Arytmii

Arytmii, also called arrhythmias, are disorders of the heart rhythm caused by abnormalities in the electrical impulses that coordinate heartbeat. They can make the heart beat too fast (tachyarrhythmia), too slow (bradyarrhythmia), or irregularly.

Common examples include atrial fibrillation, atrial flutter, other supraventricular tachycardias, ventricular tachycardia, and ventricular fibrillation, as well as conduction blocks such as AV block and sinus node dysfunction. The clinical impact ranges from benign to life-threatening, depending on the underlying condition and the rhythm disturbance.

Causes of arytmii include structural heart disease, ischemia or prior myocardial infarction, electrolyte disturbances, thyroid disorders, certain medications or recreational drugs, congenital conduction system abnormalities, and lifestyle factors like heavy alcohol use or sleep apnea. Age and comorbidities increase risk.

Symptoms vary and may be absent or include palpitations, dizziness, fainting, chest discomfort, and shortness of breath. Diagnosis relies primarily on electrocardiography (ECG). Additional tests may include Holter or event monitoring, echocardiography to assess heart structure, exercise testing, and, in selected cases, invasive electrophysiological studies.

Management depends on the specific arrhythmia and patient risk. Approaches include observation for benign conditions, rate control with medications such as beta blockers, rhythm control with antiarrhythmic drugs or electrical cardioversion, catheter ablation, and anticoagulation to reduce stroke risk in atrial fibrillation. Device therapies—pacemakers for bradyarrhythmias and implantable cardioverter-defibrillators for malignant ventricular rhythms—may be indicated.