Hearts that lose their rhythm

Hearts that lose their rhythm
  • Arrhythmias increase with an ageing population but technology has improved the way they are treated

Everyone carries a song inside them, a constant percussion in the chest, the rhythm that gives us life. That beat isn't always as even and regular as it should be, however. Arrhythmia is a condition which changes the normal pace of the heart (which should be between 60 and 100 beats a minute) and affects more men than women.

José Luis Roberson, a septuagenarian whose heart lost its natural rhythm 12 years ago, tells us his story:

"It was January 21st and the weather was horribly cold, but I went out running anyway because I was training for a marathon. I have always been athletic and in good physical shape, but I suddenly felt a fluttering in my chest and a feeling of fatigue from the waist down. My legs didn't seem to want to work and the pulsometer started to go crazy. There was nobody else around, and no high-tension equipment, so there was no reason for the gadget to do that. I turned round and decided to go straight to a doctor I knew from my rowing club, but by the time I got there I had a very fierce pain in the left part of my chest. The doctor said I had arrhythmia," he explains.

Since then, José Luis has had heart surgery three times, is undergoing treatment and has written a book about his experience, called Usted No Tiene Nada.

"I gave it that title [it means 'there's nothing wrong with you' in English] because that's what the first cardiologist I saw told me," he says. And something was wrong with him. He had atrial fibrillation (AF), the most common type of arrhythmia in Spain, which affects between one and two per cent of the general population, but rises to 4.4 per cent in the over-40s and up to nine per cent in octogenarians. With the ageing of the current population, it is calculated that these figures will double in the next five decades.

Even so, the title of José Luis' book is quite apt, because many patients are affected by the fact that atrial fibrillation is under-diagnosed, as a study published in the Journal of the American College of Cardiology indicated in April.

Nevertheless, arrhythmias can occur in a large number of conditions, not just AF. These are distinguished depending on whether they speed up or slow down the pulse. If it is working at more than 100 beats a minute we are looking at tachycardia (the heart beats faster than normal). That occurs because of irregularities in the way the atria, the upper chambers of the heart, function, such as in the case of atrial fibrillation or atrial flutter, or through alterations in the activity of the ventricles, (lower chambers of the heart), such as ventricular tachycardia or ventricular fibrillation.

If the heart beats fewer than 60 times a minute, this is bradycardia (a slowing of the heart), and this is often related to problems in the sinus node (our natural pacemaker), and also atrioventricular block, in other words when the electrical signals which are transmitted through the atria do not reach the ventricles.

Each of these pathologies can have different causes depending on who suffers from them, because arrhythmias can be acquired (which is most common) or hereditary.

"An acquired arrhythmia responds to risk factors such as ageing, hypertension, diabetes, smoking, high cholesterol or a coronary illness, among others, while many cardiac illnesses are genetically determined and are predisposed to suffer arrhythmias," says Javier Jiménez Candil, president of the Cardiac Rhythm Association of the Spanish Cardiology Society (SEC).

Continual stress and high-intensity sport have also been classified as enemies of the heart. That was exactly the reason for José Luis' arrhythmia.

"When I thought about it afterwards, I was very stressed at work and that, combined with high-resistance sport, was like a bomb as far as my heart was concerned," he says.

This is why experts advise having a medical check-up before starting any new sport, especially people who have never done sport before.

Arrhythmias can also occur during foetal life, childhood or adolescence, but "the vast majority are benign and easily documentable and treatable", says the cardiologist.

In adults this is less common, although it is possible that arrhythmia shows only minor symptoms or perhaps none at all. The latter is a problem in serious cases, because the lack of treatment can have fatal consequences, such as a stroke.

The symptoms of arrhythmias depend on the type of alteration. "Tachycardias result in a fast pulse, palpitations, fatigue, pain in the chest and difficulty in breathing, while bradycardias appear in the form of syncopes [fainting]," says Dr Jiménez. Some malign arrhythmias can also lead to sudden death.

"I have lost consciousness several times and found myself in hospital when I came round. It makes you feel very insecure. That's why some people with arrhythmia are too scared to leave their homes," says José Luis. "My advice to them would be to confront their fears, eat healthily, exercise within their capabilities and find a good cardiologist who will monitor them," he says.

Diagnostic apps

The latest news with regard to diagnosing arrhythmias comes in the form of mobile apps which carry out quality electrocardiograms. "This is a great advance because they make it easier to detect sporadic arrhythmias, which are difficult to identify, and therefore to treat," says Jiménez.

Treatments for arrhythmias are divided into three groups: the ones that change bad lifestyle habits (losing excess weight, taking exercise, controlling risk factors); specific drugs for each type of arrhythmia, and intervention techniques which depend on each patient.

For example, pacemakers are ideal to treat bradycardias with syncopes, while a patient with tachycardia which is not responding to medication will benefit from a cardiac ablation.

Thanks to all this, say the specialists, a large number of arrhythmias can be cured or controlled nowadays, thereby improving the quality of life of those who suffer from them.


Eat healthily

Mediterranean diet. The best

A cardio-healthy diet means avoiding excess calories (less saturated fat, sugar and salt) and more fruit, vegetables, fish and fibre. Obesity and cholesterol are very damaging for the heart. The countries with the best cardiac health are those that follow the Mediterranean diet.


Be more active. More cardio

When we exercise, our heart speeds up. It’s a type of healthy tachycardia, because it oxygenates the body and reduces blood pressure. Recommended moderate exercise includes walking for an hour, swimming or doing cardio exercise like dancing or aerobics.

Sleep for 8 hours

Insomnia. Possible heart attacks

People who have difficulty sleeping are 45% more at risk of having a heart attack, according to a study by Norwegian experts. Recommendations for better sleep are: keep regular hours, avoid heavy meals in the evening, and take exercise.

Don’t smoke

Mortality. Three times the risk

Research has shown that tobacco speeds up the heart, damages the cells that cover the blood vessels and contracts the main arteries, among other effects. It is also known that the incidence of cardiovascular illnesses is three times higher in smokers.

Drink in moderation

A cup of tea. An exceptional ally

Alcohol, even in small amounts, alters cardiac rhythm, says an article in the Journal of the American College of Cardiology. However, a cup of tea a day reduces the risk of cardiovascular problems by 35 per cent, according to a study by the Johns Hopkins Hospital.

Avoid stress

Meditation. A simple respite

Stress increases blood pressure, can cause arteriosclerosis, arrhythmias and increases the risk of heart attack. People under stress are about 27% more likely to have heart problems. Try not to work too many hours, stay positive, meditate or do yoga.