Introduction
In an absolute arrhythmia, the atria of the heart beat much too fast as is common in atrial fibrillation. In addition, however, the atrial movement that is too fast causes the chambers of the heart to beat irregularly so that the heart twitches completely irregularly. As a result, the blood that has to be pumped through the heart stops because of the many twitches and no more blood can enter the circulation. Such a condition is very dangerous and involves several risks.
These accompanying symptoms occur in the case of an absolute arrhythmia
The absolute arrythmia runs unnoticed in most cases, as no typical symptoms occur. Possible symptoms and complaints that can occur in atrial fibrillation, however, are dizziness attacks, in rare cases even with fainting, anxiety and inner restlessness, as well as the increased perception of one’s own pulse or palpitations. In severe forms of absolute arrhythmia, which occur together with heart disease, there may be a deterioration in heart function and, as a result, symptoms of heart failure.
These primarily include reduced resilience with associated shortness of breath, irritable cough, fluctuations in blood pressure, water in the legs and frequent urination at night. Another serious accompanying symptom of atrial fibrillation can be the consequence of a blood clot, for example after a stroke. If there is atrial fibrillation, there is a greatly increased risk of a blood clot forming in the atrium and being ejected into the body with potentially serious consequences, such as blockage of one of the blood vessels that supply the brain.
Causes of absolute arrhythmia
Atrial fibrillation or absolute arrhythmia can occur as a result of many different diseases. Only in the fewest diagnosed absolute arrhythmias, no underlying cause can be found. In these cases one speaks of idiopathic atrial fibrillation.
Among the most common causes are diseases of the heart, such as an inflammation of the heart muscle that has occurred, a narrowing of the heart valve, coronary heart disease, chronic heart failure, heart damage or congenital heart defects. However, diseases far from the heart can also cause atrial fibrillation and must therefore not be ignored during the diagnostic process. These include hyperthyroidism, acute displacement of the pulmonary artery due to a blood clot, prolonged cardiac stress due to a chronic lung disease such as chronic obstructive pulmonary disease (COPD), or the incorrect use of some medications. In young and heart-healthy people, atrial fibrillation can also occur after alcohol excesses or as a result of many years of endurance sports.
How is an absolute arrhythmia diagnosed?
The diagnosis of atrial fibrillation is made on the basis of the ECG. However, a detailed medical consultation and clinical examinations can confirm the diagnosis of atrial fibrillation in advance. It is important to find out whether there is a known trigger for atrial fibrillation, such as physical strain, alcohol consumption or infections.
In addition, it should be determined whether competitive sports were practiced in the past or whether there have already been infarctions or strokes. In the subsequent physical examination, the focus should be on the heart examination. Here, the first indication of the presence of atrial fibrillation can already be seen when the pulse is felt.
A useful indicator is an irregularly palpable pulse or a difference between the palpated pulse and the heart action audible through a stethoscope. When listening to the heart, a changing volume of the first heart tone may be noticeable. Various scores are used in the diagnosis and therapy planning of absolute arrhythmia.
Probably the most important one is the so-called CHA2DS2VASc score, which is used to assess the risk of a stroke. From a score of 2 points on, a blood-thinning medication should be administered for the prophylaxis of a stroke. The CHA2DS2VASc-Score includes the following risk factors, each of which is scored with one or two points Chronic heart failure or left ventricular dysfunction, hypertension (high blood pressure), age > 75 years, diabetes mellitus, stroke or thrombosis, vascular disease (e.g. a CHD or PAD), age 65-74 years, and gender.
The ECG is the method of choice for the diagnosis of cardiac arrhythmia and, in the course of this, also for the diagnosis of an absolute arrhythmia. Atrial fibrillation or absolute arrhythmia is shown as a visual diagnosis on the printed ECG. Typical ECG complexes are normally seen, with each jag reflecting a specific heart action.
In simple terms, a complex can be described as the sequence of a small wave (the P wave) followed by a high peak (the R wave). The p-wave represents the contraction of the atria, followed by the high R-wave, which reflects the action of the ventricles. If an absolute arrhythmia is present, an irregular sequence of R-waves occurs.
The ventricular spikes, which otherwise always occur at the same intervals, are now irregular and vary in their timing. In the case of an absolute arrhythmia, the P-wave is no longer recognizable in the ECG, but instead, as a result of the uncontrolled activity of the atria, there is a kind of serpentine line in front of the R-waves. If the atrial fibrillation is not permanent, it is possible to make the diagnosis by means of a long-term ECG.
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