Re-entry ventricular arrhythmia

Re-entry Ventricular Arrhythmia is a type of cardiac arrhythmia that occurs when a disturbance in the heart's electrical conduction system leads to rapid, uncoordinated heartbeats originating in the ventricles, the lower chambers of the heart. This condition is a significant concern because it can compromise cardiac output and lead to serious complications, including sudden cardiac death.

Causes

Re-entry ventricular arrhythmia is primarily caused by the presence of a "re-entry circuit" within the heart's ventricular tissue. This situation can arise due to various factors, including:

• Myocardial infarction (heart attack), which can create scar tissue that disrupts the normal flow of electrical impulses.
• Cardiomyopathy, a disease of the heart muscle that affects its size, shape, and structure.
• Electrolyte imbalances, particularly involving potassium and magnesium, which are critical for the proper electrical functioning of the heart.
• Genetic conditions, such as Long QT Syndrome and Brugada Syndrome, which affect the heart's electrical properties.

Symptoms

Symptoms of re-entry ventricular arrhythmia can vary widely among individuals, ranging from no symptoms at all to severe manifestations, including:

• Palpitations, a sensation of the heart racing or pounding
• Dizziness or lightheadedness
• Syncope (fainting)
• Chest pain
• In severe cases, cardiac arrest

Diagnosis

Diagnosis of re-entry ventricular arrhythmia involves a combination of clinical evaluation and diagnostic tests, including:

• Electrocardiogram (ECG or EKG), which records the electrical activity of the heart and can identify abnormal rhythms.
• Holter monitor, a portable ECG device worn for 24 hours or longer to record the heart's activity over time.
• Electrophysiological study (EPS), an invasive test where catheters are inserted into the heart to study its electrical system and identify re-entry circuits.

Treatment

Treatment for re-entry ventricular arrhythmia aims to prevent future episodes and reduce the risk of complications. Options include:

• Antiarrhythmic drugs, which help regulate the heart's rhythm.
• Catheter ablation, a procedure that destroys the tissue forming the re-entry circuit, thereby interrupting the abnormal electrical pathway.
• Implantable cardioverter-defibrillator (ICD), a device implanted in the chest to monitor the heart's rhythm and deliver electrical shocks when a dangerous arrhythmia is detected.
• Lifestyle modifications, including dietary changes, exercise, and avoiding triggers like alcohol and caffeine, may also be recommended.

Prognosis

The prognosis for individuals with re-entry ventricular arrhythmia varies depending on the underlying cause, the presence of heart disease, and the effectiveness of treatment. With appropriate management, many patients can lead normal, active lives.

See Also

• Cardiac electrophysiology
• Ventricular fibrillation
• Ventricular tachycardia