Cardiac Arrythmia

Cardiac Arrythmia

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Definition

  • Cardiac arrhythmia, also known as cardiac dysrhythmia or irregular heartbeat, is a group of conditions in which the heartbeat is irregular, too fast, or too slow. A heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia and a heart rate that is too slow – below 60 beats per minute – is called bradycardia. (http://www.nhlbi.nih.gov/)

Epidemiology and burden of Cardiac Arrythmia

  • The estimated number of individuals with AF globally in 2010 was 33∙5 million [(20∙9 million males (UI, 19∙5-22∙2 million) and 12∙6 million females (UI, 12∙0-13∙7 million)]. (2014 Feb 25;129(8):837-47)
  • Although deaths linked to atrial fibrillation are rising around the world, more women with atrial fibrillation are dying in developing countries. In the U.S., deaths linked to atrial fibrillation now are comparable between the sexes. (https://www.cedars-sinai.edu)
  • In the recent report of The Lancet, by 2010, 60% of the world’s heart patients will be in India. (http://wwwp.medtronic.com/Newsroom)

Treatment for Cardiac Arrythmia

  • For the treatment of stable, monomorphic ventricular tachycardia (VT), procainamide, ajmaline and sotalol Are all superior to lidocaine; amiodarone was not more effective than procainamide. (Emerg Med J.2015 Feb;32(2):161-7)
  • Sotalol can be recommended as the drug of first choice for treatment of fetal AF and has been shown to be an effective and safe first-line treatment option for supraventricular tachycardia (SVT) (Ultrasound Obstet Gynecol.2013 Sep;42(3):285-93)
  • For the treatment of bradycardia atropine sulfate should be adjusted at least to lean body weight in order to avoid paradoxical heart rate response in patients with obesity. (BMJ Case Rep.2015 Jan 29;2015)
  • Both long-acting calcium channel blockers and beta blockers improve symptoms in 60%-80% of patients with SVT. (Eur Heart J.1997 May;18 Suppl C:C27-32)

Prevention of Cardiac Arrythmia

  • Administration of prophylactic magnesium reduced the risk of supraventricular arrhythmias after cardiac surgery by 23% (atrial fibrillation by 29%) and of ventricular arrhythmias by 48%. (Am J Med.2004 Sep 1;117(5):325-33)
  • Smoking cessation is accompanied by a marked reduction in arrhythmic death and overall mortality. (J Am Coll Cardiol.1995 Nov 1;26(5):1287-92)
  • Moderate tea intake is associated with a lower prevalence, and higher coffee intake with a slightly higher prevalence, of ventricular arrhythmias among patients hospitalized with acute myocardial infarction. (J Am Coll Nutr.2006 Dec;25(6):472-9)
  • Recommend doses of eicosapentanoic acid and docosahexanoic acid in the combined range of 800 to 1000 mg/day for primary and secondary prevention of cardiovascular disease. (J Cardiopulm Rehabil Prev.2008 Mar-Apr;28(2):92-8)

Risk factors for Cardiac Arrythmia

  • Age positively correlates with an increasing risk of cardiac problems including arrhythmias. Not only the prevalence but also the severity of arrhythmias escalates with age. (Expert Rev Cardiovasc Ther.2011 Aug;9(8):1059-67))
  • Arrhythmia hospitalization or mortality were associated with air pollutants and with increases in PM2.5 (RR = 1.015 per 10 μg/m³, 95% CI: 1.006-1.024, PM10 (RR = 1.009 per 10 μg/m³, 95% CI: 1.004-1.014), carbon monoxide (RR = 1.041 per 1 ppm, 95% CI: 1.017-1.065), nitrogen dioxide (RR = 1.036 per 10 ppb, 95% CI: 1.020-1.053), and sulfur dioxide (RR = 1.021 per 10 ppb, 95% CI: 1.003-1.039). Compared with Europe and North America, a stronger association was noted in Asia. (Int J Environ Res Public Health.2016 Jun 28;13(7))
  • Meta-analysis suggests that current domperidone use increases the risk of cardiac arrhythmia and sudden cardiac death by 70%. (Clin Drug Investig.2016 Feb;36(2):97-107)
  • Presence of left ventricular hypertrophy (LVH) in hypertensive patients is associated with a greater risk of sustained supraventricular/atrial and ventricular arrhythmias, and there is an unmet need for identifying and refining risk stratification for this group. (Am J Cardiol.2014 Oct 1;114(7):1049-52)
  • beta(2)-Agonist use in patients with obstructive airway disease increases the risk for adverse cardiovascular events. (2004 Jun;125(6):2309-21)

Systematic reviews

  • The effectiveness and cost-effectiveness of dual-chamber pacemakers compared with single-chamber pacemakers for bradycardia…more
  • Risk Factors For Bradycardia Requiring Pacemaker Implantation In Patients With Atrial Fibrillation…more
  • Herb–drug interactions: an overview of systematic reviews…more

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