Problems with the electrics
Abnormal fast rhythms: these can develop from both the upper and lower chambers and cause symptoms and these include: palpitations, breathlessness, feeling lightheaded and rarely fainting. Rhythm disturbances can often be treated with drugs to slow these down or convert them back to normal but occasionally more specialised procedures are needed. An irregular heart rhythm originating from the upper chambers is atrial fibrillation, which is very common and often needs long term blood thinners to reduce your long-term risk of stroke. ECGs and holter monitors are often used to diagnose heart rhythm problems but rarely an implantable monitor called a loop recorder (ILR) is needed.
Abnormal slow rhythms: these are most commonly due to faulty conduction, often between the upper and lower chambers, and often a pacemaker is needed to treat these.
Problems with the pump function
Problems with the pumping function of the main chambers (ventricles) can develop for several reasons. This can cause accumulation of fluid in the lungs leading to breathlessness and fluid in the lower legs causing swelling (called oedema). The collection of symptoms and fluid congestion is called heart failure. Whilst treatment of underling causes (e.g. valve problems) can help specialist tablets, often overseen by a heart failure specialist, help clear excess fluid and improve symptoms. Details of tablets used for heart failure are described in the section: MEDICAL THERAPY FOR HEART FAILURE. Problems with the pumping function are often associated with electrical problems and often specialised pacemakers are needed with either a defibrillator and or third pacemaker lead (resynchronisation pacemaker).
Your heart has it’s own electrical supply which stimulates the chambers to pump in a co-ordinated way. The current passes from the upper chambers via a circuit called the AV node to the lower chambers, where it then stimulates contraction and pumping of the lower chambers in turn, after pumping of the upper chambers is complete.
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