Patients who experience symptoms such as palpitations, irregular heartbeats, dizziness or fainting should consult a cardiologist who specializes in arrhythmias.
Cardiac arrhythmias are disorders of the heart's normal rhythm that affect millions of people worldwide. These disturbances, which can manifest as irregular, rapid, or slow heartbeats, range from brief, harmless episodes to situations requiring urgent medical attention. Although often unnoticed, arrhythmias can cause symptoms such as palpitations, dizziness, or fainting, significantly impacting the quality of life of those who experience them. In other cases, they can lead to serious complications. For all these reasons, Dr. Juan Benezet, head of the Arrhythmia Unit at La Luz University Hospital , emphasizes the importance of understanding the causes, types, and treatments of these conditions to ensure early diagnosis and effective management. “Cardiac arrhythmias are common, especially in later life. While some are benign, others can lead to serious complications if not treated properly,” warns the specialist.
Arrhythmias can have various causes . The aging of the heart is one of the main causes, but there are also associated risk factors such as high blood pressure, hormonal imbalances, and stress. Thyroid disorders, as well as emotional factors like anxiety, can trigger these conditions.
According to Dr. Juan Benezet, in some cases, arrhythmias are due to structural problems in the heart , such as valvular diseases or scarring caused by various circumstances (ischemic or inflammatory processes, previous surgeries, etc.). In other cases, abnormal electrical circuits, present from birth or acquired over time, can also be responsible for these disturbances. “Identifying the specific cause is essential to choosing the most appropriate treatment,” he emphasizes.
The head of the Arrhythmia Unit at UICAR classifies arrhythmias into two main categories according to their origin: supraventricular and ventricular. Supraventricular arrhythmias, explains Dr. Benezet, originate in the atria and include, among others, atrial fibrillation , atrial flutter, and atrioventricular nodal reentrant tachycardia. Ventricular arrhythmias, on the other hand, which are more serious in many cases, originate in the ventricles and can be life-threatening if not treated promptly.
The cardiologist points out that the most common arrhythmia is extrasystoles , premature heartbeats, which can originate in both the atria and ventricles. “Although they are generally benign, they can be bothersome if they occur frequently.” On the other hand, the expert continues, atrial fibrillation is the most prevalent sustained arrhythmia and is associated with a higher risk of serious complications such as stroke and heart failure. “This condition requires specialized monitoring by a cardiologist,” the doctor explains.
The challenge of diagnosis
Diagnosing arrhythmias presents a challenge due to their sporadic nature. “In many cases, the episodes are brief and may not register on a conventional electrocardiogram, as the symptoms often disappear before medical attention is received. Furthermore, these episodes are commonly mistaken for anxiety attacks, which delays a proper diagnosis ,” emphasizes Dr. Benezet.
For this reason, the doctor insists, it is essential that patients experiencing symptoms such as palpitations, irregular heartbeat, dizziness, or fainting consult a cardiologist specializing in arrhythmias. The specialist can conduct a thorough evaluation and even order advanced tests when necessary, such as electrophysiological studies, which allow for real-time analysis of the heart's electrical activity and determination of the type of arrhythmia.
The treatment for arrhythmias depends on their type and underlying causes. In this regard, Dr. Juan Benezet emphasizes the importance of addressing the triggering factors. “Once these factors are controlled, treatment may include medication, invasive procedures, or a combination of both,” he explains.
Antiarrhythmic medications are used to control symptoms and prevent further episodes. “Although they are effective in many cases, they can have side effects and require regular monitoring by a specialist,” warns Dr. Benezet.
Electrophysiological studies and ablations
When medication is insufficient or not the best option, electrophysiological studies and ablations become the treatment of choice. “These minimally invasive procedures are performed by inserting very thin catheters through the femoral vein to reach the heart. During the study, specialists induce the arrhythmia to identify its origin and, if possible, perform an ablation. Ablation consists of destroying the fibers responsible for the arrhythmia using heat (radiofrequency) or cold (cryoablation) techniques. These procedures have a high success rate and, in many cases, allow for the permanent elimination of the heart rhythm disturbance,” the doctor concludes.