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Cardiac Arrhythmias

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Papworth Clinic in Cambridgeshire provides innovative treatments for heart and chest problems at the UK’s largest cardiothoracic hospital.

 

Their services are internationally recognised and include diagnostic and interventional cardiology, electrophysiology, cardiac surgery including coronary artery bypass grafting (CABG) and heart valve repair/replacement, cardiothoracic surgery and transplantation.

 

Visit the Papworth Clinic website

 

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Cardiac Arrhythmias fig 1

Cardiac Arrhythmias

Cardiac arrhythmias are abnormal heart rhythms that can be develop throughout life. Rhythm disturbances can occur from childhood to old age causing a range of symptoms that include palpitation (an awareness of abnormal or irregular heartbeats), breathlessness, lethargy, dizziness and blackouts, or feelings of chest discomfort and anxiety. The heart rhythm can be abnormal either because it may be beating too slowly, too rapidly or becomes irregular.

 

Arrhythmias are in the top 10 causes for hospital attendances. There are 700,000 people in the UK that suffer from these symptoms. Some arrhythmias such as ectopic beats are benign but others such as ventricular arrhythmias arising from the lower ventricular pumping chamber can be life threatening.


Intensive research over the last 2 decades has significantly improved our knowledge and understanding of the basic mechanisms of how arrhythmias occur and new treatments developed to cure these conditions.

The UK government has recently published guidelines for the treatment of cardiac arrhythmias in chapter 8 of the National Service Framework, a document setting out best practise and minimum standards in the treatment of arrhythmias in the UK. In this official document it is advised that patients with arrhythmias should be referred to a cardiac rhythm specialist to receive the most appropriate advice and treatment.

 

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Cardiac Arrhythmias fig 2

Normal cardiac conduction

The basic function of the heart is to pump blood around the body for all the essential of the vital organs to keep us alive. In fact, we can only survive for a few minutes if the heart stopped pumping before irreversible damage and subsequent death would occur.

 

The heart consists basically of 4 chambers, 2 upper atrial collection chambers which collects blood coming back to the heart, each is connected to a lower “high pressure” pumping chamber that are able to generate the forward driving pressure to pump blood around the body.

 

The entire mechanical pump is driven by an electrical system. The sinus node is the area of the heart that initiates electrical signals (pacemaker) to start a heartbeat. Activation results in contraction of the upper atrial chamber passing this onto the lower ventricular pumps. The pacemaker signals then continues onto a relay station (AV node), which is connected to the lower pump by specialised bundles of electrical wiring (His Purkinje system).

 

There are a total of 4 one way valves in the heart that open and close in sequence during periods of filling and active pumping that keep blood flowing in one direction (Figure 1). Normally the His Bundle leading from the AV node, is the only connection between the top atrial chamber and the lower ventricle. Normally the whole process repeats itself always starting from the pacemaker area progressing from a top to bottom direction (Figure 2). Abnormities occur when the normal sequence is disrupted leading to cardiac arrhythmias.

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