【Common Diseases】Arrhythmia
A must-read guide to treating arrhythmias in Hong Kong
Arrhythmia is an abnormal heartbeat rhythm that can be too fast (tachycardia), too slow (bradycardia), or irregular. It is not a single disease but a group of conditions related to the heart's electrical conduction system.
In Hong Kong, cardiac arrhythmias are common, especially among the elderly, those with coronary heart disease, thyroid disease, and those with hypertension or diabetes. According to clinical observations by the Hong Kong Hospital Authority, atrial fibrillation (AF) is one of the most common types of sustained arrhythmias and is closely associated with stroke risk.
As an editor, I find that many people's understanding of arrhythmia is still at the stage of "a faster heartbeat is no big deal." However, in fact, some arrhythmias may have no symptoms but pose potentially fatal risks. For example, ventricular fibrillation can be fatal within minutes.
1. What is arrhythmia?
Under normal circumstances, the heartbeat is initiated by the sinoatrial node (SA node) located in the right atrium, which transmits electrical signals to the ventricles through the atria and atrioventricular node (AV node), forming a stable rhythm (the resting heart rate of an adult is about 60–100 beats/minute).
Arrhythmia is an abnormality in this electrical conduction system that causes the heart to beat too fast, too slow, or irregularly. Common types include:
- Atrial fibrillation (AF)
- Atrial Flutter
- Supraventricular tachycardia (SVT)
- Ventricular tachycardia (VT)
- Ventricular fibrillation (VF)
- Sinus bradycardia/atrioventricular block
2. Causes
Common causes of arrhythmia in Hong Kong include:
- Structural heart diseases : coronary artery disease, valvular heart disease, cardiomyopathy.
- Hypertension : Long-term high blood pressure can cause the atria to enlarge and increase the risk of atrial fibrillation.
- Thyroid dysfunction : Hyperthyroidism can increase your heart rate.
- Electrolyte imbalance : Abnormal levels of potassium, magnesium, sodium, or calcium.
- Excessive alcohol consumption/caffeine : Hong Kong people love to drink coffee and milk tea, and excessive consumption may trigger arrhythmia.
- Side effects of medications : certain asthma medications, cold medicines, antidepressants.
- Stress and lack of sleep : Long-term mental stress can affect the autonomic nervous system.
3. Symptoms
- Palpitations (feeling of fast, heavy, or irregular heartbeats)
- Dizziness and blurred vision
- shortness of breath
- Chest discomfort or pain
- Syncope (in severe cases)
💡 Editor's reminder: Some arrhythmias are completely asymptomatic and can only be detected through electrocardiograms.
4. Why is treatment needed?
The dangers of an irregular heartbeat are that it can:
- Increased risk of stroke (especially with atrial fibrillation)
- Leading to heart failure
- Causes sudden death (such as ventricular fibrillation)
In Hong Kong, the disability and mortality rates of atrial fibrillation-related stroke are very high, so early diagnosis and treatment are very important.
5. Treatment Principles
Treatment goals include:
- Control heart rate or restore normal heart rhythm
- Preventing blood clots and stroke
- Improve symptoms and quality of life
- Preventing fatal heart arrhythmias
5.1 Lifestyle Improvement
Even if medication or surgery is needed, lifestyle adjustments are essential:
- Limiting alcohol and caffeine : Reducing triggers of arrhythmia
- Quit smoking : Smoking harms cardiovascular health
- Eat a balanced diet : plenty of fruits and vegetables, whole grains, and fish, and avoid high-salt and high-fat foods.
- Regular exercise : helps improve cardiovascular function (but the intensity of exercise needs to be assessed by a doctor)
- Managing stress and getting enough sleep : reducing autonomic nervous system fluctuations
5.2 Drug treatment
Commonly used drug categories in Hong Kong cardiology:
- Antiarrhythmic drugs (such as Amiodarone, Flecainide, Sotalol) – control heart rhythm or rate
- Beta-blockers – slow down the heartbeat and stabilize the heart rhythm
- Calcium channel blockers (eg, Diltiazem, Verapamil) – to control ventricular rate
- Anticoagulants (such as warfarin, NOACs: dabigatran, rivaroxaban, apixaban) – to prevent blood clots and stroke (especially in patients with atrial fibrillation)
💡 Editor's tip: Public hospitals in Hong Kong use the CHA₂DS₂-VASc score to determine whether patients with atrial fibrillation require anticoagulation. Private doctors may offer more newer medication options with fewer side effects and fewer monitoring requirements, but at a higher cost.
5.3 Interventional and surgical treatment
When medications are ineffective or the patient is at high risk for arrhythmia, intervention or surgery may be necessary:
-
Catheter Ablation
- Use radiofrequency or cryoenergy to destroy areas of abnormal electrical conduction
- Significant effect on atrial fibrillation, supraventricular tachycardia, etc.
-
Pacemaker implantation
- For bradycardia or atrioventricular block
- Hong Kong hospitals generally provide single-chamber or dual-chamber pacemakers
-
Implantable cardioverter-defibrillator (ICD)
- Preventing sudden death caused by high-risk ventricular arrhythmias
- Often in patients with cardiomyopathy or a history of ventricular fibrillation
-
Left Atrial Appendage Occlusion
- Reducing stroke risk in patients with atrial fibrillation who cannot take long-term anticoagulants
6. Hong Kong’s medical resources
- Cardiology departments in public hospitals : provide comprehensive diagnosis, medication, and surgical treatments at low cost but with long waiting times
- Private cardiology clinics : Fast examinations and advanced equipment, suitable for those who need to complete treatment in a short period of time
- Community Health Program : Some non-profit organizations provide electrocardiogram (ECG) screening and heart health education.
7. Regular monitoring and follow-up
- Regular electrocardiogram (ECG)
- Holter monitor for 24 hours or longer
- Blood tests (to monitor drug side effects and electrolytes)
- Echocardiography (to assess heart structure and function)
Editor's summary
Arrhythmia is not simply a matter of "heart speed" but a complex condition involving the heart's electrical conduction system. Hong Kong's fast-paced lifestyles, high stress levels, and a diet high in salt and caffeine, coupled with an aging population, are expected to increase the number of cases. Early detection, appropriate treatment, and lifestyle adjustments are crucial to reducing the risk of stroke and sudden death.
Disclaimer : This article is for reference only and does not constitute any medical advice. The source is referenced from major medical articles.
