aritmia

Aritmia, or arrhythmia in English, refers to any abnormality in the heart’s rhythm. It can involve the rate, regularity, or site of impulse formation and conduction. Most arrhythmias are not immediately life-threatening, but some can cause symptoms such as palpitations, dizziness, or fainting, and others can be dangerous or fatal if not treated.

Classification of arrhythmias is typically based on rate and mechanism. Tachyarrhythmias are rhythms that are fast, usually defined as over 100 beats per minute, while bradyarrhythmias are slow, generally below 60 bpm. Mechanistically, disturbances may arise from abnormal impulse generation (often called ectopy or reentry) or from impaired electrical conduction (such as heart blocks). Commonly encountered arrhythmias include atrial fibrillation and atrial flutter, which are supraventricular; ventricular tachycardia and ventricular fibrillation, which are ventricular; and premature atrial or ventricular contractions.

Causes and risk factors are diverse. They include structural heart disease (ischemic heart disease, cardiomyopathy), electrolyte disturbances (notably potassium and magnesium imbalances), ischemia, congenital conditions, thyroid disorders, and side effects or toxicity from medications. Other contributing factors can be increased sympathetic activity, sleep apnea, alcohol or stimulant use, and various systemic illnesses.

Diagnosis typically relies on electrocardiography (ECG). Prolonged or intermittent arrhythmias may require ambulatory monitoring (Holter or event monitors), echocardiography to assess heart structure, exercise testing, and laboratory tests to evaluate electrolytes, thyroid function, and other contributors.

Management depends on the type and clinical impact. Hemodynamically unstable rhythms require urgent electrical cardioversion. Long-term strategies include rate control (beta-blockers or calcium channel blockers), rhythm control (antiarrhythmic drugs or ablation), and anticoagulation when stroke risk is elevated, such as in atrial fibrillation. Device therapies (pacemakers and implantable cardioverter-defibrillators) may be indicated for certain bradyarrhythmias or malignant ventricular arrhythmias. Prevention focuses on treating underlying conditions and avoiding triggers, with lifestyle measures and management of cardiovascular risk factors.