Too fast, too slow, stumbly: even a healthy heart can lose its rhythm. Frank Ruschitzka, Director of the Department for Cardiology at the University Hospital Zurich, explains when an assessment is needed and how cardiac arrhythmia can be treated.
Mr. Ruschitzka, when the beating of the heart gets out of sync, we quickly feel uneasy. Why?
What is special about the heart is that we can hear and feel this organ. This is why we are also very aware of changes in the heartbeat. And because the heart is so vital, short interruptions or stumbles in the heartbeat can be very worrying.
When should I worry about my heart?
The accelerated heartbeat during exertion or palpitations during excitement is a normal reaction of the heartbeat. In a long human life, the heart beats around three billion times. Even in healthy people, the heart can occasionally lose its rhythm briefly and harmlessly. However, if arrhythmias occur again, become more frequent, last more than a few seconds or are accompanied by dizziness or pain, you should get to the bottom of the cause and assess whether there is a pathological change that could be dangerous and needs to be treated – and can usually be treated thanks to many treatment options.
When is the heartbeat considered a cardiac arrhythmia?
We speak of a cardiac arrhythmia if the heart beats faster than 100 times per minute or slower than 60 times per minute, if the heart beats irregularly or if there are pauses lasting longer than three seconds. In addition to palpitations, stumbles or a slowed beat, cardiac arrhythmia can also manifest itself in dizziness and the feeling of fainting or actually fainting. Often, pronounced cardiac arrhythmias are based on a disease. However, there are deviations: In endurance athletes who train regularly, the pulse rate is generally lower at rest. Your heart is so powerful that fewer beats are sufficient to pump enough blood through your body. Normally, there are no pathological changes even with significantly less than 60 beats.
What are the possible causes of the disturbances?
If the heart beats very slowly, this may be due to a lack of blood flow to the heart, for example if the tissue no longer transmits the stimulus required for the heartbeat well due to the ageing process. Pauses can occur when the heart’s pacemaker, the sinus node, stops. The causes may lie in a congenital change or may have arisen in the course of life, for example due to various illnesses, which then manifest themselves in rhythm disturbances.
Are heart diseases always the reason?
Often yes. However, there are also many diseases that at first glance appear to have nothing to do with the heart, but can nevertheless affect it, such as anaemia, lung diseases and oxygen deficiency or a disorder in the mineral balance through to side effects of medication for completely different diseases. At our Heart Center, we use the latest examination methods to get to the bottom of the exact cause so that we can provide the patient with targeted treatment.
When can cardiac arrhythmias become dangerous?
A cardiologist should decide whether a cardiac arrhythmia is dangerous and needs to be treated after a detailed examination. Any new symptoms, in particular dizziness or even unconsciousness, reduced performance and/or chest pain, should be investigated. Treatment is necessary if the cardiac function is impaired by the arrhythmia and thus the patient’s quality of life. Cardiac arrhythmias are usually particularly dangerous if they occur in the case of heart disease, such as a heart attack or cardiac insufficiency.
How are cardiac arrhythmias treated?
Some cardiac arrhythmias can be remedied relatively easily, especially if a lack of sleep, stress, a mineral imbalance such as a potassium deficiency or excessive consumption of coffee and alcohol are the cause of the disorder. Medication can help to suppress the arrhythmia and is mainly used to prevent and treat acute or chronic cardiac arrhythmia. If medication does not help in the long term, we can use modern, minimally invasive catheter procedures to ablate the specific area of the heart that triggers the disorder. Catheter ablation can thus help to restore the heart to the correct rhythm in a number of cardiac arrhythmias. Basically, the earlier the treatment, the higher the chances of success. We follow a holistic, personalized treatment approach – we don’t just treat an arrhythmia, we treat patients. Thanks to gentle procedures, we can now treat patients who were unable to benefit from these therapies just a few years ago. In addition, we have a state-of-the-art infrastructure in several cardiac catheterization laboratories and a team available around the clock for emergencies. Patients can register themselves for an initial consultation or a second opinion or be referred to the USZ by their doctor.
Initial consultation and second opinion
We offer patients with cardiac arrhythmias quick and easy access to a qualified assessment.
