Brief Review of Cardiac Arrhythmias

By Richard N. Fogoros, M.D., About.com Guide,

http://heartdisease.about.com/cs/arrhythmias/a/cardarrhy_3.htm

Updated December 02, 2003

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 arrhythmias
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Figure 5 - Ventricular fibrillation

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Ventricular fibrillation

Ventricular fibrillation (VF) is a rapid, chaotic ventricular arrhythmia that immediately brings
to a halt all meaningful ventricular contractions. Blood therefore immediately stops flowing,
and loss of consciousness occurs within seconds. Unless cardiopulmonary resuscitation
measures are initiated within a few minutes of the onset of VF, sudden death will occur.

Figure 5 - Ventricular fibrillation. The multiple purple lines represent the chaotic electrical
activity seen in VF.

As a general rule, neither VT nor VF occur in patients without underlying cardiac disease.
For people who have underlying cardiac disease, in general, the worse the left ventricular
function, the higher the risk of developing life-threatening ventricular tachycardias.

There are exceptions to this general rule. One such exception is long QT syndrome, a
condition in which a specific type of ventricular tachycardia occurs that is associated with
certain ECG abnormalities (a prolonged QT interval). Patients with long QT syndrome
usually have no identifiable underlying cardiac disease, but appear to be born with the
propensity to develop a particular variety of ventricular tachycardia under certain
circumstances. (These circumstances can include exercise, or the administration of certain
drugs). These patients most often present with episodes of syncope (fainting) due to episodes
of ventricular tachycardia. (Click here for a discussion of long QT syndrome.)

While in some cases life-threatening VT or VF can be controlled with antiarrhythmic drugs,

by far the most effective means to prevent sudden death is to insert the implantable
defibrillator.

PACs and PVCs

Premature atrial complexes (PACs) and premature ventricular complexes (PVCs) are
abnormal electrical impulses arising either in the atria or the ventricles, respectively. These
arrhythmias often produce palpitations, but in general have very little medical significance.
(Click here for a discussion of PVCs and their treatment.)

Ventricular tachycardias

The ventricular tachycardias include both ventricular tachycardia itself, and ventricular
fibrillation.

Ventricular tachycardia (VT) is a rapid heart rhythm originating within the ventricles. VT
tends to disrupt the orderly contraction of the ventricular muscle, so that the ventricle’s
ability to eject blood is often significantly reduced. That, combined with the excessive heart
rate, can reduce the amount of blood actually being pumped by the heart during VT to
dangerous levels. Consequently, while patients with VT can sometimes feel relatively well,
often they experience – in addition to the ubiquitous palpitations – extreme lightheadedness,
loss of consciousness, or even sudden death.

Figure 4 - Ventricular tachycardia. The small purple line indicates a typical VT circu