Arrhythmie

Arrhythmie, known in English as arrhythmia, refers to an abnormal heart rhythm caused by problems with the generation or the conduction of electrical impulses in the heart. It covers a wide spectrum of conditions, from harmless variations to potentially life-threatening disorders. The term arrhythmie is commonly used in French-language medical texts; in English, arrhythmia is the standard term.

Classification of arrhythmies generally divides them into tachyarrhythmias, where the heart rate is too fast, and bradyarrhythmias, where the rate is too slow. Within tachyarrhythmias, distinctions are made between supraventricular rhythms (originating above the ventricles) and ventricular rhythms (originating in the ventricles). Common examples include atrial fibrillation, atrial flutter, other atrial tachycardias, ventricular tachycardia, ventricular fibrillation, sinus node dysfunction, and varying degrees of atrioventricular block.

Causes and risk factors are diverse. Structural heart disease such as ischemic heart disease or cardiomyopathy, electrolyte disturbances, drug effects or interactions (including certain antiarrhythmics and stimulants), congenital conduction system abnormalities, and autonomic or endocrine influences can all contribute. Lifestyle factors, sleep apnea, and thyroid disorders may also play a role.

Clinical presentation ranges from no symptoms to palpitations, dizziness, syncope, chest pain, or fatigue. Diagnosis relies primarily on electrocardiography (ECG); extended monitoring with Holter or event recorders, echocardiography, and laboratory tests are often used to identify causes and assess heart function. Management aims to control rate, restore or maintain normal rhythm, prevent complications, and treat underlying conditions. Treatments include medications (beta-blockers, calcium channel blockers, antiarrhythmic drugs), catheter ablation, and device therapies such as pacemakers or implantable cardioverter-defibrillators. Anticoagulation is considered for stroke prevention in certain atrial fibrillation cases. Emergency care for unstable or pulseless arrhythmias requires immediate resuscitation and cardioversion or defibrillation. Prognosis depends on the arrhythmia type and the presence of other heart disease or risk factors.