Bradycardia, or slow heartbeat, is often present in athletes. It may, however, indicate conduction problems, especially in older people. In one type of bradycardia, called sinoatrial or atrioventricular block, or heart block, rhythm can be maintained by implanted electrodes that act as artificial pacemakers.
Tachycardia, or heartbeat faster than 100 beats per minute in the adult, can be precipitated by drugs, caffeine, anemia, shock, and emotional upset. It may also be a sign of overactivity of the thyroid gland or underlying disease. Flutters, and the even faster fibrillations, are rapid, uncoordinated contractions of the atrial or ventricular muscles that usually accompany heart disorders. Atrial fibrillation may be idiopathic, the result of rheumatic mitral valve disease (see rheumatic fever) in young people or hypertensive heart disease (see hypertension) and arteriosclerotic heart diseases (see arteriosclerosis) in older people. It may result in a rapid pulse rate and may be associated with thrombus formation in the atria and a risk of embolization to the brain (stroke) or other organs. Atrial fibrillation is often treated with digitalis and other drugs that regulate heart rhythm or heart rate. Ventricular fibrillation is a sign of the terminal stage of heart failure and is usually fatal unless defibrillation is achieved by immediate direct-current defibrillation. Some tachycardias can be managed by the implantation in the upper chest of small defibrillators that sense dangerous fibrillations and administer an electric shock to the heart to restore normal rhythm.
Variation from the heartbeat's normal rate or rhythm, caused by problems in the heart's pacemaker or in nerves conducting its signals. Occasional arrhythmias are normal. Tachycardia is a fast regular rhythm; bradycardia is a slow rhythm. Premature atrial or ventricular beats are extra contractions in normal rhythm. Ongoing arrhythmia in some heart diseases can reduce the heart's ability to supply the body with blood and can lead to heart failure. Severe arrhythmias can trigger atrial fibrillation or ventricular fibrillation. Arrhythmias are detected by electrocardiography and treated by electric shock (often with an implanted pacemaker) or by drugs such as quinidine and digitalis.
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