiologists, cardiac physiologists, specialist nurses and allied medical staff. In addition to rapid access assessments, treatments offered include Cardiac Resynchronisation Therapy for patients with heart failure, and Implantation of Cardioverter Defibrillators. We ablate (cauterise) all common arrhythmias, and specialise in the treatment of complex arrhythmias including atrial fibrillation, and arrhythmias seen in adults with congenital heart disease. For more information on arrhythmias and their treatments, please go to the London Arrhythmia Centre Website.