A Message from the Heart to the Heart

Prepared by:

Dr. Abdulwahab Arrazaghi

(Specialist of Internal Medicine and Cardiovascular Diseases)

University of Toronto, Canada




1. What does Arrhythmia mean ?

Arrhythmia means an abnormality in the heartbeat (rhythm, or rate, or combined).


2. What does the patient with arrhythmia would feel ?

This ranges from no symptoms to a large mix up of symptoms including lightheadedness, fatigue, tiredness, exertional, or resting dyspnea (short of breath), chest pain, and in extreme cases syncope (loss of consciousness, or even death).


3. What does tachycardia and bradycardia mean ?

Tachycardia and bradycardia mean non-specific fast or slow heartbeat (respectively), both of these conditions can be physiological or pathological.


4. What does sick sinus syndrome mean ?

Sick sinus syndrome most commonly present with transit loss of consciousness (syncope, or severe lightheadedness) and it is usually related to severe drop in the heart rate due to a malfunction of your heart pacemaker called the SA node, which is firing too slowly for the physiological activity that you are performing at a particular time. The condition can be brought up by aging alone, but heart disorders, and some cardiac and non-cardiac medications can bring the same problem.


5. What does atrial fibrillation mean ?

Atrial fibrillation is a heart rhythm problem characterized by fast heartbeat resulting from the electrical activity in the atria (the upper chambers of your heart is being totally disorganized), condition results in a very rapid contractions of the heart's upper chambers, which prevent them from pumping the blood effectively. Because of that this can lead to stagnation (slowness) of the blood flow from the upper chambers (the atria) to the lower chambers (the ventricles) and this can result into clot formation and that is why this condition can increase the risk of stroke.


6. What does ventricular tachycardia mean ?

Ventricular tachycardia occurs when the ventricles (the lower chambers of the heart are beating too fast). It is a potentially very dangerous condition because the ventricles responsible for pumping blood to rest of the body and because of the very fast heartbeat, the ventricles cannot pump effectively resulting in sudden death if the condition was not reversed.


7. How do we diagnose arrhythmias ?

Clinical history and proper physical exam are very important help in diagnosing arrhythmias; most of the time the physician would require to perform specific testings to help in identifying the rhythm for proper treatment. This would include 12-lead ECG, heart monitoring, or loop monitoring recorder, an exercise stress test, echocardiography study, and in some patient's the diagnosis can all be achieved or further confirmed by performing invasive study called electrophysiology study.


8. How do we treat arrhythmias ?

This varies from medical treatment to surgical treatment. The medications that we commonly use to prevent arrhythmias from occurring, or to minimize the presenting symptoms on a particular patient; at other times, we use surgical treatment which would include pacemaker implant, implantable defibrillators, catheter ablation and less commonly open heart surgeries.