Arrhythmia: Causes, Concerns, and Treatment Options

Arrhythmia-related issues

Hello, Doctor.
Last month, I underwent an examination due to renal edema and discovered that I have a left ureteral stone.
I received extracorporeal shock wave lithotripsy, which successfully addressed the stone.
Initially, my condition of left renal edema led to hypertension, with blood pressure fluctuating between 140 and 150.
After treatment, my blood pressure has returned to normal (between 115-125/78-88, measured every morning and evening).
However, recently, I have been experiencing an inexplicable irregular sensation in my heart, which raises concerns about potential cardiovascular issues.
I had blood tests done, including lipid profile, cholesterol, triglycerides, fasting blood glucose, and thyroid function tests, all of which returned normal results.
Subsequently, I underwent a 24-hour Holter monitor test, which indicated arrhythmia.
Is this considered very serious? Is surgical treatment necessary? Could the long-term unnoticed renal edema have contributed to heart issues? Thank you for your attention.

Blood test results:
TSH 1.97 (0.4-4.4) mg/dl
Glucose AC 98 (70-99) mg/dl
Uric acid 5.8 (3.5-8.0) mg/dl
Cholesterol 141 (0-200) mg/dl
Triglyceride (TG) 59 (0-150) mg/dl
Calcium 9.8 (8.5-10.0) mg/dl
Sodium 140 (135-145) mmol/dl
Potassium 4.2 (3.5-5.3) mmol/dl
HDL 45 (40-85) mg/dl
LDL 92 (0-130) mg/dl
Holter monitor report:
Impression:
1.
Sinus rhythm with a rate of 46-150/min and a mean of 73/min.

2.
Frequent atrial premature contractions (total 4352).

3.
No ventricular premature contractions.

4.
No pauses.

5.
There were intermittent T wave inversions.

6.
Total of 3 events: 1 event was sinus rhythm with APC and 2 events were sinus tachycardia.

Note: Three Channels (MV5, MV1, Lead III).

Jian Xiansheng, 30~39 year old female. Ask Date: 2023/09/07

Dr. He Dongjin reply Cardiology

Hello, it seems to be okay.
Benign arrhythmia can be controlled with medication and is not considered serious.
There is no need for surgical treatment, so don't worry.
Changhua Hospital cares about you.

Reply Date: 2023/09/07

More Info

Understanding arrhythmia is crucial for managing heart health, especially after experiencing symptoms like those you've described. Your recent medical history, including kidney issues and the subsequent treatment for ureteral stones, has understandably raised concerns about your cardiovascular health. Let's break down the situation and address your questions regarding arrhythmia, its causes, and treatment options.

What is Arrhythmia?
Arrhythmia refers to an irregular heartbeat, which can manifest as a heart that beats too quickly (tachycardia), too slowly (bradycardia), or with an irregular rhythm. In your case, the 24-hour ECG revealed a sinus rhythm with a heart rate ranging from 46 to 150 beats per minute, indicating episodes of both bradycardia and tachycardia. The presence of frequent atrial premature contractions (APCs) suggests that your heart is experiencing extra beats originating from the atria.

Causes of Arrhythmia
Several factors can contribute to the development of arrhythmias, including:
1. Electrolyte Imbalances: Abnormal levels of potassium, sodium, calcium, or magnesium can disrupt the electrical signals in the heart.

2. Structural Heart Changes: Conditions such as hypertension, heart valve disease, or previous heart attacks can alter the heart's structure and function.

3. Medications: Certain medications can affect heart rhythm.

4. Lifestyle Factors: Stress, caffeine, alcohol, and smoking can trigger arrhythmias.

5. Underlying Health Conditions: Conditions like hyperthyroidism, as well as your recent kidney issues, can influence heart rhythm.

Your Situation
Given your history of kidney swelling and fluctuating blood pressure, it is possible that these factors have contributed to your current arrhythmia. The kidneys play a vital role in regulating blood pressure and electrolyte balance, and any dysfunction can have downstream effects on heart health.

Severity and Treatment Options
The severity of your arrhythmia depends on various factors, including the frequency of the APCs and any associated symptoms. While frequent APCs can be benign, they can also indicate underlying issues that may need to be addressed. Here are some considerations:
1. Monitoring: Regular follow-up with your healthcare provider is essential. They may recommend additional tests, such as echocardiograms or stress tests, to assess heart function and structure.

2. Lifestyle Modifications: Reducing stress, avoiding stimulants (like caffeine), and maintaining a healthy diet can help manage arrhythmias.

3. Medications: Depending on the frequency and severity of your symptoms, your doctor may prescribe medications to help control your heart rate or rhythm.

4. Interventional Procedures: In cases where arrhythmias are symptomatic and not manageable with medication, procedures like catheter ablation may be considered. However, this is typically reserved for more severe cases.

Conclusion
While your arrhythmia may not be classified as "very severe," it is essential to take it seriously, especially given your recent health history. The absence of significant abnormalities in your blood tests is reassuring, but continued monitoring and communication with your healthcare provider are crucial. They will help determine the best course of action based on your specific situation, including whether further intervention is necessary.

If you experience any alarming symptoms, such as chest pain, severe shortness of breath, or fainting, seek immediate medical attention. Your health is paramount, and staying proactive about your cardiovascular health will serve you well in the long run.

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